States are Calling Racism a Public Health Crisis — Here’s Why
Over the past six months, cities and counties in 20 states have officially declared racism a public health crisis, and the list is growing. But what exactly does that mean?
While there is no formal consensus on the definition of a public health crisis, most public health experts agree that a problem must negatively affect the health of a large number of people over the long-term and require the adoption of large-scale solutions to be considered one.
“Whatever the technical threshold is, or definition is, racism clearly meets the definition of a public health crisis,” Ashish Jha, dean of Brown University’s School of Public Health, told Supermajority News. “[Racism] causes very substantial burdens in peoples’ lives and has effects on their long-term well being.”
Overall, the average life expectancy of Black Americans is four years less than the rest of the U.S. population. Studies have shown excess deaths soar above 80,000 annually among Black Americans compared to their white counterparts. Black Americans are more likely to die from heart disease, stroke, cancer, asthma, and diabetes than white Americans, and Black women are up to four times more likely to die of pregnancy related complications than white women. More recently, the COVID-19 crisis has highlighted these health disparities: studies show that Black Americans have been falling ill and dying from COVID-19 at higher rates than white Americans.
“Life expectancy is different depending on if you’re black or white in the U.S.,” said Gregg Gonsalves, epidemiologist and professor at the Yale School of Public Health.
Dr. Georges Benjamin, executive director of the American Public Health Association, took the connection a step further: “Health inequities at their very core are due to racism,” he told Pew Research in June.
But why is this? According to experts, social determinants play a major part in health outcomes, especially when it comes to social constructs like race.
“Health is not only biologically determined, it’s socially determined,” said Gonsalves. “We’ve known for a long time that health is not just about bodies and viruses and bacteria. Health is really dependent on socioeconomic and political factors.”
These social determinants include macro and micro effects of systemic oppression and racism like generational trauma, mass incarceration, air and noise pollution, access to safe drinking water, neighborhood walkability and safety and the toxic effects of long-term stress.
“A lot of things that affect the health of people are not driven by the traditional medical model,” said Jha. “Your environment, where you live, your education and the quality [of it],” are some factors, she said, as are “your income and your job, all of those end up having a very profound effect on your health so all of those things together are called the social determinants of health.”
According to the American Psychological Association, the stress associated with racism increases the risk for several chronic conditions like heart disease disease, diabetes, and both inflammatory and autoimmune disorders.
“Your life expectancy can be as far as ten years apart depending on where you live,” said Gonsalves when explaining the lingering effects of redlining, a longstanding discriminatory practice that denied Black Americans access to mortgages and loans. Though redlining was banned in 1968, Gonsalves said these long-term social and economic policies are still determining health close to a century later.
Add in a racist health care system where only five percent of physicians identify as Black, Black populations get sicker and have less access to health care when they do experience the negative effects of racism.
“We spend more on health than anyone on the planet, and we have terrible outcomes,” said Gonsalves. “People get sicker here, and a lot of it has been [because of] social policy.”
Though declaring racism as a public health crisis is just a first step towards addressing it, health experts believe it’s an important first step.
“Noting racism is a public health crisis acknowledges the enormous toll racism takes on human health, the many lives impacted, and the scale at which intervention is necessary,” Rhea Boyd, a pediatrician and advocate in the San Francisco Bay Area, told Supermajority News.
“You can’t really solve it unless you can name it,” said Jha. “As long as we guise it under palatable terms like ‘disparity’ without naming racism as the root cause, we can’t address it…I think some of the reason we haven’t made as much progress with racial disparities in public health is that we have not talked about racism as openly as we need to and talking about it won’t solve it, but talking about it is a really important step to solving it.”