By Dominique Kato
The Justice Collaborative Institute published a report last week with recommendations for governments interested in implementing laws declaring racism a public health crisis.
The report, “How Racism is a Public Health Crisis,” outlines racism as a system, and how it is present in education, law enforcement, housing, and healthcare, and provides recommendations for governments looking to declare racism a public health crisis.
In 2003, the Institute of Medicine issued a report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare,” which related racism to access to housing, employment, and mortgage lending.
This report, along with the World Health Organization’s 2008 report on health equity, led to the U.S. Department of Health and Human Services’ Social Determinants of Health Framework (SDOH), which discussed how racial health disparities are a result of inequalities in education, employment, healthcare, housing and law enforcement.
Ten years after the implementation of the SDOH framework, the JCI report states that racial health disparities persist. The report states between 2007 and 2016, Black, Native, and Alaska Native 
women were two to three times more likely to die from pregnancy related causes than white women.
Further, they note that Black people, 65 and up, had higher death rates than white people for all-cause mortality between 1999 and 2015.
The report also argues that current anti-discrimination laws, like Civil Rights Act of 1964 and Equal Protection Clause of 14th amendment, are too narrow to combat the vast system of racism that causes racial health disparities.
While governments have made the efforts to include definitions of racism, and funds to address racism and evaluate community engagement, the report says that “none of the current laws and policies include all these best practices.”
The report says the first step is declaring racism a public health crisis. The report offers five recommendations for governments which are seeking to implement laws declaring racism a public health crisis.
First, laws and policies must identify racism as a system that causes racial inequality in many areas of life, like healthcare, education, employment, etc.
In Manchester, Connecticut, they passed a resolution noting that race has no biological basis, and that racism is a social construct. The resolution defines individual racism, interpersonal racism, internalized racism, systemic racism and institutional racism.
They argue that defining racism as a system moves beyond the current limited framework and allows for solutions crafted to change the system.
Second, in 2016 research showed that it would take 228 years on average for a Black family and 84 years for a Latinx family to gain the same amount of wealth as a white family.
The report recommends that racism cannot be rectified without providing material, institutional, and social support for those communities.
For example, the report recalls Asheville, North Carolina, which in July approved a reparation policy for its Black residents. They created a Community Reparations Commission to “increase minority homeownership and access to other affordable housing, increasing minority business ownership and career opportunities, strategies to grow equity and generational wealth, closing the gaps in healthcare, education, employment and pay, neighborhood safety and fairness within criminal justice.”
Third, governments must use racial equity tools in their decision-making process in order to anticipate and alleviate any disproportionate racial harm.
The Seattle Race and Social Justice Initiative was a city-wide effort to eliminate racial disparities, and follows six steps to guide the “development, implementation, and evaluation of policies, initiatives, programs, and budget issues to address the impacts on racial equity.”
This initiative has led to a majority of employees receiving racial justice training. Further between 2009 to 2011 the city increased money to minority-owned businesses from $11 million to $34 million.
Fourth, in order to dismantle systemic racism, there needs to be collaboration with marginalized communities. They argue that laws and policies must engage community members, with shared decision-making, community involvement, and building alliances throughout each stage.
Further, racial and ethnic minorities must be given equal power in the crafting of these laws and policies, that will address their current needs and past harms.
Washtenaw County, Michigan, for instance, OK’d a resolution requiring community engagement and dedicates their resources to work in solidarity with social movements regarding racial justice.
Fifth, racism will not be addressed without healing.
They refer to W.K. Kellogg Foundation which stated transformational and sustainable change must include “ways for all of us to heal from the wounds of the past, to build mutually respectful relationships across racial and ethnic lines that honor and value each person’s humanity, and to build trusting intergenerational and diverse community relationships that better reflect our common humanity.”
Providence, Rhode Island, has put this in practice with a truth telling and reparations process. This first began with the mayor and a group of advisors to discuss a plan for sharing the state’s role throughout the history of slavery and genocide of Indigenous people.
This was followed by the review of laws and policies that resulted in discrimination of Black and Native people. The last step included plans to bring the community together to discuss “state’s history and the ways in which historical injustices and systemic racism continue to affect society today.” Reparations are then decided.
The report lists many states and counties which have already started to make progress toward racial equity.
Between March and July 2020, 84 cities and towns, and 42 counties, have declared racism a public health crisis. Two state governors have issued executive orders and several federal bills have been proposed, one including the Anti-Racism and Public Health Act of 2020.
The report concludes that putting an end to systemic racism will be a long-term effort, and racial equity and the eradication of harm has been caused by 400 years of racism and won’t end swiftly. And that governments, local and federal, must work to ensure that racial and ethnic minorities are not only treated fairly, but that they also receive the support they need to overcome the harms of the past.
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