Two crises have defined the summer of 2020: escalating police violence and a worsening public health situation. Both have disproportionately targeted communities of color.

While the killing or maiming of people of color by state authorities is far more visible, the extraneous deaths through failures in health care and public health are much more numerous. The privatization of health care and the failed policy decisions by the U.S. government have led to persistent stark racial disparities in health. The coronavirus pandemic exacerbated these problems.

But the fact the pandemic has coincided with a growing movement demanding racial justice presents a unique opportunity for meaningful reform. Only by understanding and confronting this entangled web of racism and public health can we actually solve a problem that has been centuries in the making.

Rethinking our health-care system during and after the current pandemic requires no less radical a restructuring of society than that was required during 19th-century Reconstruction. The challenges of that era, including pandemic disease, offer guidance today, even when efforts failed, as we work to address historical inequalities and begin to confront injustice and enduring racism.

Following the end of the Civil War, local and state officials grappled with how to best facilitate the transition from slavery to freedom. The redistribution of land represented the best chance for formerly enslaved people “to best take care of ourselves,” explained a group of Black ministers in Georgia in 1865. It never came to fruition. After just a few months of land distribution in several states, President Andrew Johnson gave those lands taken from former Confederate enslaver planters back to them. The promise of economic freedom for African Americans was dashed in the refusal of federal will to counter white supremacy.

The shorthand “Forty Acres and a Mule” persisted, however, as a recognition the federal government had a responsibility to provide economic resources to build Black communities after the centuries of plundered labor they and their ancestors had already provided to the nation. But this idea provoked a swift backlash from largely Southern White leaders and the federal government, accompanied by a reign of terror that shaped the conditions that exacerbated the existing health gap between Black and White people.