For this month’s issue, we are excited to share our conversation with Dr. Michelle Morse, Acting Health Commissioner and Chief Medical Officer of the NYC Department of Health and Mental Hygiene—and a valued Rx Foundation Board member.

Dr. Morse recently co-authored an article in The Lancet, “Moving from Indifference to Reparative Action: A Public Health Approach to Racial Health Inequities in Life Expectancy in Cities in the USA,” which lays out a compelling case for why public health must take a reparative approach to racial inequities in life expectancy. The article highlights the stark reality: racial inequities in life expectancy persist not due to chance or genetics but because of structural decisions that have systematically marginalized Black and Indigenous communities.

Rx’s Strategic Communications Manager, Blessitt Bryant, sat down with Dr. Morse to discuss the article’s key themes: life expectancy inequities, economic justice in healthcare and public health, and the responsibility of philanthropy in advancing structural change and repair. Their discussion underscored the necessity of bold, sustained action to achieve health justice for all.

Rx: Your recent Lancet article details the stark inequities in life expectancy across racial and ethnic lines. Why is investing in racial equity in health outcomes not just a moral imperative but a strategic one for healthcare funders and industry leaders?

Dr. Michelle Morse:
“Race is socially constructed, and we see life expectancy gaps along racial lines everywhere in the U.S. That’s not due to genetics—it’s because of the structures we’ve built. These inequities exist because of our history of enslavement and settler colonialism and our choices as a society. That means we have the power to change them.”

Dr. Morse emphasized that philanthropy, which often stems from historical wealth accumulation , is responsible for repairing rather than simply funding.

Rx: One of the most striking points in your Lancet article is that racial inequities in life expectancy have been accepted as natural for generations. How can social justice leaders and healthcare experts disrupt that mindset?

Dr. Michelle Morse:
“Honestly, I used to believe that if we showed the data—if we made it clear that Black, Latinx, and Indigenous communities were disproportionately dying during COVID—that would be the wake-up call. But the urgency faded. We have to ask why.”

Dr. Morse’s words underscore the pressing need for immediate action in addressing health disparities. She pointed out that many still believe health inequities are due to individual behavior or individual failures rather than unjust history and systemic inequities.

“If people believe Black communities have lower life expectancy because of bad personal choices, they won’t see a reason to change the system. We have to reframe this conversation to make it clear that these inequities are designed—and what is designed can be redesigned.”

Dr. Morse’s words remind us that we can’t create urgency if we’re blaming the victim. Health inequities are designed—and what is designed can be redesigned. This reiteration of the urgency in addressing inequities is a call to action for all healthcare funders and industry leaders.

Rx: Your article discusses how eliminating the racial wealth gap through reparations could significantly close the life expectancy gap. What role should healthcare institutions and funders play in advocating for economic justice?

Dr. Michelle Morse:
“Public health has long acknowledged the link between socioeconomic status and health outcomes, but wealth is an even more powerful determinant. And healthcare institutions have largely avoided this conversation.”
She highlighted the Anchor Institution Model, where hospitals and health systems commit to hiring locally and contracting with minority-owned businesses, as one approach to advancing economic justice.

“Healthcare institutions are often the largest employers in their communities. They should use that power to invest in economic justice—not just as a side project, but as a core institutional strategy.”

Dr. Morse also challenged funders to push healthcare institutions beyond traditional lobbying for revenue protection for their institution and into advocating for policies like reparations and community wealth-building. She urges them to use their power to invest in economic justice, not as a side project, but as a core institutional strategy.

Rx: Your article makes it clear that we cannot address racial inequities in life expectancy without sustained investment. If you had one message for healthcare funders right now, what would it be?

“Be ready to act—quickly, boldly, and outside your usual portfolios. We are entering an era where public health will be tested beyond what we’ve seen before. If philanthropy sticks to business as usual, we will fail the communities that need us most.” -Dr. Michelle Morse

Dr. Morse’s Lancet article and this conversation reinforce a crucial truth: Health justice is not a theoretical concept—it’s a fight for the right to live.
Her insights remind us that racial inequities in life expectancy are not accidents—they result from structural policy decisions that can and must be changed. Philanthropy has a role to play, but it’s not just a role—it’s a responsibility. We must be willing to move beyond indifference and into reparative action.

We are deeply grateful for Dr. Morse’s leadership, her unwavering commitment to health equity, and the opportunity to share her voice with our community.