Across the United States in 2025, Black families are grappling with a range of urgent issues—economic instability, limited access to health care, and the ongoing fallout from legal and political battles over reproductive rights. Recent data and firsthand accounts reveal how these challenges are deeply interconnected, shaping not only the daily lives of Black communities but also the work and well-being of the medical professionals who serve them.
According to a multi-state poll conducted between May and June 2025 by PerryUndem for In Our Own Voice: National Black Women’s Reproductive Justice Agenda (NBWRJA), economic insecurity and restricted health care access are the two most pressing concerns among Black families today. The poll surveyed 5,000 Black adults across 10 states and found that more than half of respondents reported struggling with financial insecurity. Even more striking, 90% said Medicaid has been important to them and their families—a statistic that underscores the essential role public health coverage plays in these communities.
"The margin of sampling error ranges from ±5.7 to ±6.6 percentage points, varying by state," NBWRJA noted, but the overall message is clear: health care and economic policy decisions are felt acutely in Black households. The organization, whose mission is to ensure policymakers understand and respond to Black voters’ realities and priorities, emphasized that these findings highlight the collective power of Black communities in shaping policy.
Yet health care isn’t the only concern. Over 80% of those surveyed said dismantling systemic racism is necessary for Black families to thrive. The poll also revealed that large majorities across all demographics support abortion rights and access, reflecting a strong consensus on reproductive freedom—a topic that has become even more urgent in the wake of recent legal changes.
This sense of urgency is echoed in the results of another NBWRJA-commissioned survey from January 2024, which focused on Black women who are registered voters across nine states. Conducted with 1,005 participants, it found that the cost of living, maternal health, housing affordability, and racism were the most urgent issues. The margin of sampling error for this survey was ±3.5 percentage points, but the message was consistent: Black women, especially those of reproductive age, continue to face systemic barriers to achieving what NBWRJA calls “Reproductive Justice.”
These obstacles aren’t new, but they have been exacerbated by recent political events. In 2022, before and after the Supreme Court’s decision to overturn Roe v. Wade, NBWRJA and PerryUndem conducted additional surveys. The timing was critical—data was collected in May, before the Uvalde, Texas, school shooting and the Supreme Court’s ruling, and again in September, after both events. The post-Roe findings showed a noticeable shift: abortion rights became a higher voting priority across nearly all states, with more voters—including Black women—listing it among their top five concerns. NBWRJA reported that Black women were significantly more likely after the Roe decision to support candidates who advocated for abortion rights and access.
But the impact of Roe’s overturning hasn’t been limited to voters and patients. It’s also been felt keenly by the medical professionals tasked with providing reproductive care. On October 23, 2025, Erika L. Sabbath, director of the Harvard Center for Work, Health and Wellbeing, presented research at the Harvard Center for Population and Development Studies that shed light on the increased moral distress experienced by obstetricians and gynecologists (OB-GYNs) since Roe was overturned.
Interviewing more than 50 OB-GYNs working in 13 states with near-complete abortion bans, Sabbath and her team found that physicians reported heightened guilt and anxiety when unable to provide necessary abortion-related interventions to patients. As Sabbath recounted, one OB-GYN described how her patients were “sobbing and crying and begging.” The doctor’s sense of helplessness was palpable: “You have the chills because you’ve got the procedure room just down the hall. You’ve got medications right next door. You could fix this person’s problem, and you’re not.”
That sense of helplessness is compounded by the legal landscape. In many states, abortion bans include exceptions only when maternal life—not maternal health—is threatened. This means clinicians sometimes must withhold treatment until a patient’s condition worsens to the point where intervention is legally permissible. “The person’s life had to be in danger before the hospital said that the physician could proceed,” Sabbath explained. The ambiguity of state abortion laws, often written in non-medical language, has left many clinicians fearful and uncertain about what is legally allowed, increasing their anxiety and sense of risk.
Some OB-GYNs reported feeling paranoid that their patients, or their patients’ partners, might record their interactions to implicate them—a fear that legal consultations can sometimes alleviate, but not always. "Many medical emergencies occur outside of lawyers’ working hours," Sabbath added, highlighting a gap in support for clinicians facing urgent, high-stakes decisions.
The consequences have been significant. More than 10% of the OB-GYNs interviewed by Sabbath’s team have already moved to states with more relaxed abortion laws, while an additional 60% have considered relocating. Yet not all are able—or willing—to leave. As one clinician put it, “I thought so many times about leaving, but I’m one of only three people left in the state who can take care of a patient who is possibly dying from their pregnancy.”
Interestingly, Sabbath’s ongoing research, now expanded to include clinicians in all 50 states, found that OB-GYNs nationwide—not just those in restrictive states—are experiencing heightened distress. Sabbath suggested several possible explanations, including the passage of time since Roe’s overturning and the growing national climate of uncertainty around reproductive care. Her team is conducting further research to pinpoint the reasons behind this broader trend.
Against this backdrop, the findings from NBWRJA’s surveys gain even more significance. Black families and women are not only disproportionately affected by limited access to health care and threats to reproductive rights, but also by the broader systemic inequities and discrimination that persist in American society. The data underscores the vital importance of voting and equitable political representation for communities most impacted by these challenges.
Ultimately, the intertwined struggles of patients and providers highlight the far-reaching consequences of policy decisions on health care and reproductive rights. As the nation moves forward, the voices and experiences of Black families—and the clinicians who serve them—will remain central to debates about justice, equity, and the future of American health care.
