Racism as a Public Health Crisis
by Sarah Badawi
At a White House press briefing in April 2020, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, talked about the fact that a disproportionate number of Black people in the United States were dying of COVID-19. This fact has remained true as the pandemic has continued, and it is a trend that applies to all people of color. Though the differences vary by degrees, people of Native American, Asian, Pacific Islander, and Latino ancestry have all suffered greater rates of mortality than white people during the current pandemic.
In his comments, Dr. Fauci noted that sometimes a public crisis highlights a serious, underlying problem in a society. In this case, he pointed out that racial inequalities in health and health care are not new, especially disparities between Black and white people. “Health disparities have always existed for the African-American community,” Fauci explained, “but the crisis is shining a bright light on how unacceptable that is.”
While that light was shining on health-related inequities, protests then spread across the country following the killing of George Floyd by Minneapolis police officers on May 25. Tens of thousands of activists in big and small cities from coast to coast called on public officials everywhere to confront systemic racism. With national attention focused on unequal health during a pandemic and racism, over 60 U.S. city and county governments — in states ranging from Texas, California, and Ohio to Tennessee, Georgia, and Washington — issued declarations that racism is a public health crisis. Wisconsin issued a statewide declaration on June 4, 2020.
By July 2020, state legislatures in California, Michigan, Minnesota, and Ohio were considering their own statewide declarations. At the federal level, similar resolutions were introduced in both the U.S. Senate and the House of Representatives.
Inequalities in Health Care
Major national health researchers have been documenting racial health inequities for years. In fact, because of the inequities, Milwaukee County, Wisconsin, made the first declaration of racism as a public-health emergency in May 2019, followed by the city of Milwaukee in July 2019. Other cities including Kansas City, Missouri, and Pittsburgh, Pennsylvania, soon followed with declarations of their own.
Why is racism itself considered a public-health emergency? Disparities in health quality between white people in general and people of color in general exist, but the disparities facing Black Americans are the most severe.
Overall, when compared to other ethnic or racial groups, African Americans have higher rates of long-term conditions, like diabetes, high blood pressure, and heart disease. These are the kinds of “underlying conditions” that have contributed to Black people getting more seriously ill and dying from COVID-19 at a higher rate than white people. Extensive, widely publicized research has also exposed the fact that Black women — regardless of their level of wealth, education, or health insurance — are far more likely to suffer fatal complications of pregnancy than white women.
Chronic stress is widely known to harm people’s overall health, but psychologists and public-health researchers have documented that exposure to pervasive racial discrimination, as well as the intense coping it demands, is an added daily stress on Black people in our society. The experience of discrimination and racism therefore can contribute to certain brain diseases, speed up the aging process, and harm vascular and kidney functions for Black people and people of color.
Evidence also shows that the experiences of Black people and other people of color with health-care providers are often shaped by those providers’ implicit bias (negative stereotypes and false beliefs). Finally, African Americans, Hispanic Americans, and Native Americans consistently have lower rates of health insurance coverage than white Americans.
A 2013 study for the National Center for Biotechnology Information notes that low rates of insurance can account for why African-American children experience a higher risk of hospitalization and death from asthma than do non-Hispanic white children each year. Parents without insurance or who have non-private insurance cannot afford to buy prescription medications to treat their children’s asthma. They are also more likely to rely on emergency-room care for their children, rather than seeing primary care physicians or specialists.
Declarations and Resolutions
In response to the inequities in health care, local governments and the state of Wisconsin began issuing declarations or resolutions that racism is a public health issue. A declaration or resolution is an official action but is not the same thing as a law. Take a look at the table below to compare and contrast these different types of policy.
Keep in mind that all of these different kinds of policies can come from any level of government (city, county, state, or national).
Declarations and resolutions usually have two parts. The first part is an introductory section often called the preamble. This section includes a number of statements that typically begin “Whereas. . .” These statements provide important facts and background information about the issue at hand.
The second section is the operative part and includes a statement or statements that each begin with something like “Therefore, be it resolved. . .” or just “Resolved . . . .” These statements are the commitments to actions that the governmental body believes should be taken.
Questions for Discussion
- What is the purpose of these city, county, and statewide declarations and resolutions of racism as a public-health crisis or emergency?
- Look at the Milwaukee resolution and the Boston executive order. Do you think these actions can be effective in addressing the problems described in the reading? Why or why not?
This article was originally published as part of Civics on Call, CRF’s series of online, classroom-ready lessons on current events. To access a more detailed lesson plan plus an additional classroom activity, click here.
