Tag: elite

  • Challenge of Leading Elite Institutions in Populist Age of Distrust

    Challenge of Leading Elite Institutions in Populist Age of Distrust

    In the face of the Gaza protests, presidents at the nation’s most prestigious campuses were caught between a rock and a hard place—and somehow managed to trip over both.

    Pressured on one side by students and faculty demanding moral clarity and action and on the other by donors, trustees and politicians insisting on firm leadership and institutional neutrality, they found themselves in a no-win situation.

    In attempting to balance these competing forces, they pleased no one, offering statements too vague to satisfy activists yet too equivocal to reassure their critics.

    Instead of navigating the crisis with principled leadership, many stumbled into a public relations disaster, alienating both their campus communities and external stakeholders.

    What should have been a moment for measured, thoughtful leadership instead became a showcase of hesitation, miscalculation and rhetorical gymnastics that satisfied neither moral conviction nor strategic pragmatism.

    Could Presidents Have Done Better?

    Yes, the leading university presidents could have handled the Gaza protests more effectively, but doing so would have required a combination of patience, strategic engagement and deft leadership—qualities that many struggled to summon under intense pressure.

    In his forthcoming memoir, former Harvard president Neil Rudenstine argues that navigating the crisis required time, strong relationships with key stakeholders, active faculty involvement and innovative problem-solving—qualities that were largely absent in the response.

    1. Patience: A Scarce Commodity in a Crisis

    Rudenstine’s call for patience underscores a fundamental challenge: Neither protesters nor institutional critics were willing to wait for careful deliberation. Protesters demanded immediate moral clarity and action, while external stakeholders—donors, trustees, politicians—expected firm and unequivocal leadership.

    University presidents, caught between these forces, often reacted hastily, issuing statements that satisfied neither side. A more patient approach would have required resisting the impulse to make rapid, reactive pronouncements and instead creating structured, ongoing dialogue with campus constituencies. It would have meant acknowledging the urgency of the moment while also emphasizing the need for thoughtful decision-making.

    1. Rapport With Stakeholders: The Perils of New Leadership

    Building trust with students, faculty, alumni, trustees and external critics is difficult in the best of times, and it is even harder for new university presidents who have not yet cemented their authority or personal relationships within their institutions. Many of the university leaders embroiled in the controversy were relatively new to their positions, inheriting polarized political environments without deep reservoirs of goodwill to draw from.

    In moments of crisis, long-standing relationships and credibility matter. Presidents who had not yet established rapport with key stakeholders found themselves viewed with suspicion from all sides, making it difficult to act decisively or persuasively. This underscores the importance of proactive engagement: University leaders must invest in relationship-building early, so that when crises inevitably arise, they have a foundation of trust to rely upon.

    1. Faculty Engagement: An Untapped Resource

    University faculty represent a deep well of institutional knowledge and intellectual expertise, yet in many cases, faculty were sidelined as presidents struggled to navigate the crisis.

    A more effective response would have involved drawing on faculty members—especially those with expertise in history, diplomacy, political science and conflict resolution—to help craft statements, advise on messaging and offer guidance on institutional policy.

    Faculty could have also served as intermediaries between student activists and administrators, helping to create structured conversations rather than performative clashes. By failing to engage faculty early, many presidents lost an opportunity to ground their responses in scholarly insight and institutional legitimacy.

    1. Creative Responses: Beyond the Standard Playbook

    The default approach to campus protests—issue a statement, enforce campus policies and hope the storm passes—was woefully inadequate in this case. Rudenstine’s emphasis on creativity suggests that university leaders needed to think beyond standard crisis-management tactics. Instead of simply trying to placate or rebuff different constituencies, presidents could have:

    • Convened structured debates or forums featuring scholars and public intellectuals with diverse perspectives, transforming conflict into an opportunity for rigorous academic engagement.
    • Established faculty-led committees to develop thoughtful, universitywide policies on how the institution engages with global conflicts, providing a long-term framework for future crises.
    • Created dedicated spaces for dialogue, ensuring that protesters had a platform for their voices to be heard while also setting clear boundaries on disruptions to academic life.

    The Leadership Test They Failed

    The Gaza protests revealed deep weaknesses in university leadership, exposing the inability of many presidents to navigate the complex intersections of free speech, academic integrity, donor pressure and campus activism. A better response would have required patience, trust-building, faculty engagement and creative problem-solving—qualities that were largely absent in the moment.

    The lesson for future leaders is clear: Effective university leadership is not just about managing crises when they arise but about laying the groundwork well in advance, ensuring that when the inevitable storm comes, the institution has the resilience and credibility to weather it.

    The High Cost of Leadership: Neil Rudenstine’s Harvard Presidency

    In a 2001 Harvard Crimson article entitled “The Final Word on Neil Rudenstine,” Catherine E. Shoichet, now a senior writer for CNN, offers a detailed account of that president’s tenure at Harvard—dissecting both his successes and the significant sacrifices and costs it exacted.

    Presidents are chosen to solve particular problems, and Rudenstine was tasked with two major challenges: overseeing Harvard’s first universitywide capital campaign and knitting together a sprawling, fragmented, disjointed institution. As president, he transformed the university’s financial standing—adding billions to its endowment—and initiated wide-ranging administrative reforms, including the re-establishment of the provost position.

    His most notable achievement was increasing Harvard’s endowment from roughly $4 billion to $19 billion in just 10 years, laying the financial foundation that sustains the university’s wealth today.

    However, the article also stresses the heavy personal toll these challenges took on him—a topic that Rudenstine’s own account surprisingly omits.

    Few presidents were better prepared for the job; he had been a respected faculty member, a productive scholar, a well-regarded dean of students, an effective provost and an extraordinarily hard worker. Yet his relentless focus on fundraising and institutional overhaul led to a three-month leave of absence in 1994, fueling rumors of a nervous breakdown. Remarkably, he went on to serve for another seven years after that difficult period.

    Shoichet notes that for all his accomplishments, including launching development of a new campus in Allston and revitalizing Harvard’s Afro-American Studies Department and establishing a then-novel interdisciplinary initiative in mind, brain and behavior, his presidency also resulted in a perceived disconnect between the administration and the student body—a criticism that has followed him since his Princeton days.

    His reserved public persona, which contrasted with the more overtly engaging styles of his predecessors, led to both admiration for his methodical, inclusive approach and criticism for being too detached from everyday campus life.

    The Shoichet article exposes the inherent trade-offs of his approach. Rudenstine’s intensive focus on high-stakes fundraising and administrative restructuring appears to have come at the expense of deeper engagement with the student body. His humility was confused with weakness and a lack of strong convictions. His leave of absence illustrates how the pressures of managing an institution as vast and complex as Harvard can affect even the most capable leaders.

    This duality—the balance between transformative success and the personal, institutional costs—forms the crux of Shoichet’s argument.

    Her narrative situates Rudenstine within a broader historical context. By comparing his tenure with those of former Harvard presidents such as Nathan M. Pusey and Derek Bok, Shoichet argues convincingly that the challenges Rudenstine faced were unique to a new era of higher education—one marked by rapid expansion, increased institutional complexity and a heightened focus on financial management.

    Despite his remarkable achievements, Rudenstine never garnered the same level of acclaim as his illustrious predecessors. In much the same way, many of his successors—including Lawrence Summers, Lawrence Bacow and Claudine Gay—have often been met with ambivalence or even disdain.

    The reality is that leading an institution as formidable as Harvard has become nearly impossible. It is no wonder that the average tenure of college presidents nationwide has shrunk from around eight years to just about five—hardly enough time to make a lasting impact.

    Rudenstine’s legacy, therefore, is not simply measured by his achievements but by the enduring questions it raises about the nature of leadership in a modern academic institution.

    The Daunting Realities of University Leadership: A Seat of Prestige, Not Power

    We often imagine university presidents as powerful figures—intellectual stewards shaping the future of higher education. But Rudenstine’s Our Contentious Universities flips this perception on its head. He’s not speaking truth to power; he’s speaking truth about power—revealing that university presidencies are as much about constraint as they are about command.

    The title of university president carries an air of authority, but Rudenstine’s message is clear: The power of the office is often more symbolic than substantive. Instead of wielding control, presidents juggle competing interests, manage crises and navigate the impossible demands of faculty, students, donors and politicians. The real truth? The presidency is more burden than throne.

    Holding the most prestigious seat in higher education, Rudenstine isn’t telling us how to wield power—he’s telling us how little of it university presidents actually have. His book dismantles the myth of the omnipotent academic leader and replaces it with a far grittier reality: that influence is fragmented, authority is constrained and leadership is often just crisis management in an ivory tower.

    If “speaking truth to power” is about confronting authority, Our Contentious Universities reveals an unexpected reversal: Often, those in power are the ones struggling to be heard. Rudenstine lays bare the paradox of university leadership—an office that looks commanding from the outside but feels impossibly constrained from within.

    The real work of a university president is not about wielding authority but about navigating limits, managing expectations and negotiating between forces that are often beyond their control.

    The power we imagine? It’s largely an illusion.

    Why University Presidents Have Less Power Than We Think

    Through a mix of historical analysis, personal experience and candid reflection, Rudenstine argues that the role of the modern university president is far more constrained than many outsiders assume.

    Three overarching arguments structure his book:

    1. The Paradox of Institutional Wealth and Administrative Complexity

    Elite universities have never been wealthier, yet they have become significantly more challenging to manage. The sheer scale and bureaucratic complexity of modern research institutions—coupled with the decentralized governance structures of many elite universities—make it extraordinarily difficult for a president to assert a unifying vision.

    Harvard, perhaps the most extreme case, operates under the philosophy of “every tub on its own bottom,” meaning that each of its schools, institutes and centers manages its own budget and academic affairs with substantial autonomy. Its endowment, divided into over 11,000 different funds with various restrictions, further complicates efforts to mobilize financial resources for cross-university initiatives.

    But Harvard is not unique in this regard—many elite institutions lack a clear common mission or identity beyond their reputation for excellence. As a result, university presidents often find themselves in the role of coordinators rather than decision-makers, navigating a complex web of faculty interests, donor expectations and institutional traditions.

    1. Student Protests: A Recurring but Intensifying Challenge

    Student activism has long been a defining feature of American higher education, and today’s campus protests are in many ways a continuation of past movements—whether over free speech, civil rights, the Vietnam War, South African apartheid, a living wage and labor rights, or fossil fuel divestment.

    Rudenstine reminds readers that campus unrest is not a new phenomenon and, in many cases, past protests were just as contentious as, if not more so than, those of today.

    However, he argues that contemporary campus protests present a unique set of challenges that make them especially difficult to resolve.

    First, the media and political spotlight on higher education is more intense than ever before, amplifying every controversy into a national debate. Social media accelerates and inflames conflicts, often distorting the reality of what is happening on the ground.

    Second, outside political actors—including legislators, donors and advocacy groups—now intervene more aggressively in campus affairs, using protests as flash points in larger ideological battles over academic freedom, free speech and institutional neutrality.

    Third, many of today’s most contentious issues—such as foreign conflicts, racial justice and free speech—extend far beyond the authority of any university administration. Unlike past movements that targeted specific institutional policies (e.g., divestment from apartheid South Africa), today’s protests often demand action on global or national issues that university leaders have little power to directly influence.

    1. The Constraints of the University Presidency

    While university presidents are often seen as the face of their institutions, their actual power is far more limited than public perception suggests. Much of their time is spent off campus, engaged in fundraising and alumni relations, rather than in direct governance. This distance often creates a perception—among both students and faculty—that they are out of touch with the daily realities of campus life.

    Moreover, while presidents are expected to be moral leaders, crisis managers and public intellectuals, they operate within institutional structures that limit their ability to enact significant change. The vast majority of academic decisions are made at the department and faculty level, not by the president’s office.

    Their financial resources, while seemingly vast, are often constrained by donor restrictions and endowment policies. And while they are expected to foster dialogue and intellectual engagement, they must also navigate intense political and ideological pressures that make consensus-building nearly impossible.

    The Unwinnable Presidency in a Populist Age of Distrust

    Leading an elite university in a populist era of distrust is an unwinnable job. University presidents are expected to be moral leaders, crisis managers and public intellectuals—yet they wield less power than ever before. They must balance the demands of faculty, students, donors, trustees, politicians and the public, all while navigating an institutional landscape that is more fragmented, more scrutinized and more politically charged than at any point in recent history.

    Between a rock, a hard place and a social media firestorm, university leaders face an impossible equation. Caught between student activists demanding moral clarity, faculty insisting on academic freedom, donors expecting institutional stability and politicians eager to score ideological points, they must navigate a minefield with no safe path forward.

    Every decision, no matter how carefully considered, is met with outrage from one side or another. When every choice is controversial, the safest option is still the wrong one.

    Speaking truth to power is one thing—leading an institution when you are the power, yet have none, is another. A university president’s job isn’t to lead; it’s to survive. The modern presidency is less about shaping the intellectual future of a university and more about managing crises, defusing conflicts and enduring public scrutiny.

    Part fundraiser, part diplomat, part scapegoat, today’s university leader embodies a paradox: prestigious, powerful and profoundly constrained.

    The university presidency is a job where everyone expects everything, but no one is ever satisfied. And yet, the ambitious vie for this job. The challenge for future university leaders is not just to weather the storm but to prove that, even in an era of distrust and division, higher education still has a role to play in the pursuit of truth, knowledge and the public good.

    Reclaiming the Visionary College Presidency: The Legacy of the Big Three B’s

    At a time when the university presidency has become synonymous with crisis management, political crossfire and institutional paralysis, we would do well to reclaim an older vision of academic leadership—one embodied by the Big Three B’s: Derek Bok, William Bowen and Kingman Brewster.

    These men were not just administrators; they were visionaries. They understood that a great university is not simply a collection of departments, endowments and buildings, but a living intellectual community that requires bold leadership, principled decision-making and a deep appreciation for the institution’s unique identity.

    Unlike today’s university presidents, who often appear hemmed in by competing pressures, Bok, Bowen and Brewster exuded a sense of command. They were coalition builders who understood how to navigate the tensions of their time—not by appeasement or retreat, but by articulating a clear and compelling vision for their institutions.

    They did not shy away from controversy; they faced it head-on, using their moral authority and intellectual gravitas to persuade rather than merely pacify. Their leadership was not about survival—it was about transformation.

    The Power of Institutional Identity

    One of the defining strengths of these presidents was their deep understanding of what made their universities distinctive. They did not try to turn their institutions into all-purpose, generic centers of higher learning. Instead, they leaned into their unique strengths and traditions, reinforcing the core values that defined them.

    • Kingman Brewster at Yale championed the arts and humanities, elevating Yale as a beacon of intellectual and cultural leadership. He understood that Yale’s prestige was not just in its research output, but in its commitment to a broad, humanistic education that shaped future leaders in the arts, government and public service.
    • William Bowen at Princeton preserved and reinforced the university’s distinctive commitment to undergraduate education, mentoring and close faculty-student engagement. He saw Princeton as the ideal blend of a research university and a liberal arts college, where students could experience the best of both worlds.
    • Derek Bok at Harvard expanded the university’s reach and redefined its role in shaping society. He recognized Harvard’s unique position as an institution that was not just educating students, but cultivating thought leaders in law, government, business and the sciences. Bok’s presidency was marked by efforts to bring in a broader, more diverse array of scholars and students who were shaping the world outside the academy.

    These men understood that universities are not interchangeable—they have distinctive missions, histories and cultures that must be nurtured, not diluted. They resisted the impulse to make their institutions all things to all people and instead worked to sharpen and deepen their defining strengths.

    Leadership With Gravitas and Moral Authority

    What made the Big Three B’s remarkable was not just their institutional savvy, but their personal presence and sense of moral authority. These were men who commanded respect, not because of their titles, but because they embodied the very ideals their universities stood for. They were not timid bureaucrats, nor were they detached figureheads. They were intellectuals, statesmen and educators who carried themselves with the weight of their institutions behind them.

    More importantly, they were unafraid to make tough decisions and stand firm in the face of opposition. Brewster took a bold stance in support of civil rights and coeducation and against the Vietnam War, even when it made him a target of political backlash. Bowen helped lead Princeton through transformative changes in financial aid and faculty governance, navigating opposition with both decisiveness and diplomacy. Bok spearheaded Harvard’s expansion into applied learning and professional education, while also defending the university’s core commitment to academic freedom.

    Each of these presidents had the ability to thread the needle—to stand up for their principles without alienating key constituencies. They were neither populists nor technocrats; they were strategic leaders who understood how to bring faculty, students, trustees and alumni into alignment around a shared purpose.

    Reclaiming a Lost Model of Leadership

    The contrast between the Big Three B’s and today’s university presidents is stark. Where they projected confidence and authority, many modern university leaders appear cautious and reactive. It’s quipped that their present-day counterparts can’t go to the bathroom without consulting their general counsel. Where the Big Three articulated grand visions for their institutions, many of today’s presidents are consumed by damage control. Where they commanded the respect of faculty and students, today’s leaders often seem disconnected from both.

    Of course, the world of higher education has changed. Universities are larger, more complex and more deeply entangled in political and cultural battles than ever before. But that is precisely why we need a new generation of university presidents who can reclaim the mantle of true leadership.

    The university presidency should not be reduced to a balancing act of donor relations, media messaging and political risk management. It must once again become a platform for vision, courage and institution-building.

    The lesson of the Big Three B’s is clear: Great universities do not thrive under timid leadership. They flourish when they are guided by bold, intellectually rigorous and morally grounded presidents who understand both the weight of their office and the enduring value of higher education. The future of our great universities depends on whether we can find leaders who, like Bok, Bowen and Brewster, embody the very ideals their institutions were meant to uphold.

    Steven Mintz is professor of history at the University of Texas at Austin and recipient of the AAC&U’s 2025 President’s Award for Outstanding Contributions to Liberal Education.

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  • The Dark Legacy of Elite University Medical Centers

    The Dark Legacy of Elite University Medical Centers

     

    (Image: Mass General is Harvard University Medical School’s teaching hospital.)  

     

    For decades, America’s elite university medical centers have been the epitome of healthcare research and innovation, providing world-class treatment, education, and cutting-edge medical advancements. Yet, beneath this polished surface lies a troubling legacy of medical exploitation, systemic inequality, and profound injustice—one that disproportionately impacts marginalized communities. While the focus has often been on racial disparities, this issue is not solely about race; it is also deeply entangled with class. In recent years, books like Medical Apartheid by Harriet Washington have illuminated the history of medical abuse, but they also serve as a reminder that inequality in healthcare goes far beyond race and touches upon the economic and social circumstances of individuals.

    The term Medical Apartheid, as coined by Harriet Washington, refers to the systemic and institutionalized exploitation of Black Americans in medical research and healthcare. Washington’s work examines the history of Black Americans as both victims of medical experimentation and subjects of discriminatory practices that have left deep scars within the healthcare system. Yet, the complex interplay between race and class means that many poor or economically disadvantaged individuals, regardless of race, have also faced neglect and exploitation within these prestigious medical institutions. The legacy of inequality within elite university medical centers, therefore, is not limited to race but is also an issue of class disparity, where wealthier individuals are more likely to receive proper care and access to cutting-edge treatments while the poor are relegated to substandard care.

    Historical examples of exploitation and abuse in medical centers are well-documented in Washington’s work, and contemporary lawsuits and investigations reveal that these systemic problems still persist. Poor patients, especially those from marginalized racial backgrounds, are often viewed as expendable research subjects. The lawsuit underscores the intersectionality of race and class, arguing that these patients’ socio-economic status exacerbates their vulnerability to medical exploitation, making it easier for institutions to treat them as less than human, especially when they lack the resources or power to contest medical practices.

    One of the most critical components of this issue is the stark contrast in healthcare access between the wealthy and the poor. While elite university medical centers boast state-of-the-art facilities, cutting-edge treatments, and renowned researchers, these resources are often not equally accessible to all. Wealthier patients are more likely to have the financial means to receive the best care, not just because of their ability to pay but because they are more likely to be referred to these prestigious centers. Conversely, low-income patients, especially those without insurance or with inadequate insurance, are often forced into overcrowded public hospitals or community clinics that are underfunded, understaffed, and unable to provide the level of care available at elite institutions.

    The issue of class inequality within medical care is evident in several key areas. For instance, studies have shown that low-income patients, regardless of race, are less likely to receive timely and appropriate medical care. A 2019 report from the National Academy of Medicine found that low-income patients are often dismissed by healthcare professionals who underestimate the severity of their symptoms or assume they are less knowledgeable about their own health. In addition, patients from lower socio-economic backgrounds are more likely to experience medical debt, which can lead to long-term financial struggles and prevent them from seeking care in the future.

    Moreover, class plays a significant role in the underrepresentation of poor individuals in medical research, which is often conducted at elite university medical centers. Historically, clinical trials have excluded low-income participants, leaving them without access to potentially life-saving treatments or advancements. Wealthier individuals, on the other hand, are more likely to be invited to participate in research studies, ensuring they benefit from the very innovations and breakthroughs that these institutions claim to provide.

    Class-based disparities are also reflected in the inequities in medical professions. The road to becoming a physician or researcher in these elite institutions is often paved with significant economic barriers. Medical students from low-income backgrounds face steep financial challenges, which can hinder their ability to gain acceptance into prestigious medical schools or pursue advanced research opportunities. Even when low-income students do manage to enter these programs, they often face biases and discrimination in clinical settings, where their abilities are unfairly questioned, and their economic status may prevent them from fully participating in research or other educational opportunities.

    Yet, the inequities within these institutions don’t stop at the patients. Behind the scenes, workers at elite university medical centers, particularly those from working-class and marginalized backgrounds, face their own form of exploitation. These medical centers are not only spaces of high medical achievement but also sites of labor stratification, where workers in lower-paying roles are largely people of color and often immigrants. Support staff—such as janitors, food service workers, custodians, and administrative assistants—are often invisible but essential to the functioning of these hospitals and research institutions. These workers face long hours, poor working conditions, and low wages, all while contributing to the daily operations of elite medical centers. Many of these workers, employed through third-party contractors, lack benefits, job security, or protections, leaving them vulnerable to exploitation.

    Custodial workers, who are often exposed to hazardous chemicals and physically demanding work, may struggle to make ends meet, despite playing a crucial role in maintaining the hospital environment. Similarly, food service workers—many of whom are Black, Latinx, or immigrant—also work in demanding conditions for low wages. These workers frequently face job insecurity and are not given the same recognition or compensation as the high-ranking physicians, researchers, or administrators in these centers.

    At the same time, the stratification in these institutions extends beyond support staff. Medical researchers, residents, and postdoctoral fellows—often young, early-career individuals, many from working-class backgrounds or communities of color—are similarly subjected to precarious working conditions. These individuals perform much of the vital research that drives innovation at these centers, yet they often face exploitative working hours, low pay, and job insecurity. They are the backbone of the institution’s research output but frequently face barriers to advancement and recognition.

    The higher ranks of these institutions—senior doctors, professors, and researchers—enjoy financial rewards, job security, and prestige, while those at the lower rungs continue to experience instability and exploitation. This division, which mirrors the economic and racial hierarchies of broader society, reinforces the very class-based inequalities these medical centers are meant to address.

    In recent years, some progress has been made in addressing these inequalities. Many elite universities have implemented diversity and inclusion programs aimed at increasing access for underrepresented minority and low-income students in medical schools. Some institutions have also begun to emphasize the importance of cultural competence in training medical professionals, acknowledging the need to recognize and understand both racial and economic disparities in healthcare.

    However, critics argue that these efforts, while important, are often superficial and fail to address the root causes of inequality. The institutional focus on “diversity” and “inclusion” often overlooks the more significant structural issues, such as the affordability of education, the class-based access to healthcare, and the economic barriers that continue to undermine the ability of disadvantaged individuals to receive quality care.

    In addition to acknowledging racial inequality, it is crucial to tackle the broader issue of class within the healthcare system. The disproportionate number of Black and low-income individuals suffering from poor healthcare outcomes is a direct result of a system that privileges wealth and status over human dignity. To begin addressing these issues, we need to move beyond token diversity initiatives and work toward policy reforms that focus on economic access, insurance coverage, and the equitable distribution of medical resources.

    Scholars like Harriet Washington, whose work documents the intersection of race, class, and healthcare inequality, continue to play a pivotal role in bringing attention to these systemic injustices. Washington’s book Medical Apartheid serves as a historical record but also as a call to action for creating a healthcare system that genuinely serves all people, regardless of race or socio-economic status. The fight for healthcare equity must, therefore, be a dual one—against both racial and class-based disparities that have long plagued our medical institutions.

    The story of Henrietta Lacks, as told in The Immortal Life of Henrietta Lacks by Rebecca Skloot, exemplifies the longstanding exploitation of marginalized individuals in elite university medical centers. The case of Lacks, whose cells were taken without consent by researchers at Johns Hopkins University, brings to light both the historical abuse of Black bodies and the profit-driven nature of academic medical research. Johns Hopkins, one of the most prestigious medical centers in the world, has been complicit in the kind of exploitation and neglect that these institutions are often criticized for—issues that disproportionately affect not only Black Americans but also economically disadvantaged individuals.

    The Black Panther Party’s healthcare activism, as chronicled by Alondra Nelson in Body and Soul, also directly challenges elite medical institutions’ failure to provide adequate care for Black and low-income communities. Nelson’s work reflects how, even today, these institutions are often slow to address the systemic issues of health disparities that activists like the Panthers fought against.

    Recent lawsuits against elite medical centers further underscore the importance of holding these institutions accountable for their role in perpetuating medical exploitation and inequality. In An American Sickness by Elisabeth Rosenthal, the commercialization of healthcare is explored, highlighting how university hospitals and medical centers often prioritize profits over patient care, leaving low-income and marginalized groups with limited access to treatment. Rosenthal’s work highlights the role these institutions play in a larger system that disproportionately benefits wealthier patients while neglecting the most vulnerable.

    A Global Comparison: Countries with Better Health Outcomes

    While the United States struggles with systemic healthcare disparities, other nations have shown that equitable healthcare outcomes are possible when class and race are not barriers to care. Nations with universal healthcare systems, such as those in Canada, the United Kingdom, and many Scandinavian countries, consistently rank higher in overall health outcomes compared to the U.S.

    For instance, Canada’s single-payer system ensures that all citizens have access to healthcare, regardless of their income. This system reduces the financial burdens that often lead to delays in care or avoidance of treatment due to costs. According to the World Health Organization, Canada has better health outcomes on a variety of metrics, including life expectancy and infant mortality, compared to the U.S., where medical costs often lead to unequal access to care.

    Similarly, the United Kingdom’s National Health Service (NHS) provides healthcare free at the point of use for all citizens. Despite challenges such as funding constraints and wait times, the NHS has been successful in ensuring that healthcare is a right, not a privilege. The U.K. consistently ranks higher than the U.S. in terms of access to care, health outcomes, and overall public health.

    Nordic countries, such as Norway and Sweden, also exemplify how universal healthcare can lead to better outcomes. These countries invest heavily in public health and preventative care, ensuring that even their most marginalized citizens receive the necessary medical services. The result is a population with some of the highest life expectancies and lowest rates of chronic diseases in the world.

    These nations show that, while access to healthcare is a critical issue in the U.S., the challenge is not a lack of innovation or capability. Instead, it is the systemic barriers—both racial and economic—that persist in elite medical centers, undermining the potential for universal health equity. The U.S. could learn from these nations by adopting policies that reduce economic inequality in healthcare access and focusing on preventative care and public health strategies that serve all people equally.

    Ultimately, the dark legacy of elite university medical centers is not something that can be erased, but it is something that must be acknowledged. Only by confronting this painful history, alongside addressing class-based disparities, can we begin to build a more just and equitable healthcare system—one that serves everyone, regardless of race, background, or socio-economic status. Until this happens, the distrust and skepticism that many marginalized communities feel toward these institutions will continue to shape the landscape of American healthcare. The path forward requires a concerted effort to address both racial and class-based inequities that have defined these institutions for far too long. The U.S. can, and must, strive for healthcare outcomes akin to those seen in nations that have built systems prioritizing equity and fairness—systems that put human dignity over profit.

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  • Elite Universities With Legacy Admissions (edreformnow.org)

    Elite Universities With Legacy Admissions (edreformnow.org)

    Here is a short list of US universities with legacy admissions. These elite and highly selective schools give preferential treatment to applicants who are related to alumni, which rewards parents, grandparents, and relatives of students rather than rewarding deserving students for their skills and efforts.

    For a more exhaustive list, visit edreformnow.orgThe spreadsheet is here.

    California banned legacy admissions for private colleges in 2024. The practice is also under increased scrutiny in the wake of the recent U.S. Supreme Court ruling against college admissions policies that consider race.

    While it may not be just or fair, the process is not illegal in the
    United States, nor is there much public outcry about this elitist tradition.
    Without insider information, it’s also difficult to know how individual schools use legacy admissions and
    how the murky process operates.

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  • As diversity rates at elite colleges hang in the balance, some students still face increased exclusion and barriers

    As diversity rates at elite colleges hang in the balance, some students still face increased exclusion and barriers

    Diversity rates at several elite colleges and universities have plummeted, a little over a year after the Supreme Court’s restriction on race-conscious admissions. It’s a divisive but unsurprising blow to historically underrepresented students seeking educational opportunity and access.

    While demographic data is still forthcoming, the challenges these students face to attend certain colleges continue to build. MIT, Amherst College, and Tufts have already seen sharp declines in the diversity of their student populations.

    But not all is lost. Ethnically diverse students have options to express their full identities, and organizations providing services to them have options to support these students’ overall success through postsecondary pathways.

    While assessing the state of race in higher education admissions, we cannot ignore its historical context in colleges in America. Colleges and universities were built by and explicitly served the educational needs of wealthy white men. For too long, the only people of color on campus were the (often enslaved) servants of white students.

    We should also bear in mind that, at elite universities today, the students who are overlooked in favor of race-neutral policies are not the only ones who miss out — students already on campus lose out on the richness that having a diverse array of educational experiences can provide, with their opportunities to encounter alternative viewpoints limited.

    Related: Interested in innovations in the field of higher education? Subscribe to our free biweekly Higher Education newsletter.

    Oftentimes, first-generation, Black, Hispanic and Native American students experience an inherent and often unspoken isolation on campus at predominantly white institutions.

    As a Black Chicana, I vividly remember being the singular student of color in my freshman-year seminar at Michigan State. My experience was not without the awkwardness of questioning my own merit and if I belonged there in the first place. We traveled to Ireland, and due to the humidity, I put on my silk bonnet to protect my hair. It was met with questions and stares.

    Here we are in 2025, discussing the all-too-familiar concept of racial bias in America, while institutions are bound by new laws that result in restricted access for the students whose right to educational access has historically been systematically denied. So what can we do?

    While it requires creativity, students can still highlight who they are in their applications by foregrounding their lived experiences outside of their grades, test scores and academic histories. For example, students can share the intricacies of being a historically marginalized person in America — from being asked to speak English to being pulled over for driving while Black. They can write about their experiences and identities in personal statements and on their resumes and through discussions of their community involvement. Students owe it to themselves to share their personal moments of overcoming barriers in everyday life.

    Related: What’s a college degree worth? States start to demand colleges share the data

    Institutions can ask essay questions that provoke such responses and allow students to share without prejudice or fear of reprisal. Students’ insightful perspectives should be applauded by educational institutions, and the power of their words should be respected.

    Underrepresented students also have options other than the traditional elite universities. Historically Black colleges and universities (HBCUs) and Hispanic-serving institutions (HSIs) are an alternative to predominantly white institutions like the ones mentioned above. Students can make the college experience what they want and need, and it is no different at smaller institutions like Lane College, an HBCU, or Colorado State University, Pueblo, an HSI.

    At these schools, a student’s culture and identity are revered and shared. Educational institutions that see the value in diversity should be reconsidered as the best option for ethnically diverse students.

    And, as educational institutions grapple with the effects of the Supreme Court ruling, they should support the students from historically marginalized populations already on their campuses to ensure that they feel welcome, supported and valued. Building robust affinity groups not only provides current students with communities they can co-create and adapt to their needs, but also demonstrates that the institutions are committed to creating spaces for all students.

    Scholarship providers and organizations that support underrepresented students will continue to play a vital role in fostering diversity on college campuses. Mission-driven organizations like the one I work for, the Sachs Foundation, still help Black students who lack the financial capacity or easy access to attend elite schools like MIT and Brown.

    Students deserve to have their whole selves valued, welcomed and supported when applying for higher education.

    Pamela Roberts-Mora is the chief operations officer at the Sachs Foundation, serving Black youth from Colorado through educational and community programs. She was a first-generation college student.

    Contact the opinion editor at opinion@hechingerreport.org.

    This story about college diversity was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for our higher education newsletter. Listen to our higher education podcast.

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