The history of healthcare in the United States reveals how marginalized communities have been systematically denied boththe right to be cared for and the right to provide care—a basic human function that reflectsautonomy, dignity, and solidarity. This denial manifests in various ways, from the suppression of Indigenous healing traditions tothe forced sterilization of women of color, from the criminalization of Black midwives to the incarceration and disenfranchisement ofimmigrant caregivers.
In every case, the right to care for others has been selectively granted, weaponized tocontrol bodies, maintain racial hierarchies, and reinforce social and economic power structures. These denials ofcare are deeply intersectional, as race, gender, class, disability, and immigration status have all intersected to determinewho has the right to give and receive care.
This essay explores how U.S. healthcare policies haverestricted the right to provide care across various communities, examining the intersections of race, gender, class,disability, sexual orientation, and immigration status.
By framing care as a fundamental right, it becomes clear that thehistorical and ongoing denial of the right to care not only perpetuates inequality but also fractures the social andfamilial bonds that define our humanity.
1. Colonial Medicine: The Right of Indigenous Healers to ProvideCare
In pre-colonial America, Indigenous healers were vital to the health and well-being of theircommunities, offering holistic care rooted in land-based knowledge, spirituality, and community interdependence. Europeancolonization sought to systematically dismantle these practices by outlawing Indigenous medicine and persecuting healers.Indigenous women, often the primary caregivers and spiritual leaders in their communities, were labeled as witchesor “primitive,” their knowledge dismissed or actively suppressed.
The denial of Indigenous peoples' right to provide care was notonly about undermining their medical systems but also about disrupting the social fabric of their communities. The erasure ofIndigenous healing practices was tied to broader efforts to erase their cultures and connections to land, an attempt to fracturetheir resistance to colonization. The colonizers imposed European medical practices, further embedding their control over Indigenousbodies and asserting the dominance of white, Christian values.
The right to care for one’s community andfamily was systematically stripped from Indigenous healers, with long-lasting consequences for their descendants, as many Indigenouscommunities still face severe healthcare disparities today. This legacy of erasure continues to intersect with environmentaldegradation and legal battles over land rights, as the struggle for the right to care for the land is intertwinedwith the fight for bodily autonomy and health sovereignty.
2. Slavery: The Right to Reproductive and CommunityCare
Enslaved Africans were denied basic human rights, including the right to care for their ownbodies and the right to provide care to others, particularly in matters of reproduction. Enslavedwomen, in particular, were forced into reproductive labor, their bodies commodified for their ability to produce morelaborers. Black midwives and healers, who often provided care within the enslaved community, were systematicallyexcluded from the broader medical establishment and treated as expendable tools of plantation economies.
The violent denial ofreproductive autonomy through forced breeding, medical experimentation, and coerced sterilization underscores how the rightto provide care was not just limited but weaponized. Figures like J. Marion Sims, who experimented onenslaved women without anesthesia, reflect how Black women’s pain was ignored and their bodies violated for the advancement ofwhite medical science. The ongoing medical exploitation of Black women highlights the intersection of race, gender, and class, whereBlack women’s reproductive care was controlled by a state and society that valued their labor but not their humanity.
While enslaved women often acted as caregivers and healers within their communities, they did so under duress, as their capacityto care for their children was constantly under threat. Children born into slavery were seen as the property of their enslavers,often sold away from their mothers, severing the most fundamental caregiving bond of all. The denial of the right to providefamilial care is one of the most violent forms of exploitation, leaving legacies of trauma that persist through generationsof Black families.
3. Post-Civil War and Jim Crow: The Exclusion of Black Physicians and Midwives
After the Civil War, Black physicians, midwives, and healers faced systemic exclusion from the medicalprofession, even as Black communities attempted to reclaim autonomy over their healthcare. The Flexner Report of1910, which led to the closure of most Black medical schools, significantly restricted the ability of Black Americans toprovide care within their communities. The exclusion of Black healthcare professionals was compounded by Jim Crow segregation laws,which limited access to resources, professional networks, and medical training.
Black midwives, who hadprovided reproductive and childbirth care during slavery and Reconstruction, were increasingly marginalized by the formalization ofmedical licensing, which favored white male doctors. This legal and professional exclusion was particularly devastating for Blackwomen, whose access to culturally competent care diminished as white doctors took over obstetric care. The right to providecare was denied not only by racial segregation but also by the institutionalization of medicine, which devalued traditionalcaregiving roles, particularly those held by Black women.
This period also saw the rise of medical apartheid,as Black communities were forced to rely on underfunded, segregated hospitals that offered substandard care. The exclusion of Blackmedical professionals reinforced healthcare inequities, deepening racial disparities in maternal and infant mortality rates, anddenying Black communities the ability to care for themselves on their own terms.
4. Eugenics and Forced Sterilization:The Denial of Reproductive Care for Women of Color and Disabled Women
The eugenics movement, which spanned from theearly 20th century into the 1970s, was rooted in white supremacy, ableism, and classism. Women of color, disabled women, poorwomen, and immigrant women were disproportionately targeted for forced sterilization, particularly under the guise of publichealth initiatives aimed at improving the genetic “fitness” of the population. These women were denied the rightto reproductive autonomy and the right to provide care for their own children, as the state intervened tocontrol their reproductive lives.
In many cases, sterilizations were performed without consent, often during routine medicalprocedures such as cesarean sections, or as a condition for receiving welfare benefits. Latina women in California,Black women in the South, Indigenous women across the country, and disabled womenin institutions were all targeted by these policies, which sought to limit the reproduction of those deemed “unfit” bythe state. This intersection of race, gender, disability, and class underscores how the right to provide familialcare was systematically denied to those considered socially and economically expendable.
This legacy of forcedsterilization has had long-lasting effects, particularly in communities of color, where mistrust of the healthcare system persists.The violation of reproductive rights is a fundamental breach of the right to care for one’s family, reflectingthe state’s ongoing control over the bodies and lives of marginalized women.
5. LGBTQ+ Communities and the AIDSCrisis: The Right to Care for One Another
The AIDS crisis of the 1980s and 1990s exposed the deadlyconsequences of government neglect and homophobia. As the virus ravaged LGBTQ+ communities, particularly gay men,the federal government, under the Reagan administration, refused to acknowledge or respond to the crisis. Hospitals turned away AIDSpatients, leaving many to die without adequate medical care. The state’s refusal to provide care to those most affected by AIDSis one of the most egregious examples of how healthcare systems fail marginalized groups, particularly when race and sexualorientation intersect.
In response, LGBTQ+ activists, many of them living with HIV/AIDS, formed grassrootscaregiving networks to provide medical, emotional, and financial support to those abandoned by the healthcare system. ACTUP (AIDS Coalition to Unleash Power) and similar organizations demanded access to life-saving medications and raised publicawareness about the government’s indifference. The caregivers within these communities, often unpaid and underresourced, tookon immense personal risk to provide care for their friends, partners, and families.
The denial of healthcare for LGBTQ+communities intersected with race and class, as Black and Latino gay men were disproportionately affected by thevirus but had even less access to care. The right to care for one’s community was denied by institutionalhomophobia and systemic neglect, but LGBTQ+ caregivers reclaimed this right through mutual aid and activism, creating new models ofcare that centered solidarity and survival.
6. Immigrant Communities: The Right to Care for One’s Family AcrossBorders
For undocumented immigrants and migrant workers, the right to provide care
for their families has been systematically restricted by immigration policies and healthcare exclusions. Many undocumentedimmigrants, who work in dangerous and exploitative industries such as agriculture and domestic labor, are denied access tohealthcare, leaving them unable to care for themselves or their families. The criminalization of undocumented status further stripsimmigrants of the right to provide care for their children, as family separations, detentions, and deportations tearfamilies apart.
Immigrant women, particularly those working as domestic caregivers, often provide care towealthy American families while being denied the ability to care for their own children, who may live in their home countries or beleft vulnerable in the U.S. due to immigration enforcement. The intersection of race, class, and immigration status exacerbates thebarriers to care, as undocumented immigrants are often excluded from public healthcare programs like Medicaid, making healthcareunaffordable and inaccessible.
The denial of the right to provide care for one’s family is a profoundviolation of human rights, leaving immigrant parents in the agonizing position of being unable to protect their children’shealth or well-being. Immigration enforcement policies such as family separations at the U.S.-Mexico border have furtherinstitutionalized this denial, ripping families apart and denying both parents and children the fundamental right to familial careand support. The emotional and psychological trauma of these separations, compounded by inadequate healthcare in detention centers,reflects how the intersection of immigration status, race, and economic marginalization denies entire communities the ability to carefor one another.
7. Incarceration: The Right to Provide Care in Prisons
The U.S. has the highestincarceration rate in the world, and incarcerated individuals, disproportionately Black, Latino, andpoor, are systematically denied the right to provide care—for themselves, their families, and theircommunities. Prisoners often face substandard or outright neglectful healthcare, and their ability to provide care to others, even insmall ways, is restricted by prison rules that isolate and dehumanize.
Incarcerated parents are oftenseparated from their children for decades, depriving them of the ability to offer emotional, physical, or financial support. Theright to provide parental care is systematically undermined by a system designed to punish rather than rehabilitate.Incarceration severs family bonds, leaving children of incarcerated parents more likely to experience economic hardship, trauma, andhealth issues, perpetuating cycles of poverty and inequality.
Within the prison system, individuals who have healthcaretraining or caregiving experience, such as former nurses or caregivers, are often restricted from offering support to fellow inmates.Prisons rarely allow inmates to organize healthcare or caregiving networks, and those who attempt to care for others, whether byproviding informal mental health support or assisting the elderly or sick, are often punished for violating prison rules. Theright to provide care within prison walls is treated as an affront to the punitive logic of incarceration, furtherisolating prisoners and reinforcing a system of medical neglect.
8. Environmental Racism: The Right to ProvideEnvironmental Care
The Flint Water Crisis is one of the most glaring examples of environmentalracism, where predominantly Black, low-income families were denied the right to provide environmentalcare for their children and communities. When government officials switched Flint’s water source to the polluted FlintRiver in 2014, thousands of residents were exposed to toxic levels of lead, causing a public health disaster with long-termconsequences for the city’s children.
Parents, particularly mothers, were robbed of their ability to protect theirchildren from harm as they were forced to rely on poisoned water for drinking, cooking, and bathing. The state’s failure toprovide safe water—and its subsequent cover-up—denied families the most basic resources needed to care for their health.Residents of Flint were left to navigate a healthcare system that was ill-equipped to address the effects of lead poisoning, furtherexacerbating the health disparities that already existed in their community.
The right to provide care isinseparable from the right to live in a safe and healthy environment. Environmental justice, particularly in low-income andcommunities of color, is deeply tied to healthcare equity. Flint residents, many of whom were already struggling with poverty andlimited access to healthcare, were left to deal with the financial and emotional costs of lead poisoning, while the state absolveditself of responsibility. The denial of clean water, compounded by a lack of healthcare resources, underscores how environmentalracism intersects with healthcare inequity to strip communities of their right to care for one another.
9.COVID-19 Pandemic: The Right to Provide Care Under Strain
The COVID-19 pandemic broughtlongstanding healthcare inequities into sharp relief, particularly for Black, Latino, Indigenous, and low-incomecommunities. Essential workers, many of whom were people of color, were denied adequate protection and healthcare, even asthey were expected to continue providing critical services to the public. Frontline healthcare workers, many of themwomen of color, faced overwhelming workloads in underfunded hospitals, often working without sufficient personal protective equipment(PPE) and at great personal risk.
The right to care for one’s family was compromised for many essentialworkers, as they were forced to choose between their jobs and the safety of their loved ones. Many brought the virus home to multi-generational households, where older family members were particularly vulnerable. This was exacerbated by overcrowded livingconditions, economic instability, and limited access to healthcare, which disproportionately affected communities of color.
Prisons, nursing homes, and immigrant detention centers became epicenters for COVID-19 outbreaks, where the denial of theright to care was most acute. Incarcerated individuals were often left without access to testing, treatment, orvaccines, and family members were cut off from visiting, leaving both inmates and their families in isolation. The failure to provideadequate healthcare in these institutions, compounded by systemic neglect, led to devastating death tolls.
The unevendistribution of vaccines also highlighted how healthcare inequities disproportionately affect marginalized groups. Indigenouscommunities, many of whom faced extreme healthcare disparities before the pandemic, had some of the highest infection anddeath rates due to COVID-19. Despite this, vaccine rollout was slower in rural and tribal areas, further denying these communitiesthe right to care for their elders and families.
10. Disabled Communities: The Right to Care forOneself and Others
Disabled people have long been denied both the right to be caredfor and the right to provide care in ways that affirm their autonomy and dignity. Historically, disabledindividuals have been institutionalized, isolated from their families and communities, and denied the opportunity to liveindependently. The denial of access to proper healthcare, assistive technology, and community-based support has left many disabledpeople unable to care for themselves or others in ways that align with their needs and values.
The intersection of disabilitywith race, gender, and class further complicates these barriers. Disabled women of color are particularly vulnerableto healthcare neglect, often facing compounded discrimination in medical settings where their pain, autonomy, and caregiving rolesare dismissed or undermined. Disabled parents, especially those from marginalized communities, often face heightened scrutiny and thethreat of losing custody of their children due to assumptions about their ability to provide care.
Disabled caregivers,particularly those who care for other disabled individuals, are often excluded from formal caregiving roles due to systemic ableism,despite having lived experience and expertise that could benefit those in their care. The exclusion of disabled people fromprofessional caregiving roles reflects broader societal devaluation of disabled bodies and minds, denying them the right toprovide care both personally and professionally.
The Right to Provide Care as aFundamental Human Right
The right to provide care is central to human dignity, autonomy, and community well-being. Yet, throughout U.S. history, marginalized communities have been systematically denied this right—whether through racisthealthcare policies, forced sterilization, environmental racism, mass incarceration, or the exclusion of disabled individuals fromcaregiving roles. The ability to care for oneself, one’s family, and one’s community is not merely a personal or familialobligation but a fundamental human right that must be recognized and protected.
Reclaiming the right to providecare requires addressing the deep structural inequities in healthcare, immigration, the criminal justice system, andenvironmental policy. This means advocating for universal healthcare, dismantling policies that criminalize orseparate families, ensuring environmental justice, and empowering marginalized communities to take control of their own health andwell-being.
The historical denial of care reflects how intersecting forms of oppression—racism, sexism, ableism,classism, and xenophobia—have shaped the healthcare landscape in the United States. By acknowledging and rectifying theseinjustices, we can begin to build a future where the right to care—for ourselves and for each other—is afundamental, inalienable right for all people.