United States history is rooted in structural racism that continues to oppress minority populations today. It pervades all our social, economic and political systems. As COVID-19 disproportionately affects Black, indigenous and people of color (BIPOC) and police violence perpetuates devastation to families and communities of color, local governments across the country are acknowledging racism as a public health crisis through public declarations.
As more localities sign resolutions, we want to better understand the social, economic and political effects these declarations may have on local communities, states and the nation. In watching this trend progress, we wondered, “Will these declarations make a difference?” We spoke with the following experts to hypothesize about the short- and long-term impacts of these resolutions:
- Claudia Wilson Randall, associate director of the Community Development Network of Maryland, who focuses on membership development, peer learning and capacity building; housing counseling and communications.
- Hillery Tsumba, director of Organizational Strategy at the Primary Care Coalition, who leads the communications, human resources, advocacy and government relations, and fund development functions within the organization.
- Vinu Ilakkuvan, founder and primary consultant of PoP Health, LLC, a woman and minority-owned business based in Fairfax, Virginia, that provides a range of consulting services to strengthen and support multi-sector community health improvement.
Municipalities across the nation have voiced concerns about the detrimental effects of racism on the health, wealth and sociopolitical power of racial minorities. All three experts agreed this initial acknowledgement of the problem is a good start. Randall said their declarations signal a change in the conversation about racism in America.
“I look at these declarations like representations in art,” Randall said. “Kehinde Wiley — the artist who painted Obama’s portrait in the National Gallery — paints portraits of black men and women … [that] allow us to imagine a different world and see … potential through depiction. Similarly, these declarations are the beginning of communities seeing the humanity of Black people.”
Alongside sociocultural change, the statements also hold the potential for promoting political change. The city declarations indicate legislatures and administrations are “beginning to recognize the effects of racism on [health] outcomes” and will be “more deliberate in addressing racism” moving forward, Tsumba said. However, she added that the amount of lasting structural change these declarations bring about depends on the “motivation and political will” of those making them. In Montgomery County, Maryland, where Tsumba works, councilmembers followed their declaration with action by allocating $600,000 to expand the county’s Mobile Crisis Outreach Teams with additional staff to respond to mental health emergencies.
Conversely, some municipalities’ declarations simply acknowledge the issue. For example, in Youngstown, Ohio, councilmembers described their declaration as a crucial “first step” towards racial equity. Commissioners in Mecklenburg County, North Carolina, admitted that their proclamation is “largely symbolic.” These declarations, unbacked by real plans for change, are what Ilakkuvan described as “surface-level actions.”
“Sometimes, surface-level actions are purely performative and selfishly motivated, and other times, they are important first steps in learning, in acknowledgement, in representation. Either way, what we need to remember is that they are far from sufficient. We must pursue changes to the policies, systems and environments that underpin structural racism. Otherwise, merely stating that ‘racism is a public health issue’ is meaningless,” she said.
To meaningfully address structural racism, Ilakkuvan explained that municipalities can dedicate resources and infrastructure to action, commit to policy and system changes, and create detailed racial equity plans.
Some municipalities have already taken steps to create structural change:
- In Boston, Mayor Walsh plans to reallocate $3 million of the Boston police department’s overtime budget towards public health, form a task force to review police use-of-force policies and propose a transfer of $9 million from the police towards housing and counseling initiatives.
- Minneapolis plans to allocate funding, staff and resources to address and repair the damage of systemic racism through actions like law enforcement reform.
- In Seattle, the King County Board of Health’s resolution includes a commitment to “assessing, revising, and writing its guiding documents and policies with a racial justice and equity lens.” Board members must complete racial equity training, engage with and respond to communities impacted by racism, establish racial equity principles and work towards anti-racist policies and practices.
- Cleveland’s resolution requires the city to follow CDC guidelines to eliminate health disparities.
- San Bernardino, California, established an “equity group.”
- Anne Arundel County, Maryland, initiated data collection to understand the connection between race and health outcomes.
- Akron, Ohio, will create a task force to develop a five-year “Equity and Social Justice Strategic Plan.”
- Columbus and Franklin County, Ohio, and Indianapolis, Indiana, stated their intent to understand and study the underlying issues of racial inequity.
When asked how these declarations could impact public health, Tsumba pointed to behavioral health care. Problems related to behavioral health and substance use disorders often result in police intervention despite the fact that law enforcement officers are not the best suited to address behavioral health concerns. She hopes to see less dependence on law enforcement and increased funding for mobile crisis teams that send licensed counselors to respond and de-escalate incidents.
The CRISES Act, a California bill that would allow community organizations to act as first responders in certain emergency situations, has gained significant public support in the past few months. The movement to divert funding away from police and towards social and health services is also gaining support from many Americans. Through these changes in the roles and funding of law enforcement, we could see improvements in public health and less police violence in the cities that are actively responding to the racism crisis.
Although many cities have shown signs of progress this year, our experts argued that other sectors must also work to create lasting structural changes. Tsumba indicated the importance of anchor institutions and community-based organizations in contributing to societal change. She explained that all organizations must provide ongoing training on structural racism and implicit bias. Hospitals and health systems in particular should educate practitioners on the role of racism in medicine, both historically and presently.
In addition to training and education, Ilakkuvan expressed the importance of leveraging resources to address the root determinants of health and referenced key practices that healthcare systems should follow to dismantle structural racism. Banks and financial institutions also have a responsibility to engage in anti-racist practices. She explained that these institutions should stop predatory and discriminatory lending practices, invest in Black-owned businesses and promote economic revitalization and community development in predominantly Black communities.
As the anti-racist movement continues to grow, organizations and institutions across all sectors must continue to build upon the goals and intentions they have established. Tsumba argued that organizations must also focus on “examining their own policies and procedures to think about how they might perpetuate structural racism.”
Ilakkuvan echoed this idea, stating, “The question we should be asking about any policy or system is whether it produces results that are unequal by race. If so, there is need for change.”
While the upsurge of declarations and plans to address racism is a sign that municipalities are striving towards this change, only time will tell if public health’s focus on race and racism will transcend to meaningful impact.
- Advancing Racial Equity in Your City
- Racism Has a Cost for Everyone
- The 10 Commitments Companies Must Make to Advance Racial Justice
Karen Kali is NCRC’s senior program manager for special initiatives.
Marjanna Smith is an NCRC special initiatives intern.