Stories from the Field: Uché Blackstock

You recently moderated a panel on the economic case for health equity at the Milken Institute Global Conference. What stood out most to you from the conversation?

The conversation quickly moved beyond the usual framing of health equity as simply a moral imperative and instead focused on what it actually takes to operationalize equity in practice.

At the start of the panel, I shared that when I think about health equity, I first think about my late mother, Dale Blackstock, MD, who practiced medicine in Central Brooklyn for decades. She understood care as something holistic, shaped not only by medicine itself but by the realities of people’s lives. That perspective shaped my own approach to medicine and to moderating this discussion.

Our conversation affirmed that health equity isn’t separate from how institutions function but rather reflected in how decisions are made, how resources are allocated, and how success is measured.

Our panelists brought perspectives from tribal health systems, academic medicine, clinical trials, and global philanthropy. Yet despite their different vantage points, there was remarkable alignment around one idea: If we want better outcomes, we have to move beyond intention and build systems that are designed to meet people where they are.

Why should health equity be understood as economic infrastructure rather than simply a social or moral issue?

Because inequity carries real economic consequences.

Too often, we talk about health equity as though it exists apart from economic performance. But the panel reinforced something I’ve long believed: Healthier communities are stronger, more resilient communities.

When people lack access to preventive care, when chronic conditions go unmanaged, and when communities experience avoidable barriers to treatment, the consequences extend beyond individual health to workforce participation, disability, caregiving burdens, lost productivity, and preventable health-care costs.

One panelist spoke about dramatic disparities in life expectancy that can exist within the same city. Another highlighted how clinical trial systems have historically excluded rural communities and patients who cannot afford the time, transportation, or flexibility required to participate. Those exclusions shape who benefits from innovation and who gets left behind.

What I appreciated most was that this discussion pushed us to think about investing differently—not just more. Several examples emerged of community-led models succeeding when institutions trusted communities to define their own priorities and build solutions grounded in local realities.

Innovation and AI were also major themes of the panel. What role should they play in advancing health equity?

Innovation has tremendous potential, but only if we are intentional.

One of the most compelling conversations centered on how advances in AI and clinical trial design could either expand access or reinforce inequities, depending on how they are built. Historically, many clinical trials have excluded patients from rural communities and populations that already face barriers to care, so the benefits of innovation are often unevenly distributed.

However, I was encouraged to hear examples of how technology can be used differently. AI, for example, can help health systems better understand patient populations, reduce unnecessary barriers to trial participation, and design approaches that more closely reflect how people actually receive care.

But innovation without representation and accountability carries risk. We can’t afford to build systems that simply automate inequity. Diverse perspectives, community engagement, and thoughtful guardrails are essential if we want technology to strengthen trust rather than erode it.

What role can convenings like the Milken Institute Global Conference play in advancing health equity?

One of the most important things the Milken Institute does is create space for unlikely conversations and commit to revisiting conversations in critical subject areas (see some of the Milken Institute’s other panel discussions focused on health equity.)

I appreciated that leaders from different disciplines on this panel challenged one another, built on one another’s ideas, and identified shared priorities. A recurring theme emerged: Partnership matters. No single institution or sector can solve health inequities alone.

Whether we discussed tribal sovereignty, workforce development, clinical trials, philanthropy, or technology, the answer was rarely a single intervention. It was collaboration, sustained investment, and shared accountability.

Health equity isn’t abstract. It lives in relationships, trust, who gets included in decision-making, and whether communities are treated as partners rather than afterthoughts. Progress becomes possible when we stop treating equity as an aspiration and begin designing systems of care that reflect how people actually live.