Individual and systemic racism affects virtually every aspect of public life. It is especially pervasive in medicine and public health. Being Black, indigenous, or a person of color (BIPOC) can be harmful to your health.
The U.S. Congress and several local and state governments have declared racism a public health crisis. While these declarations are not legally binding, they convey that racial and cultural justice is necessary to safeguard all citizens’ health. Racism at individual and societal levels negatively impacts vulnerable populations’ mental and physical health. It also prevents members of marginalized groups from receiving equitable and adequate healthcare.
Understanding why racism is a public health emergency can shed light on the health-related harms of racism and bigotry. It also stimulates efforts to remedy the injustices and improve the general health of all Americans.
Why Is Racism a Public Health Emergency?
A public health emergency occurs when the effects or consequences of a public health threat are pervasive enough to overwhelm the organizations and facilities responsible for responding to it. In most cases, policymakers and community leaders cannot legally enforce emergency declarations. Nevertheless, they serve as a call to action to review and revise current policies and practices that allow the emergency to permeate.
Racism erodes the quality of medical care and public health. The Centers for Disease Control and Prevention (CDC) defines racism as the coordination of policies, institutions, and structures that “assigns value and determines opportunity based on the way people look or the color of their skin.” Racism as a system can occur when it is legally sanctioned or held up without formal regulation, resulting in unfair advantages and disadvantages for specific groups.
Medical racism is embedded in many testing, diagnosis, and treatment recommendations. Some diagnostic tests include algorithms that include race as a factor and are often based on outdated notions or beliefs about certain racial groups. For example, a race-based point adjustment in scoring on a heart disease assessment could result in African American patients with risk factors not being correctly diagnosed.
On a systemic level, racism denigrates the overall health of the United States and puts undue burdens on the healthcare system. Research shows that ethnic minority groups in the United States disproportionately suffer more from asthma, diabetes, heart disease, hypertension, obesity, and other chronic conditions. African Americans have an average life expectancy lower than other groups by four years. African American women are four times as likely to die of pregnancy-related problems.
Racism also deprives hospitals, clinics, and medical facilities of diverse talent. Racial disparities hinder opportunities for doctors, nurses, therapists, and other professionals of color to participate equally in the healthcare community.
The Impact of COVID-19
BIPOC individuals in the United States have experienced higher rates of COVID infection, hospitalization, and death than their white counterparts. Non-Hispanic Indigenous Americans and Alaska Natives are 2.5 times more likely to require COVID-related hospitalization than non-Hispanic whites. Also, African Americans and Hispanics are twice as likely to go to the hospital because of COVID.
The increased attention to race-based health disparities has spurred many communities and agencies to declare racism a public health emergency. In 2018, Milwaukee County in Wisconsin became the first government to make such a declaration. On April 8, 2021, the CDCfollowed suit. In the same year, Congress passed the Anti-Racism in Public Health Act.
Last December, Andrew Do, a Republican member of California’s Orange County Board of Supervisors, proposed a resolution declaring racism a public health crisis. Supporting the resolution, Democratic Chair Doug Chaffee stated, “Experiencing racism has been associated with increased risk for numerous mental and physical chronic health conditions, like heart disease, cancer, asthma, stroke, Alzheimer’s, diabetics (sic), and suicide.” Although the resolution saw resistance from some community members, the board passed it unanimously.
What Does It Mean to Declare Racism a Public Health Emergency?
Declarations and resolutions are not legally binding or enforceable. However, they call attention to pressing public health and safety threats and can inspire significant action.
Declaring racism as a public health emergency is far more than symbolic. It outlines the problems resulting from biases and discrimination in healthcare. Recognizing racism as a systemic phenomenon helps to make broad changes in education, support services, policies, and practices. Declarations inspire action steps for community leaders and public health experts to revise current policies and enact new measures to fight racism.
The American Public Health Association (APHA) examined public health declarations in communities across the United States. The APHA found that the most frequently included tenet recommended promoting equity in all policies and procedures related to healthcare, health education, and community outreach. Equity promotion also involves reviewing existing policies to identify and remedy elements that intensify racial and ethnic inequalities or propagate implicit bias.
Improving Location-Based Access
States and counties can scan local medical facilities, service providers, and shelters to identify groups with limited access to care due to location. Such geographical examinations can help communities plan the expansion of much-needed services to reach more populations.
Collecting and Maintaining Data
Communities can collect local and regional health data, including illness and injury rates and service utilization. Analyzing the data can identify significant trends, and reporting key findings can alert authorities to oversights and redirect resources where needed.
Enhancing Community Engagement
Mitigating racism’s effects on public health also requires implementing programs that engage BIPOC individuals and incorporate diverse viewpoints. Initiatives that educate and provide essential services also need leaders representing the communities that need and receive these services.
Training and Education
Healthcare providers, educators, and volunteers need adequate training in diversity and inclusion. Training also must address preventing racist practices in healthcare delivery and personnel issues like hiring, promotion, and performance evaluation.
To individuals and groups who do not regularly experience racism or bias, recognizing the health effects of discriminatory practices and policies can be difficult. Nevertheless, improving the health and well-being of all Americans requires dismantling systemic racism and making health-based systems more equitable and just for everyone.
Research and materials for this article were compiled, written, and distributed on behalf of the National Public Health Information Coalition. The views and opinions expressed in this blog are those of the various authors and do not necessarily reflect the official policy or position of the National Public Health Information Coalition or its members.