Declaring Racism a Public Health Crisis in the United States: Cure, Poison, or Both?

Abstract

Declaring racism a public health crisis has the potential to shepherd meaningful anti-racism policy forward and bridge long standing divisions between policy-makers, community organizers, healers, and public health practitioners. At their best, the declarations are a first step to address long standing inaction in the face of need. At their worst, the declarations poison or sedate grassroots momentum toward anti-racism structural change by delivering politicians unearned publicity and slowing progress on health equity. Declaring racism as a public health crisis is a tool that must be used with clarity and caution in order to maximize impact. Key to holding public institutions accountable for creating declarations is the direct involvement of Black and Indigenous People of Color (BIPOC) led groups and organizers. Sharing power, centering their voices and working in tandem, these collaborations ensure that declarations push for change from the lens of those most impacted and authentically engage with the demands of communities and their legacies. Superficial diversity and inclusion efforts that bring BIPOC people and organizers into the conversation and then fail to implement their ideas repeat historical patterns of harm, stall momentum for structural change at best, and poison the strategy at worst. In this paper we will examine three declarations in the United States and analyze them utilizing evaluative criteria aligned with health equity and anti-racism practices. Finally, we offer recommendations to inform anti-racist public health work for meaningful systematic change toward decentralization and empowerment of communities in their health futures.

Implicit-Bias Remedies: Treating Discriminatory Bias as a Public-Health Problem

“…Paine et al (2021) took note of the rising frequency of declarations of racism as a public-health crisis, analyzing three of them using “evaluative criteria aligned with health equity and antiracism practices” (para. 1).…”

“…Specific procedures are described only in the "Training" section, which states that employees in all state departments and agencies should be required "to complete implicit bias training." Paine et al (2021) took note of the rising frequency of declarations of racism as a public-health crisis, analyzing three of them using "evaluative criteria aligned with health equity and antiracism practices" (para. 1).…”

Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine

“…31 Concerns of "performative allyship" in antiracism training have been previously raised. 19,20 As such, the importance of action, beyond training, is critical. However, we are encouraged by the number of Chairs that reported implementation of antiracist practices or policy changes.…”

Racism as Public Health Crisis: Assessment and Review of Municipal Declarations and Resolutions Across the United States

“…Although not a comprehensive review and only includes those on Twitter and willing and able to respond, some of the responses included the formation of an equity committee to execute new work, a new police oversight commission, and Washington, DC passed the REACH Act with five key components such as racial equity impact assessment, processes for accountability, and development of a commission (34,35). Additionally, one recently published review of three declarations of racism as a public health crisis found that while the declarations are an important first step, tremendous harm was also done (36). This includes publicity and attention to politicians while undermining existing community or grassroots anti-racism efforts (36).…”

“…Additionally, one recently published review of three declarations of racism as a public health crisis found that while the declarations are an important first step, tremendous harm was also done (36). This includes publicity and attention to politicians while undermining existing community or grassroots anti-racism efforts (36).…”