Dear Closing the Health Gap Community:

This month’s passage of President Trump’s tax bill by the U.S. House of Representatives is a devastating blow to millions of Americans, particularly those in underserved communities. The cuts to Medicaid and safety net programs will strip health care access from countless individuals and families who already face overwhelming disparities.

The National Medical Association put it clearly: “This is a devastating blow that will lock many people out of much needed medical assistance...and put a strain on our already stressed health care workforce.” We at the Center for Closing the Health Gap stand with the NMA in their unwavering commitment to equity and access.

This fight isn’t over. We will continue to advocate for health care as a human right. We call on our partners, providers and community members to raise their voices and demand better, for all of us.

Blessings to all of you for a safe and healthy week ahead. We Must Save Us.

Renee Mahaffey Harris

President & CEO

NMA Statement on Passage of Tax Bill

Statement attributable to:

Virginia A. Caine, MD

125th President, National Medical Association

With the U.S. House of Representatives passage of President Donald Trump’s new tax bill today, millions of Americans will lose health care coverage due to the cuts to Medicaid and find that other safety net programs are no longer available to them. 

As physicians, we see health care inequity every day in our country, and this is a devastating blow that will lock many people out of much needed medical assistance. The bill will also negatively impact the quality of the care that patients receive and put a strain on our already stressed health care workforce. 

The National Medical Association (NMA) has consistently worked to increase health care access and address disparities. We believe that every individual and every family in this nation deserves access to quality health care and that this bill will harm our communities for many years to come.  

We also know that this fight isn’t over. The NMA will continue to advocate for access to quality health care for all, and we encourage our members and healthcare colleagues to join us in this effort.

About the National Medical Association

The NMA is the nation's oldest and largest organization representing Black physicians and health professionals in the U.S. and promotes the collective interests of physicians and patients of African descent. We serve as the voice of Black physicians and a leading voice for parity in medicine, the elimination of health disparities, and the promotion of optimal health. To learn more about the NMA, please visit https://www.nmanet.org.

Organizing for Racial Justice in Medicine and Medical Education: An Ethnographic Study of Medical Trainee Experiences

This article investigates the experiences of medical trainee participants in movements for racial justice in medicine and the implications of these experiences in the context of growing attacks on programs and practices for equity in medical education. This study involved ethnographic participant observation - especially what some refer to as observant participation - and ethnographic interviews with a majority of the individuals organizing two movements of medical trainees confronting medical, institutional and structural racism. Interviews and ethnography focused on medical trainee experiences in these two movements as they took shape in the San Francisco Bay Area, though the research also included participants, interviews and questions to give national context. Data were analyzed via grounded theory with ethnographic and interview data coded first and then organized into categories by the authors. White Coats for Black Lives began in 2014 in response to multiple police killings to confront police and carceral violence against Black people and other people of color, as well as to demand changes in medical education itself. Several years later, medical trainees organized against the use of “race-correction factors” in clinical labs, considering the problematic evidence supporting such correction factors and the health and health care disparities they cause. In light of the data, we argue that medical trainees who experienced discrimination and inequality affecting themselves, their families or their communities bring critical expertise, insights and analyses to medical education related to social justice and health equity.

Racial Inequity and Structural Barriers to COVID-19 Services

Structural racism is a fundamental cause of racial inequities in health care infrastructure and services, laying the groundwork for the disparate impact of COVID-19 disease among Black and Latino populations in the US. In 2020, the US government changed several federal programs and policies and created new federally funded programs to bolster the country’s public health response to the COVID-19 pandemic. For example, the US government enacted Medicaid continuous coverage provisions and a program to administer the government-purchased inventory of vaccines. One of the goals of implementing these social supports was to address underlying structural barriers to equitable COVID-19 outcomes.

In a cross-sectional study, Bromley-Dulfano et al examined these underlying structural barriers to COVID-19 outcomes using electronic health record data from 530 clinical sites within a large academic health system in New England. The authors investigated racial differences in outpatient oral antiviral prescribing rates within 7 days of the first positive test for COVID-19 infection between January 2022 and January 2024.

A New Framework for Reducing Healthcare Disparities

Despite decades of efforts to address healthcare inequities in the United States through programs and policies targeting social determinants of health, disparities persist across racial, gender, socioeconomic, and geographic lines. Systematic reviews of hospital systems’ initiatives and programs to address social determinants of health (SDOH) have revealed unsatisfactory progress. Some attribute the slow progress to insufficient standardization and sharing of learnings across communities, or the underinvestment in SDOH data and measurement.

We posit that the core problem may be an overreliance on importing solutions from other communities and healthcare settings without adequately accounting for the specific needs and realities of local patient populations. Health inequities are rooted in the unique social, structural, and cultural fabric of each community, and context-blind interventions risk wasting resources, eroding trust, and perpetuating the very inequities they aim to fix.