In the 2020 US election, we can choose a just future.

When US voters go to the polls (what few are left) or attempt to mail our ballots (with what remains of the US postal service) in the 2020 election, we are not simply choosing between two parties or posturing about partisan politics. We are making a choice about the future. On the one hand, are the dangers of white supremacy, authoritarianism, and nationalism—lethal threats to our democracy, our lives, and the viability of the planet. On the other hand, is a rebuke of racist, autocratic politics, and the mandate to create a more equal, just, healthy, and habitable nation and world. The choice is stark and the stakes are high.

In terms of health, the current US administration has intentionally lied about the grave risks of COVID-19, failed to implement a coherent national pandemic strategy, hamstrung and underfunded public health agencies, initiated the process to withdraw the USA from WHO, reversed and weakened health regulations, attacked abortion and contraception access, eroded transgender health protections, and aired racist, anti-Asian, anti-science views.1, 2, 3, 4, 5, 6, 7 Furthermore, the US administration under President Donald Trump has cut food stamps, denied climate change, jeopardised the 2020 Decennial Census, undermined Indigenous sovereignty, imposed discriminatory anti-Muslim travel bans, unleashed federal force on peaceful protesters, openly appealed to white supremacists, and separated immigrant families and caged their children.7, 8, 9, 10

While Black and Indigenous communities, and people of colour more generally, are made vulnerable under the current US administration (panel ), no one is fully immune to its harms. Ultimately, unfettered racism, truncated rights, anaemic protections, and the resource inequities these exposures create shorten lives. Anyone who doubts this needs to only consider the past 9 months.

Civil rights

Undermined voter protections and worsened voter suppression

Rolled back civil and human rights protections, including prioritising conservative religious beliefs over sexual, reproductive, and LGBTQ rights

Climate

Cut Environmental Protection Agency funding and undermined and overturned environmental regulations

Withdrew from the Paris Climate Agreement and promoted coal and fossil fuels, including the Dakota Access Pipeline

Criminal justice

Reinstated the federal death penalty and stalled important criminal justice reforms

Increased prosecutorial discretion and enacted harsher sentences for offences

Economy

Provided multiple tax cuts to the richest Americans and corporations

Before COVID-19, cut food stamps and welfare programmes, and further failed to provide adequate financial support to low-income households and small businesses during the pandemic

Education

Attacked affirmative action, reinforced school segregation, and decreased funding for public schools

Rescinded school discipline reforms that protected Black and Latinx students from criminalisation

Health care

Worked to overturn the Affordable Care Act, discouraged Medicaid expansion, limited Medicaid eligibility, and tried to cut funding for the Children's Health Insurance Program

Attempted to defund Planned Parenthood and undermined federal provisions for family planning and reproductive services

Housing

Dismantled the Obama-era Affirmatively Furthering Fair Housing rule

Advocated for residential segregation

Immigration

Enacted policies to discourage immigrants' use of public benefits, such as food stamps, Medicaid, and welfare

Rescinded humanitarian protections to immigrant families and blocked efforts to grant citizenship to individuals who were children when their parents arrived as undocumented immigrants

Public safety

Worked to undo critical police reforms and encouraged police brutality

Dismissed the threat of domestic terrorism by white supremacists

Home to only 4% of the world's population, the USA accounts for about a fifth of global COVID-19 deaths. Since February, 2020, we have buried more than 215 500 of our beloved neighbours, co-workers, family members, and friends. The age-adjusted COVID-19 mortality rate among Black and Indigenous communities and people of colour in the USA is up to three times higher than among non-Hispanic white populations. Latinx and Black children account for an astounding 74% of COVID-19 deaths among people aged 21 years and younger in the USA. As of Oct 3, 2020, more than 102 200 non-Hispanic white people have also died from COVID-19 in the country. And every untimely death has occurred within the nation that spends more money on health care than any other country in the world. More exposure and less protection—eg, from racism, resource inequities, inadequate housing, and occupational and environmental hazards—not genetic differences, drive premature mortality from COVID-19 and chronic illnesses such as heart disease and cancer.16, 17, 18, 19

To make matters worse, in the face of the nation's cavernous inequalities, widespread economic immiseration, and the highest unemployment rate since the Great Depression, the current administration has proffered a one-time payment of US$1200 to limited households while giving tax breaks to the nation's wealthiest elites.20, 21 Now, up to one in eight US households are food insecure.22, 23 An estimated 30–40 million people could risk eviction in the coming months. And in July, 2020, the US gross domestic product had the largest drop on record. Yet a month later, the stock market peaked. All of this is not a coincidence. It is a consequence of racial capitalism, the profitability of inequality, and the deadly policies of the current administration.25, 26

When it comes to this administration, “it is what it is”. But seeing it clearly is essential. When torrential rain flooded parts of Louisiana, extreme winds decimated parts of Utah, and the US western seaboard spent weeks aflame, it is important to see this administration's enshrinement of fossil fuels as accelerants for climate catastrophe. When Vice President Mike Pence asserted that “We will have law and order” as a condition of a second term of a Trump presidency, it is crucial to see the rise in hate crimes, white vigilante terror, and human rights abuses that have been a condition of the first term of this administration.28, 29 Seeing this clearly prevents tacit acceptance of a dangerous diversion. This type of diversion is how Indigenous dispossession becomes “discovery”, “settlement”, and “Columbus Day”. It is how vigilante mob violence against Black communities become “race riots” with “fine people on both sides”.

In 2020, US voters can choose a just future by first confronting our past. The USA began as a slave-ocracy, built on expropriated land and Indigenous genocide. Its first ruling class were white colonisers. Its first enterprises were powered by slavery and premised on the ideology of white supremacy, environmental exploitation, and systems of governance, voter suppression, and policing that protected the right of the white, male, property-owning class to unilateral social, economic, and political control. This is the bedrock on which the “founding fathers” built their attempt at democracy. It is plutocracy perched atop precarity. The current administration only makes that more evident.

But while the “founding fathers” anchored their fledgling democracy in inequality, the expansion of US democracy owes its fragile progress to many forebearers, chief among them are the Indigenous, the formerly enslaved, and women. Starting from this fuller, more inclusive understanding of who we are as a nation and how we got here, the possibilities for who we can become and where we can go are profound.

Racism saps the strength of the whole of society. And we each live within the limitations of the worlds we build for each other. But another world is possible. Building on that conviction, since May, 2020, Black Lives Matter, a Black-led, multiracial uprising for racial justice, has become one of the largest movements in US history. Together, demonstrators across the country are asserting that our collective losses are not inevitable and our nation's deep grief need not be immutable.

So whether shrouded in a booth or the privacy of our own homes this November, US citizens who can vote must affirm these self-evident truths: white nationalism and authoritarianism imperil democracy; democracy and equality are co-constitutive; equality is essential to health; the social, economic, and political conditions necessary to advance equality safeguard the planet; and thriving societies require sustainable environments and equitable economies. All these issues are on the 2020 ballot. We hope US voters choose a just future.