Three Lessons for Advancing Equity in Challenging Times 

We must preserve the progress those before us achieved and stand firm in our belief that health should not be a privilege for some, but a right for all.

We can all agree that every person, regardless of who they are, deserves access to compassionate healthcare that honors their humanity. Yet in just 100 days, the Trump administration has leveled an all-out assault on these core values, threatening the health and wellbeing of countless Americans. Through executive orders and other actions, they have eliminated health equity programs, fired thousands of federal health workers, pulled funding for research on the social determinants of health, and more.

While these attacks may feel historic, history makes clear that we are not the first generation to face such obstacles. We can and must learn from past struggles for health equity, such as the courageous movement known as Freedom Summer, which aimed to shatter racist, systemic barriers to wellbeing throughout the South.

In 1964, Black leaders and community members in the South, joined by hundreds of activists from the North, defied recalcitrant authorities by supporting and registering Black voters. Their work for justice spurred violent beatings and attacks from local officials and their deputized confederates of terror. Scores of brutally injured advocates sought medical attention, only for segregated hospitals to deny them care. Thankfully, a group of dedicated health professionals—the Medical Committee for Human Rights—risked their own safety to step in and treat injuries. This work inspired the first federally funded community health centers in 1965, which grew into a network with 16,000 clinics throughout the United States.

This chapter in America’s history offers powerful lessons about the inextricable link between health and racial equity. And it must strengthen our resolve to persevere in the face of ongoing hostility. At RWJF, we are standing firmly with our grantees and partners. And we are committed to rising to this moment. 

As we reflect on the first 100 days of the Trump administration and prepare for the next, three critical lessons are guiding us. These lessons reflect the wisdom of those who came before us and the courage of our grantees who are fighting today for a more just future. Ultimately, we know that achieving health and racial equity requires action across every sector—from funders to advocates to service providers to research institutions. All have a role to play in creating a country where health is not a privilege for some, but a right for all.

Lesson 1: Speak boldly about why equity benefits us all

In the face of relentless attacks on our core values, we must focus on why we do this work and who we do it for.

Pursuing racial equity is fundamentally good for everyone's health. When healthcare providers implement programs targeting disparities based on race, gender, or disability, they create solutions that benefit us all. For example, by implementing a race-conscious intervention in cancer care—including health equity training, tracking care quality by race, and using culturally competent nurse navigators—hospitals dramatically improved treatment completion and timeliness for all patients. 

One study found that timely lung cancer surgeries increased from 59 percent to 87 percent for Black patients and from 75 percent to 85 percent for white patients after implementing a health equity initiative.

You won’t hear this from those attacking health equity. Fortunately, some organizations are actively working to set the record straight about racial and health equity by showing that it isn’t a zero sum game. Health Equity Works, incubated in partnership with RWJF at The Opportunity Agenda, is advancing pro-health equity narratives through proactive communications and rapid response tactics. Through messaging research, guidance, training, and technical assistance, they are reshaping the conversation and building a larger coalition of supporters for health equity.

People across the health sector can tap into this resource to tell their own powerful stories about how equity benefits everyone and makes unfair systems more just.

Lesson 2: Remain steadfast in our commitment

The administration's attacks and willful disinformation campaign are a direct attempt to undermine the hard-won progress of past and current generations. Unfortunately, some organizations are pulling back out of fear of direct consequences. This is in spite of the fact that many time-tested and evaluated diversity, equity, and inclusion initiatives are lawful and critical to the health of all. Rolling back this crucial work does more harm than good. It signals others to retreat, it affirms false accusations that this work is unlawful and un-American, and it undermines decades of hard-fought progress toward equity.

Instead of preemptively pulling back on equity efforts, now is the time to stand firm. Organizations should consider carefully reviewing their strategies for compliance with the law and developing plans for responding to financial, legal, or media attacks. While this may feel daunting, resources are available to support organizations amid these executive orders and actions. For example, the Lawyers’ Committee for Civil Rights Under Law (LCCRUL) provides pro bono legal guidance and representation for nonprofits designing or operating racial equity initiatives.

This work is worth defending and continuing. It’s tied to the wellbeing of our communities and patients.

Lesson 3: Confront injustice with resolve

President Trump’s anti-equity executive orders run counter to the Constitution and the law. They infringe on free speech and include definitions of “illegal” diversity, equity, and inclusion that are vague and nearly impossible to follow. 

Accordingly, civil rights and pro-democracy advocates are taking the lead in challenging them in court. Four lawsuits are directly challenging these anti-equity orders, including a case by RWJF grantees Democracy Forward Foundation and Asian Americans Advancing Justice - AAJC on behalf of low-wage workers, university leaders, and local government.

In the short term, these legal challenges may lead to temporary relief from enforcement of the anti-equity executive orders. They also signal that nonprofits, cities, and everyday people will not idly stand by. Challenging executive branch actions in court is not easy, but it is necessary for protecting the health of communities. 

While going to court may not be an option for all, everyone can learn from the courage of these organizations. There are many ways for organizations, leaders, funders, and even providers to signal their support. From public statements to community organizing, to protest, and more—all of us must consider how best we can take a stand for what is right, even when the path is difficult. 

With so much at stake, we cannot afford to be silent at this moment and surrender decades of progress that so many courageous civil rights advocates fought for and won.

The actions we take now, together, will shape our future.

About the Author

Giridhar Mallya is a public health physician, health policy expert, and senior policy officer at RWJF. He acts as a strategist, advisor, and grantmaker at the nexus of health, race, and policy, and helps to lead work to identify new institution-wide policy priorities, build durable policy infrastructure at the state and federal levels, and advance racial equity through governing.