OP-ED: Equity in Health Care Is Not Optional—It Is Essential for the Black Community
By Jonathan L Dotson. Executive Director at Friendship That Gives
In the United States—one of the wealthiest nations in the world—your health outcomes should not be determined by your zip code, your income, or the color of your skin. Yet for millions of Black Americans, that is still the reality. Health care equity is not simply a policy issue; it is a moral imperative, a public health necessity, and a matter of life and death.
Health disparities in the Black community are well documented and deeply rooted in structural inequities. According to the Pew Research Center, Black Americans continue to experience higher mortality rates from conditions such as cancer and maternal health complications compared to their White counterparts. These disparities are not due to biological differences, but rather to unequal access to quality care, environmental factors, and systemic barriers embedded within the health care system.
Access remains one of the most significant challenges. More than six in ten Black adults say that limited access to high-quality medical care is a major reason for poorer health outcomes. This is not surprising when we consider that many Black communities have fewer hospitals, fewer primary care physicians, and limited access to specialty care. These gaps mean delayed diagnoses, fewer preventative services, and ultimately worse outcomes.
The consequences of inequity are measurable and devastating. Life expectancy among Black Americans has historically lagged behind that of other racial groups. In recent years, it has fallen to approximately 71.8 years—lower than other populations and a stark indicator of systemic failure. This gap reflects more than health care access; it reflects the cumulative impact of social determinants such as housing, education, employment, and environmental conditions.
Chronic stress also plays a critical role. Emerging research shows that long-term exposure to discrimination and economic hardship contributes significantly to poorer health outcomes, accounting for nearly half of the mortality gap between Black and White Americans. This phenomenon, often referred to as “weathering,” illustrates how systemic inequities literally wear down the body over time.
Even within the health care system itself, inequities persist. A majority of Black Americans report experiencing at least one negative interaction with a health care provider, including feeling unheard or needing to advocate strongly to receive appropriate care. Additionally, Black physicians remain underrepresented—making up only about 5% of doctors in the United States, despite Black Americans representing roughly 14% of the population. This lack of representation can impact trust, communication, and overall quality of care.
Equity in health care means more than equal treatment—it requires intentional, targeted solutions that address these disparities at their root. It means investing in underserved communities, expanding access to preventative care, and increasing diversity within the medical workforce. It also means addressing the social determinants of health—ensuring that individuals have access to safe housing, nutritious food, clean environments, and economic opportunity.
Community-based initiatives are also critical. Organizations working directly within Black communities—providing education, advocacy, and resources—play a vital role in bridging gaps that traditional systems have failed to close. These efforts must be supported, scaled, and sustained.
Policy change is equally essential. Expanding Medicaid, funding community health centers, and implementing accountability measures for health systems can help ensure that equity is not just an aspiration, but a reality. Health care systems must also adopt culturally competent practices and prioritize patient-centered care that respects the lived experiences of Black patients.
Ultimately, health care equity is about justice. It is about recognizing that every individual deserves the opportunity to live a healthy, full life. When Black communities thrive, the entire nation benefits—from stronger economies to healthier populations.
The question is no longer whether disparities exist—the data is clear. The question is whether we have the collective will to address them. Equity in health care is not optional. It is essential.
