Ecclesiastes 9:11 contains the familiar text, “the race is not to the swift” (NIV) (or to those who run fast), but in the case of Black Americans, the race to health began well ahead of us, particularly with slavery. Newly emancipated slaves were promised 40 acres and a mule to help establish generational wealth, but that promise was rescinded after President Lincoln’s assassination. Still running a race largely behind. Free, but poor. Free, but sick.

 

In 2025, we are still trying to win the race in eradicating health disparities. In this April 18, 2024 report published by The Commonwealth Fund, data was collected in the states and the performance of their healthcare systems to measure health outcomes, access to healthcare and quality of healthcare services delivered. Ethnic groups that were reviewed for health disparities include Black; white; Hispanic; American Indian and Alaska Native (AIAN); and Asian American, Native Hawaiian and Pacific Islander (AANHPI) populations. The report found that “racial and ethnic disparities are pervasive across all states” and “substantial health and healthcare disparities exist between white and Black, Hispanic, and American Indian, and Alaska Native (AIAN) communities in nearly all states.” From their findings, Massachusetts, Rhode Island and Connecticut had “relatively high performance for all racial and ethnic groups,” and yet these states have “considerable disparities in access to care, the quality of care people receive, and health outcomes.” Furthermore, the report stated, “Health care systems in certain states, including Oklahoma, West Virginia, and Mississippi, perform poorly for all groups.”

 

How is this still happening in 2025? How does a high-income country such as the United States still fall short in how it delivers healthcare to the underserved? Why do health disparities still exist—and persist? Of the numerous articles and reports written and conferences and seminars held on the issue, and the good number of healthcare professionals (like many of you—thank you!) providing quality care to underserved communities, the disparities seem intractable. Knowledge and doing better has carried us a great distance in this race to address health disparities; yet, the victory line seems nowhere in sight.

 

In writing this, I sense that our sincere lament—our sincere sorrow, prayer and fasting—is what is desired of the Lord first and foremost in addressing this issue. In all of mankind’s intellect, education, training, reasoning and can-do spirit, we are unable to completely eradicate problems. It is in our nature to seek answers and to solve problems. We seek to fix and make sense out of. We desire to bring justice to unjust situations. We desire to bring relief to those ailed. This is all very good. However, we can’t change the story until we “loose the chains of injustice” (Isaiah 58:6, NIV) first spiritually, on our knees.

 

Per the report, some factors contributing to health disparities are higher poverty rates, elevated pollution levels with fewer green spaces, a lack of affordable, quality healthcare options making it difficult to receive timely treatment—barriers that disproportionately impact people of color. Per the report, “Black, Hispanic, and American Indian and American Native people are also less likely than other groups to have health insurance, more likely to delay care because of costs, and more likely to incur medical debt.”

 

God demands justice for the oppressed and engages His followers to be vessels that address injustice, to do justice or maintain what is right. It is our assignment to bring things into alignment with God’s kingdom.

We should not base our success on what we ourselves can accomplish. As God calls us to be change agents where He sends and places us, we know it is by His equipping that we will supernaturally transform those places and situations. First, we must understand the root causes of the situations we seek to transform, and that will require time, humility, prayer and fasting to break those strongholds and seemingly intractable issues. As told to us in Isaiah 58:6-7, “Is not this the kind of fasting I have chosen: to loose the chains of injustice and untie the cords of the yoke, to set the oppressed free and break every yoke? Is it not to share your food with the hungry and to provide the poor wanderer with shelter—when you see the naked, to clothe them, and not to turn away from your own flesh and blood?” (NIV).

 

We see the example of the impact of prayer and fasting with Nehemiah who “mourned, fasted and prayed before the God of heaven” (Nehemiah 1:4b, NIV) in learning of Jerusalem’s walls destroyed. While not directly impacted—he wept and cared about his people and the situation for many days as if the situation was his own. Nehemiah asked God for help in which he was given great help and favor from the Lord, which resulted in Jerusalem’s walls and gates being rebuilt in 52 days (amid great opposition)—a work that was otherwise estimated to take 10 years without God’s favor.

 

Although much of our advocacy efforts to protect the vulnerable (ex: protecting preborn babies from abortion and protecting the lives and health of their mothers; protecting those vulnerable to assisted suicide; protecting minors struggling with gender confusion from gender transition procedures and harmful treatments; and protecting the conscience freedoms of healthcare professionals) involves legislative advocacy and supporting policies that advance justice, there are issues that go beyond legislative advocacy. Such issues include ensuring healthcare access to all and, in doing so, working to eradicate health disparities as vessels of justice and showing God’s love to all people. This is a great expression of love and facilitates the healthcare professional’s calling to heal the sick.

 

What do we still need to uproot in our healthcare system, in society, in hearts and minds that is preventing the full delivery of equitable healthcare to be rendered to all? What improvements in patient education are needed to improve nutrition, lifestyle changes, stress management and physical activity so more of the underserved communities can begin getting a leg up in the race they were placed in well behind? What additional advocacy efforts are needed?

 

There is still much work to do. Some of these answers to treating health disparities will come first by us praying and fasting.

 

To learn more about how you can get involved in CMDA Advocacy efforts, please email [email protected].