Podcast transcript: Declaring racism a public health crisis
Listen to this interview as a recording on our podcast page.
This is The Nation’s Health Podcast. I’m your host, Aaron Warnick.
In 2018, the Wisconsin Public Health Association adopted a resolution declaring racism a public health crisis, committing to work toward change. The APHA-affiliated association inspired cities and counties in the state to take up similar declarations. Following the 2020 police killing of George Floyd in neighboring Minneapolis, Wisconsin Gov. Tony Evers also declared racism a public health crisis.
Since then, equity and social justice advocates across the U.S. have picked up the call to action, passing almost 200 declarations at the state and local level. APHA’s Center for Public Health Policy is supporting that work by tracking and sharing the declarations on an interactive online map.
The Nation’s Health’s Lindsay Syms discusses that work with center Director Tia Taylor Williams.
Hello. OK, so very first question, a little broad, just so that we can get it going: What are some of the ways public health can address systematic racism?
It's a really good question. So, in public health, we have to prioritize and invest in earning the trust of, and developing authentic relationships with, the communities we serve. This includes creating opportunities for the community to lead the direction of public health interventions and policies. And for those of us working in public health, this means that sometimes we have to abandon our own agenda and really listen to what communities have to say — what they see their challenges versus what we see as their challenges, and what also what they see are their priorities and their assets.
Public health has to have its own reckoning and truth-telling about how the field itself has perpetuated the very inequities that we aim to address. And this is, in large part due to, you know, our reluctance to name and address racism for a long time. We've ignored it as a driving force for the social determinants of health. And we know that racism and social determinants have a greatest influence on health across the lifespan.
We're at a place where in many, you know, many public health organizations and jurisdictions across the country are doing this uncomfortable work of examining and transforming systems policies and processes that are inherently biased. We have to make racial equity an essential consideration in all of our decisions about policies and programs, and we have to stop treating equity as a separate program. Whether it's the pandemic response, a nutrition program, a chronic disease effort or something in environmental health, racial equity really needs to be a lens that gets applied across all of that.
Can you explain how declaring racism a public health emergency might help to address these problems?
As long as I've been in public health, which is almost 20 years, we skirted around using the word racism. We talked about race as a contributing factor to health inequities. We talked about disparities, which are important, and then we shifted to a bit more upstream to talking about health equity.
But for a long time, racism was not specifically named as the driving force for those inequities or as a contributing factor to health, to health equity. In the health community, particularly health care and health research, we focus on the so-called biology of race, as the driver of health disparities and inequities, but we really know is that the inequitable outcomes, the disparities that we see are the result of racism, and not race.
With these declarations, jurisdictions are making a public and historic acknowledgement that not only does racism exist, but also that it's a major driver of health outcomes and that it has to be addressed now.
And looking at these declarations that are being made, you and your team have been making this map project. Can you tell me more about that, and what are some goals you have for this project?
In summer 2020, with the uprising over police brutality, the movement for Black lives, the racial reckoning that the country was going through, APHA started tracking as jurisdictions across the country began to claim racism a public health crisis. Initially, it was just for our own internal purposes, but we quickly learned that the field was really interested in staying updated on these declarations and we were positioned to meet that need.
We converted our list that we have been regularly updating (to) a map that we launched in February of 2021. The map allows you to see geographically both the spread and the concentration of declarations across the country. It contains adopted declarations. We are tracking declarations that are pending and in process, but only the ones that have been adopted are represented on the map.
It includes declarations that both the city state and county level and also declarations that have been passed by different types of entities. More states are considering making similar declarations that is a part of their legislative session. On the map, you can also see the number of declarations within a state, and a list of all those declaring entities, and we also link to the resolution itself wherever it can be found.
Overall, this map is a really great resource for seeing how many jurisdictions across the country are making these declarations. We hope to be able to add more information to the map that ultimately might allow jurisdictions to compare with similar jurisdictions in terms of size, and maybe some other kind of demographic features or indicators.
We're also working to build out resources so that as people are coming to our page — they are shown based on their location — resources for how to make a declaration, what should be included in a declaration, and then resources for those declarations for those jurisdictions and localities that have already made the declaration. How they take it from a declaration into implementation.
Is there anything else you would like to mention about this project or systemic racism that we haven't touched upon yet?
I would say that we have to acknowledge that there's no roadmap for this work necessarily. There have been many efforts over centuries to address civil rights and to address racism.
But the work that's happening now, is uncharted and it's not easy and it's not comfortable. And I think we have to get comfortable with the discomfort that comes from doing this work and recognizing that it's not going to be easy. It's not going to be straightforward and simple.
People like to ask, “What's the one thing that can be done?” or “What are the top five things that can be done?” And that really looks different for every community based on what the challenges are. There's also a lot of great work that's happening at the local level, especially that can be lifted up and that other cities and counties can learn from, recognizing that this work is complex, and that (it’s) transforming a system that took over 400 years to build. That doesn't happen overnight. I think there needs to be recognition of that across the board and public health.
And with that, we thank Tia and Lindsay for their conversation on this critical topic.
To access the map, visit APHA.org/racism-declarations. For our continuing coverage of public health work on racial equity, visit TheNationsHealth.org.
Thank you for listening to The Nation’s Health Podcast.