Achieving health equity has been one of my life’s passions since I fought for civil rights alongside giants like Harry Edwards, who taught me that top-down fixes fail marginalized communities. Lasting change happens when those facing injustice shape solutions based on lived experience.
As debates bubble on public health policies, we must ask whether proposed reforms actually empower Black Americans – or impose supposed benefits without input from those impacted. Too often, those closest to the pain lack power in health policy conversations. Yet ethical, durable progress comes when affected populations play an integral role tailoring remedies to meet their needs.
We see this in America’s ongoing struggle for equality. True empowerment soars higher when rising from grassroots advocates – those who viscerally grasp realities that elites miss. That’s why I listen closely when today’s activists discuss innovations that could save Black lives by reducing smoking-related illnesses.
Health data reveals a painful legacy of deception towards Black Americans. The decades-long failure to curb cigarette addiction has fueled health inequities experienced by Black communities, where smoking disproportionately cuts lives short. But marginalized groups now suffer a new injustice: government agencies banning tobacco alternatives that empower harm reduction.
Science shows switching to e-cigarettes provides the single most effective path for Black smokers to reduce smoking. Yet, the U.S. Food and Drug Administration (FDA) and Center for Tobacco Products (CTP) continues approving traditional cigarettes while denying Black citizens access to vaping products offering a lifeline from addiction. This contradicts the mission of Biden’s Cancer Moonshot to halve U.S cancer deaths by 2050, and the administration’s own stated health equity goals.
Banning harm-reduction options is nonsensical when the goal is curbing disease for at-risk groups. Imagine if officials barred access to HIV medications or sterile needles, worsening epidemics among marginalized populations. When politics or profiteering halt innovations that alleviate suffering, reform has lost its moral compass.
Last year, Earl Fowlkes, the Democratic National Committee caucus chair for Black and LGBTQ+ issues and the head of the Center for Black Equity, commissioned research confirming that switching to less harmful nicotine alternatives can provide effective smoking cessation benefits for marginalized groups facing tobacco-related illness. This would align with the Biden Cancer Moonshot’s goal of expanding all options to cut preventable deaths.
Despite this, regulatory agencies continue enabling traditional smoking through certain approvals, while simultaneously restricting access to emerging innovations showing potential for harm reduction. If the aim is curbing cancer and empowering change, might we achieve more by doubling efforts to support communities disproportionately impacted – rather than limiting viable alternatives? It is a question deserving earnest response from the FDA regarding the ethical application of science for the public good.
Lasting change occurs only when impacted communities command solutions reflecting lived realities – not symbolic gestures that entrench power imbalances. The key is enabling the marginalized to transform their own health outcomes, not political point-scoring that perpetuates inequity.
I pray this conversation opens seats at decision-making tables for real grassroots leaders solving big challenges – where establishment gatekeepers transition to allies taking cues from those closest to America’s deepest pains and boldest hopes. For equality depends on unraveling hierarchy so all might thrive.
The key is opening pathways for real-world expertise to transform communities, not imposing solutions from afar. Few grasp the complex drivers of addiction and disparity like those living it while being denied tools for change. Agencies must engage marginalized populations to develop harm reduction policies meeting their needs and values.
That is the Olympic-level goal we strive for: where those facing the greatest injustices can access innovations enabling them to thrive. Equality depends not just on medals and slogans, but on society lifting up and listening to the excluded until health justice reaches all: May that be the dream we renew.
If the FDA and CTP expect the Black community to take seriously their stated commitments to health equity – as more than continued deception by the U.S. public health establishment, the memory of which is all too familiar to Black Americans – they must approve e-cigarettes and other less harmful, non-tobacco nicotine products. Now.
It’s my hope that FDA and CTP will follow the indisputable science, support these alternatives, and, most importantly, save Black lives.
