In 1966, speaking to the press about a Medical Committee for Human Rights meeting in Chicago, Dr. Martin Luther King Jr. condemned the segregation of state-funded hospitals, declaring, “Of all the forms of inequality, injustice in health is the most shocking and inhumane.”
King made this statement a full twelve years after the Supreme Court’s landmark Brown v. Board decision ruled segregated public schools unconstitutional. His words shone a spotlight on a devastating reality that some present-day political leaders attempt to erase. Structural racism had such a chokehold on Americans that even a decade after the nation’s highest court declared segregated public schools unconstitutional, government-funded hospitals continued to enforce segregation—even denying care to Black patients in need.
As was the case for many of us, the injustice King denounced wove itself through the tapestry of my own family’s history. A few years before his Chicago speech, my Granny Lee birthed my father in the segregated (now-shuttered) Sydenham Hospital in Harlem. Seven years after King’s speech, my father and his siblings were among the first students bussed out of their neighborhood in Memphis to a majority-White public school as the city finally integrated its public school system decades after the Supreme Court’s mandate.
King’s spotlight on racial health inequity wasn’t the first and wouldn’t be the last. But it illuminated the path I would later follow, becoming a physician, specializing in family medicine for its commitment to community health, publishing peer-reviewed research on the impact of residential segregation on health.
King’s perspective also shaped the lens through which I watched the Eaton Fire devastate major portions of the place I’d previously called home.
As flames blazed through the Los Angeles-area towns of Altadena and Pasadena at the start of 2025, I shivered beneath layers of fleece blankets on my in-laws’ couch just outside of Chicago, my hometown. The irony wasn’t lost on me. There I was, sitting in a region forever marked by the Great Chicago Fire, while watching live coverage of another historic fire upend Los Angeles County.
In those early days of the Eaton and Palisades Fires, the nightly news and social media coverage overflowed with gray smoke and red flames, and heat…so much heat. Meanwhile, I sheltered inside, safe from the Chicagoland snow, wrestling with anxiety and the icy discomfort of my own security.
From across the Los Angeles area, my friends’ texts rolled in detailing when they’d left, what they’d left, and, days later, whether there was anything left to claim. My Altadena friends survived but with invisible, likely indelible, scars. Reassuring messages from multiple family units all seemed to strike the same chord: “We’re safe, but we’re not okay.”
Within a week, the community responded valiantly. There was coverage. There were the calls to action. Afropunk and friends spearheaded a GoFundMe campaign to create and amplify the donation pages of Black survivors in Altadena and Pasadena. We rallied to restore survivors’ financial wellbeing both because of and despite our deep awareness that structural racism had already disproportionately affected these families before the fire and would continue to shape their recovery.
These facts are well-documented in peer-reviewed journals and white papers. For example, a new UCLA data brief demonstrates the role structural racism played in increasing Black Altadenans’ fire risk. Their 20% greater fire burden was a direct legacy of 1939 redlining policies, which concentrated Black residents in the few “high-risk” neighborhoods damaged by the fire.
A 2019 study by University of Colorado researchers reviewed FEMA grants in 1,621 counties from 2012-2015 and found that counties containing significant quantities of Black, Latino and Native American residents received less FEMA aid than counties containing majority White residents even when they sustained the same amount of damage.
To be clear, this racially inequitable distribution of federal funds is a form of structural racism that amplifies the wealth gap between Black and White communities. Accordingly, the Center for American Progress details in 2022 how natural disasters have historically resulted in wealth loss for Black and Latino survivors ($27,000 and $29,000, respectively) but wealth gain for White survivors ($126,000).
If past is prologue, Black survivors of the Eaton fires, like their predecessors, will be disproportionately burdened by structural racism at every level of recovery. Disproportionate recovery is particularly devastating to largely Black communities as it compounds the underlying pattern of health resource deprivation resulting from Jim Crow, redlining and other legacies of segregation.
According to decades of census-tract data, the higher a neighborhood’s Black population, the more deprivation it experiences in social determinants of health. Compared to less Black communities, significantly Black communities in the US are less likely to have access to nutritious food options, neighborhood-based healthcare and pharmacies.
Even the community sources of drinking water in Black communities are more likely to be polluted with forever chemicals (PFAS) and other waste compared to those in majority White communities. (See South Memphis’s response to Elon Musks’s new supercomputer and the inevitable loss of their famously clean water supply).
As documented by researchers studying African-American women who survived Hurricane Katrina, these many layers of health risks added to the major trauma that set Black survivors up for a disproportionate burden of PTSD (the risk of which may be enhanced by lifetime experiences of racism). Furthermore, the probability of immediate healthcare interruptions and long-term losses of neighborhood clinics would compound existing health disparities across conditions like asthma, COPD, autoimmune diseases, heart attack, stroke and even cancer outcomes.
Each setback that compounds neighborhood-level deprivation or further compromises individual financial resources drives forward the cycle of declining social determinants of health. The cycle wrenches open existing inequities in access to essential health resources and hijacks the biological vulnerabilities established by a lifetime of exposure to racism.
In that sense, the health opportunities for generations of individuals and entire communities rest on the health support they receive over the next few years. We can not afford to overlook our communities’ health and the many forms its resources take.
Especially in this anti-DEI age, we can’t count on outside sources to affirm our humanity and protect our health. In the same way we rallied financially, we can mine community resources for health and wellness support.
I’ve donated weekly office hours at my lifestyle medicine practice to support the community’s stress management and chronic disease management needs and am seeking other medical practices and wellness companies willing to extend health resources (free or discounted medical/therapy visits, after-hours or virtual medical/therapy visits, additional yoga/breathwork classes, etc.). Please amplify the following directories, and join if you are able to provide healthcare or wellness services to directly support the Altadena survivor community: Serve Altadena, ProBonoTherapyLA and Byte Wellness.
Following King’s sentiments and working together to directly support the health of Altadena’s historic community, we’ll ensure our beloved survivors are safe and much more than just “okay.”