Medical disenfranchisement is fueled by a host of factors that include worsening shortage of primary care doctors in needy communities and a troubling scarcity of providers willing to treat the uninsured or publicly insured. Adding to the trend are fewer medical students choosing primary care over more lucrative and specialized fields.

The legacy of slavery comes from the sustained political, legal and economic effort to link permanently an entire group of people to poverty - and to mystify that systematic disenfranchisement by making up something called race, which could serve as a distraction.