America’s robust biomedical ecosystem and the therapeutic advances it has introduced are making remarkable progress against cancer, heart disease, stroke, and other serious illnesses. But much more needs to be done to ensure that all communities can access the treatments and care they need. Prohibitive costs, ingrained biases, healthcare deserts, and distrust in the medical system born of past abuses are all contributing factors that result in shorter lives and much higher disease burdens in communities of color. Confronting those requires far-reaching commitments to improve access to clinical trials, diversifying the healthcare workforce, disseminating anti-racist staff training models, and reconsidering the culture of clinical services.