To achieve health equity, we must address racism and address the associated health disparities that are now greatly magnified by COVID-19. NoHLA, along with many others in the health care, advocacy, and public health communities, demands action to address racism and related disparities as they affect health. Here are a few of the groups and individuals speaking out and how they are thinking about racism as a public health crisis. We support their recommendations.

King County Board of Health resolution

Last week the King County Board of Health passed a resolution declaring racism a public health crisis. We agree. It is clear that discrimination transcends all aspects of life – housing, education, employment, policing, and the criminal justice system. 

As part of the resolution, the Board of Health resolves to support King County and Public Health – Seattle & King County immediately in the work to advance a public health approach in addressing institutional and systemic racism.

In discussing the resolution, Board Chair Joe McDermott said:

“The strain of racism that Black, indigenous and other people of color in our community live with every day leads to differences in health and well-being, opportunities for employment, education, and housing, and truly is a public health crisis.”

Congressional Testimony of Dr. Rhea Boyd, M.D., M.P.H.

Pediatrician Rhea Boyd, M.D., M.P.H testified last week before Congress on “The Injustice of Inequitable Disease Addressing Racial Health Inequities amid the COVID-19 Pandemic.” Her written testimony convincingly demonstrates the connection between racism and public health and shows how existing disparities have been exacerbated by the pandemic, concluding:

The injustice of inequitable disease is that it is preventable, unfair, unnecessary and unjust. As such, racial health inequities in COVID-19 reveal the injustice of racism that prevails in American society and that injustice is making people sick. More can and must be done. And the need for action is urgent. We must move to abolish racism, from every institution, every practice, every policy and every social norm in which it operates (and too often hides). The future health and well-being of our children and their children will be measured by how well we succeed in this.

Dr. Boyd’s prescription to eliminate racial health inequities reveals the wide-ranging and intersectional nature of racism and public health. In summary, she recommends that the U.S.:

• Mandate reporting of COVID-19 inequities by race and ethnicity.
• Institute a universal healthcare system.
• Universal COVID-19 testing.
• Mandate universal workplace protections.
• Expand federal and state relief and continue the programs indefinitely.
• Expand access to telehealth services and provide insurance reimbursement for the online visits.
• Expand access to housing and housing supports
• Address the needs of incarcerated populations.
• Expand access to SNAP, WIC and government nutritional programs.

American Public Health Association

The APHA has adopted these Key Principles for Advancing Health Equity:

• Be Explicit! That means naming the groups impacted by equity initiatives and identifying the steps required to eliminate disparities in health.
• Identify and effectively address racism and racial implicit biases.
• Adopt a “Health in all Policies” approach.
• Create an internal organization-wide culture of equity.
• Respect and involve communities in health equity initiatives.
• Measure and evaluate progress in reducing health disparities.

Learn more on the how-to from Creating the Healthiest Nation: Advancing Health Equity (APHA). 

The APHA has also issued a powerful statement about the relationship between law enforcement violence and public health, as discussed in a NoHLA blogpost by Omid Bhageri, MPH and Julianna Alson, MPH. Now, the Black Lives Matter movement is raising these concerns to the fore. We support the close examination of questions raised in that post, including: “How do our budgets prioritize penal approaches over the social structures that support healthy communities? How can funds currently allocated to the criminal justice system be shifted to provide access to health care or housing?”

From Community Catalyst, a national health justice advocacy organization:

People of color, regardless of their economic status, face discrimination within the health system as a result of deeply embedded structural racism. This has created unjust and discriminatory barriers to care that are heightened during a public health emergency like COVID-19, impeding equitable access to treatment and care.

Policymakers must take bolder and more urgent action to make people and communities safe and to ensure everyone, no matter their race, background, or zip code, has what they need to be healthy and to thrive. That starts with acknowledging that racism is a public health crisis, and working in earnest to address it through policies that dismantle structural and systemic racism and promote equity. 

• Police brutality is a public health emergency that has too long gone unaddressed. It creates unsafe communities and undermines the health and well-being of people of color. 
• Congress must intervene and invest in data collection and transparency that enables a full accounting of incidents of racial discrimination in policing in order to build trust with the public. Congress must do more to address the social, economic and environmental factors that shape people’s lives and play a critical role in health by advancing policies that create equitable access to safe and healthy communities, healthy food, affordable housing, good jobs, and transportation. 
• Congress must also work to remove barriers to affordable high-quality health care and coverage for all people across the nation.

Putting it all together in Washington State

Washington State policymakers must systemically address issues at the intersection of structural racism, public health, health disparities, and the current pandemic. Legislators may be tempted to look at the state’s challenging budget situation caused by this crisis and conclude that we cannot avoid making cuts in health care and human services. But this will only exacerbate racial disparities. On the contrary, the crisis demands that we push in the opposite direction, by redirecting existing resources and making new investments that focus on addressing longstanding inequities.

–Janet Varon, NoHLA Executive Director, and Huma Zarif, NoHLA Staff Attorney