Freedom Day Didn't Free Our Health

On June 19, 1865, enslaved people in Galveston, Texas heard the news. The Civil War was over. The Confederacy had fallen. And by order of the United States government, they were free.

That moment became Juneteenth. Freedom Day. And it deserves every celebration we give it. The cookouts, the music, the red KoolAid, the gathering of families who once were not allowed to gather. The joy of that day is real, and it is right and it is ours.

But we also have to tell the whole truth. Because the whole truth is what sets us free—and right now, some of us are still waiting on that freedom.

Freedom from slavery did not mean freedom from suffering. It did not mean freedom from a medical system that had spent centuries deciding whose bodies mattered and whose did not. The same country that held Black people in bondage for more than 250 years did not suddenly, in 1865, decide that Black lives were worth protecting. The laws changed. The system—the deep architecture of who gets care, who gets believed, who gets to live long—did not.

And we are still living inside that architecture today.

In 2026, Black Americans live an average of 5.5 fewer years than white Americans. Read that again slowly. Five and a half years. That is not a rounding error. That is not a statistical footnote. That is five and a half birthdays a child might not see their parent reach. Five and a half years of grandchildren, of autumn mornings, of your favorite pastimes, of watching someone you love grow old. Five and a half years that data says our community loses—not because of anything we did wrong, not because of choices we made, but because of the country we were born into and the system that has governed our care since before any of us drew our first breath.

Black women die in childbirth at two to four times the rate of white women. And this is not a problem that money or education fixes. Serena Williams—one of the most celebrated athletes in human history, a woman with resources most of us will never have—had to fight to get her own doctors to take her seriously after giving birth. She had to advocate loudly for herself while recovering from major surgery. She survived because she knew enough to push back. Women who do not have her platform, her resources, or her voice are not always so lucky. They are dying in hospitals and birth centers across this country, and most of their names never make the news.

Only 4.7% of physicians in the United States are Black. In a country where Black Americans make up more than 13% of the population, that means that when most of us walk into a doctor’s office, nobody in the room looks like us. Nobody in the room grew up in a community like ours, carries the same history in their body, or fully understands what it means to navigate this healthcare system as a Black person in America. That gap has consequences—for trust, for communication, for whether we feel safe being honest about what is going on with our health.

This is not about blame. The doctors who serve our communities, of every background, are often doing the best they can within a system that was not designed with us in mind. But we have to be honest about the design. You cannot fix something you refuse to look at clearly.

Here is what this history actually looked like in practice. During slavery, Black bodies were used as medical subjects without consent. Physicians built careers and reputations on experiments performed on enslaved people who had no power to refuse. After emancipation, Black Americans were systematically excluded from hospitals, medical schools, and the research that shaped what we now call modern medicine. The Tuskegee Syphilis Study—where Black men with syphilis were deliberately left untreated for forty years so researchers could observe the disease progress—did not end until 1972. Nineteen seventy-two. That is within the lifetime of people who are alive right now. People who are grandparents. People who are sitting in church pews and at family dinner tables and who carry that knowledge in their bodies when they decide whether or not to trust a doctor.

This is the inheritance. Not just cultural, not just emotional but biological, institutional, and structural.

Juneteenth is a health equity milestone because it marks the moment we were told we were free and the moment the real work of freedom began. Not just the freedom to move, to vote, to build. Health freedom. The freedom to live long, full, dignified lives without fighting the system every step of the way. The freedom to walk into a clinic and be believed. The freedom to give birth and come home. The freedom to grow old.

That freedom is not fully here yet.

But we are not starting from nothing. There are researchers, physicians, advocates, and organizations who have been working toward health freedom for decades—who study our specific needs, who train the next generation of Black doctors, who push policy in the direction of our lives. NIAAH is one of them. And this month, we are connecting the dots between that history and this moment. Because you cannot build health freedom without understanding why it was taken. And you cannot take it back without knowing who is already in the fight.

Freedom Day happened. The news eventually arrived. Now we keep going.

Look ahead: What history left inside our bodies—and why it is not your fault.