Black Leaders Describe What America Needs for a Better Future

These Black visionaries are keeping hope alive and building a future the next generation deserves.

A shared belief in freedom and justice for all runs as a powerful undercurrent throughout this country, uniting us as Americans. But as flags and banners decked out in red, white, and blue go up around the country ahead of America’s 250th anniversary many of us feel conflicted. These ideals seem out of reach right now as we face the most intense authoritarian takeover most of us have witnessed in our lifetimes. 

During this time of unrest, I’ve been returning to a quote from legendary American writer and civil rights activist James Baldwin who said, “I love America more than any other country in the world and, exactly for this reason, I insist on the right to criticize her perpetually.” I interpret “criticize” to mean fighting for the vision of America we deserve until we have it, one where health is not a privilege, but a right for all. Everyone shares the same basic needs: the dignity of living in peace and safety, with the reassurance that their government is honoring the standard of democracy required to make that happen. 

To better understand how we can collectively pave the way to this future, I sat down to talk with several incredible Black leaders. They provided insight into historic struggles for health equity and shared how we can collectively build a prosperous future of health, justice, and belonging.  

The healthcare workforce must reflect the communities it serves.  

Joel Bervell, a doctor and health advocate known as the “Medical Mythbuster,” has been confronting a troubling American reality: hospitals, clinics and doctor’s offices don’t yet represent the people they serve. 

Dr. Bervell was one of only two Black medical students in his class. His experience reflects the data – only about 6% of physicians in the United States are Black, even though about 14% of America self-identifies as Black. He explained how having a provider who looks like you and understands your experiences lowers stress and increases trust in the medical system. It also makes it more likely that you’ll follow medical advice. 

A clear solution to increasing diversity in healthcare professions is to invest in institutions that have a strong, long-standing legacy of training diverse healthcare professionals. RWJF supports Historically Black Colleges and Universities that are building the next generation of healthcare leaders. While these schools represent a small share of the nation’s medical schools, they produce a disproportionately high number of Black physicians who often go on to work in medically underserved communities.

Dr. Bervell also described how medical students, researchers, and physicians are successfully challenging outdated practices that embed race into medical decisionmaking—such as removing race-based calculations from formulas that test for kidney function. Their efforts are proof that people can transform flawed systems into new ones that truly serve everyone.

To maintain this momentum, we must protect and expand pathways into healthcare careers. We discussed how the administration’s student loan caps will make graduate nursing education unaffordable for many aspiring nurses. That combined with the new $100,000 H-1B visa fee, which is being challenged in the courts, makes it harder for hospitals and healthcare systems to recruit physicians, nurses, and other healthcare professionals. These measures threaten to deepen our healthcare workforce shortages, leading to longer wait times, delayed treatment, and reduced access to care for everyone.

Dr. Bervell is showing us that it’s possible and powerful to challenge broken systems and build better ones. 

The healthcare system must recognize that midwives save lives

Dr. Uche Blackstock is a physician, author, and advocate for equity in healthcare. She has spoken candidly about racism she’s faced in medical settings as a Black woman and witnessed as a provider. These inequities are especially severe in maternal health.

The United States is one of only seven countries to see a significant increase in childbirth-related deaths since 2000. As of last year, pregnancy-related mortality rates were three times higher for Black women than for White women. 

Dr. Blackstock says that our healthcare system must recognize how lifesaving midwifery can be during pregnancy and childbirth. Midwives and doulas can catch issues earlier and advocate for the mother during birth. Data confirm this model of care reduces complications and deaths during pregnancy and delivery. 

“We don't need to reinvent the wheel,” Dr. Blackstock said. “The community has solutions, we just have to find ways to really uplift and support their work.”

I am a mom of three, and I had the support of both a doula and a midwife during my pregnancies. The experts trained by Mamatoto Village made sure I had a trauma-free, healthy birth that was vulnerable and joyful.

Only about 15% of births right now have access to midwifery care in our country. Expanding access would help families feel supported and protected in the way that our government promises but does not yet deliver. 

The urgency of this moment demands “staying loud” 

An energizing, empowering conversation with Reverend Shavon Arline-Bradley, the president and chief executive officer for National Council of Negro Women, added fuel to my fire to keep pushing in the fight for our democracy. 

One of my favorite parts of this conversation was about the importance of sustained hope in action. Threats to our rights and democracy can feel overwhelming. But Rev. Arline-Bradley took us back to the Civil Rights era, recalling how people of all races and religions came together to advance laws that advanced our rights and made our democracy better for all of us. “People power will always outlive this process,” she said, warning that “when we accept what they allow, then we are complicit.”

“I may not see the work that we do reverse what is happening now,” Rev. Arline-Bradley said. “But I'm going to do everything I can while I have breath to fight on the front lines, particularly for healthcare.”

Her call to action is exactly what we all need to hear on the 250th anniversary of the United States. We must commit to taking an active part in shaping our future and raising our voices for the collective good.

Our country may be far from reaching its ideals, but the fact that in every generation people have stood up for themselves and their neighbors to demand justice and freedom for all shows me that there is plenty to make us proud. And these inspiring leaders are offering plenty of reasons to stay hopeful despite the challenges we face. However you celebrate this 250th anniversary, know that the power of all our voices combined will create the future we imagine.

About the Author

Avenel Joseph is vice president, Policy, at the Robert Wood Johnson Foundation. She brings a wealth of government, management, and political expertise to leading the Foundation’s programming.