Dear friends,

Please vote on or before November 3rd.

And when you do, we urge you to vote to defeat Donald Trump.

We don’t make this recommendation lightly. But, as Upstreamists, we must. Here’s why.

We’ve always understood the impact of political and structural determinants of health inequity. Baked into our work as Upstreamists is an explicit understanding of the impact of politics and policy on the health of not just patients and communities but the entire nation. The people we put in local, state, and federal government, including the White House, and the pressure and checks that we place on them, impact our lives profoundly — in the ways resources and power are distributed, the ways health is promoted or undermined, the ways justice is applied or sabotaged, the ways equity is manifested or left as just an afterthought.

We’ve known that justice, equity, and health are always on the ballot.

The last four years have made that painfully obvious. This newsletter would be insufficient to review all the attacks that the Trump Administration has made on justice, equity, and health, and on democracy at its core — attacks which have refueled and reinforced long-standing racism and harmed communities of color and poor people most heavily of all. You would need an encyclopedia to catalog them all. Some of these attacks are better understood as forms of “structural violence” and are summarized in the New England Journal of Medicine, Scientific American, and the The Lancet, each of which has offered its own unprecedented endorsement.

That’s why we are compelled to endorse Joe Biden and Kamala Harris as a necessary alternative to Donald Trump. Because justice, equity, and health are on the line. This election represents a moment to choose between a future where justice, equity, health, and democracy continue to be undermined and attacked versus a future with greater opportunity to restore and promote these essential values and the institutions that uphold them. Regardless of the political moment, we’ve always come down on the side of the latter. (Find our resource list for understanding and advancing equity here.)

Of course, our work will not end on November 3rd. As critical as it is to remove Trump from office and elect Joe Biden, we know that electing a new President is far from a panacea for what ails us in this country. The work of moving upstream, and the work of advancing justice, equity, and health, will continue to be necessary regardless of who occupies the White House, Congress, or state and local elected office. We are simply endorsing what we believe to be the best conditions under which to organize, drive improvement, and continue to fight the pandemic and injustice. That’s why, after the election, we will continue to work with you, learn from you, and elevate opportunities for collective action on the journey upstream.

In that spirit, please save the date and register here for our November 18 webinar: “The Fight Continues: Health Equity in 2021 and Beyond.” Whatever happens on Election Day, we’ll bring together leading thinkers and actors on health equity in this real-time response to lay the groundwork for our work to come.

But for now, the most important opportunity for collective action is right in front of us. Please vote on or before November 3rd (for state-specific instructions, see VoteHealth2020). And when you do, please vote to defeat Trump. Justice, equity, health — and democracy itself — are on the ballot.

Best,

Rishi Manchanda

HealthBegins is responsible for the content of this communication and it is not authorized by any candidate or candidate’s committee.