Communities recognizing racism as a public health crisis: Declarations grow =========================================================================== * Kim Krisberg ![Figure1](http://www.thenationshealth.org/https://www.thenationshealth.org/content/nathealth/50/10/1.2/F1.medium.gif) [Figure1](http://www.thenationshealth.org/content/50/10/1.2/F1) A protestor holds a sign decrying racism during a police violence protest in New York City in June. The killing of George Floyd in May has drawn new calls to action against racism. Photo by Ron Adar, courtesy SOPA Images/LightRocket/Getty Images When Jen Freiheit stepped in as health officer in Kenosha County, Wisconsin, in late 2019, working to have racism officially declared a public health crisis was on the top of her to-do list. The Kenosha health division led countywide declaration efforts, drawing on an antiracism resolution adopted in 2018 by the Wisconsin Public Health Association and drafting a localized declaration that lays out the county’s stark racial inequities in health outcomes and opportunity. The final resolution, which the Kenosha County Board voted 18-1 to adopt in early August, declared racism a public health crisis and called for policy and procedural action. “It’s vitally important that public health moves away from old practices and learns how to integrate equity and the social determinants of health into everything we do,” said Freiheit, PhD, MCHES, director at the Kenosha County Division of Health. “And clearly, many of those center around racism.” The critical importance of rethinking old practices became apparent a few weeks after the resolution was passed, when Kenosha police shot Black resident Jacob Blake seven times in the back, leaving him paralyzed. The shooting and protests that followed added a heightened sense of urgency to translate the new declaration into practice, said Freiheit, who noted that officials are in the “storming stages of how we put this into motion.” “Right now, we’re fighting two pandemics: “COVID-19 and racism,” Freiheit, an APHA member, told *The Nation’s Health.* Across the country, more jurisdictions are adopting resolutions declaring racism a public health crisis, citing growing research linking racism to poor physical and mental health outcomes, as well as data showing Black Americans are many times more likely than whites to be killed by police. As of November, about 150 states, cities and counties had passed declarations, according to Tia Taylor Williams, MPH, CNS, director of APHA’s Center for Public Health Policy, which last year began tracking and sharing such declarations in an open-access database. Williams said there were relatively few such declarations on the books before the police killing of George Floyd on May 25. However, the combination of his murder and racial disparities in COVID-19 deaths has helped expose the structural nature of racism and accelerated the pace of adoption. “There are people who will view these declarations as purely symbolic — and in some cases, that’s true — but that symbolism is still very important,” said Williams, who noted that the APHA policy center is working on a visualization project to map racism declarations. “For far too long, as a country, we’ve danced around and flat-out denied the impact and existence of racism.” Williams said the declarations can provide a new opportunity to examine structural policies that reinforce inequities, enabling communities to begin dismantling and replacing systemic racism. In Genesee County, Michigan, work is underway to make sure a racism declaration adopted in June is translated into practice. APHA member Kent Key, PhD, MPH, who authored the declaration, said stakeholders in Genesee County — home to the city of Flint, which also passed a racism declaration last summer — had been organizing around racial disparities for years. But he said it was important to see the declaration through a public health lens. “Public health gives us the opportunity to engage and have dialogue around racism from a systems perspective,” said Key, a disparities researcher and faculty member in Michigan State University’s College of Human Medicine. Key is co-principal investigator on the Beyond Rhetoric project, which is working to ensure that the Genesee County resolution goes beyond supportive statements. The project will develop a decision-making Community Action Council, create a strategic plan for eliminating racist policies and practices, and develop a website to widely share antiracist strategies, policies and resources. Lisa Lapeyrouse, PhD, a co-principal investigator on the project, said a major goal is to share what is learned. “If you’re not looking at racism as a systemic problem, then it becomes a lot easier to ignore,” said Lapeyrouse, an associate professor in the Department of Public Health and Health Sciences at the University of Michigan-Flint. To help people nationwide rally support around and advocate for local racism declarations, Salud America released an action kit in June. The kit — which includes model news releases, talking points and social media messages — is based on work in jurisdictions that have already adopted a declaration and will be updated as more communities begin the implementation phase, said APHA member Amanda Merck, MPH, digital content curator at Salud America. By November, Merck said, the action kit had been downloaded more than 350 times. “The declaration is important because so many people still deny the existence of inequities,” she said. “It’s not a level playing field in America. There’s white advantage and racial disadvantage in every city and we need our elected officials to call that out. It’s an important first step toward change.” ![Figure2](http://www.thenationshealth.org/https://www.thenationshealth.org/content/nathealth/50/10/1.2/F2.medium.gif) [Figure2](http://www.thenationshealth.org/content/50/10/1.2/F2) Burlington, Vermont, Mayor Miro Weinberger reads a community declaration of racism as a public health crisis in July. The declaration, cosigned by the Vermont Racial Justice Alliance and more than 30 other local organizations, is one of more than 150 adopted in communities across the U.S. Photo courtesy Office of Mayor Miro Weinberger Many public health agencies have spent years working to advance health equity, so they are well-positioned to act on a declaration when adopted. In King County, Washington, local officials launched an Equity and Social Justice initiative in 2008, formalizing the work via ordinance in 2010. When the county formally declared racism a public health crisis in June — a joint effort led by county executives and the local health department — officials swiftly moved to operationalize its intent, said Matias Valenzuela, PhD, MA, equity director at Public Health—Seattle & King County. While county agencies helped drive the declaration’s passage, it was those living and working in disadvantaged communities who mobilized support to take action against structural racism, he noted. Following the declaration, King County officials proposed a 2021-2022 policy agenda and budget they said was designed to “meet the needs of and implement positive changes for Black, brown and Indigenous people of color.” In particular, the proposed budget includes new investments to divert young people away from the criminal justice system, divestments in incarceration by continuing pandemic-induced limits on jail populations, and funding to create antiracist solutions in partnership with community members. “(The declaration was) an opportunity to take our work to the next level, to really put our money where our mouth is,” Valenzuela said. Back in Wisconsin, about 130 organizations and over 300 individuals have signed onto a racism declaration adapted from the version passed by the Wisconsin Public Health Association in 2018, said Paula Tran Inzeo, MPH, director of the University of Wisconsin Population Health Institute’s Mobilizing Action Toward Community Health Program, which helped launch and oversees the statewide sign-on effort. Marshaling support took substantial engagement, Inzeo said. “No one can do this work alone,” said Inzeo, an APHA member. “Everybody has something to give. Start wherever you are and build on whatever exists.” APHA has also made addressing racism and its effects on health a priority. At APHA’s 2020 Annual Meeting and Expo, racism was at the forefront of conversations and events, including a racism summit and a high-profile session on hate. The Association also adopted an interim policy statement on structural racism as a public health issue, calling on Congress to pass and fund anti-racism legislation. To access APHA’s tracking list of state and local racism declarations, visit [www.apha.org/racism-declarations](http://www.apha.org/racism-declarations). For the Salud America toolkit, visit [bit.ly/saludtoolkit](http://bit.ly/saludtoolkit). > “For far too long, as a country, we’ve danced around and flat-out denied the impact and existence of racism.” > > — Tia Taylor Williams * Copyright The Nation’s Health, American Public Health Association