The idea of viewing racism as a public health problem has gained traction during the coronavirus pandemic.
Cities have begun to cite the concept and to connect the dots between racism and the health of communities of color.
It has become impossible to ignore how longstanding policies and practices have contributed to bad health outcomes and thus to greater vulnerability to COVID-19 — and to more deaths.
Racial discrimination has played a role in housing policies, banking practices and how school district boundaries were drawn. It plays a role in access to public transit and fresh foods and in the creation of safe sidewalks and parks.
Together, such policies and practices created better health outcomes for one set of people than for others.
It’s never too late for San Antonio to recognize those inequities and chart a course toward fairness by budgeting with an “equity lens” — allocating public funds to compensate for decades of neglect and poor services in minority neighborhoods.
On Aug. 7, City Council’s community health and equity committee unanimously approved a resolution declaring racism a public health crisis and calling for racial justice to be a fundamental part of all city policies and programs.
Next week, the full council will discuss whether to pass the non-binding measure and join a growing list of governments in recognizing what science long ago confirmed: that racism has disproportionately affected the health of communities of color.
The concept of connecting racism and public health is still relatively new. Amelie G. Ramirez, who directs UT Health San Antonio’s Institute for Health Promotion Research, says the trend goes back only five years.
And it has met with some resistance. Ramirez pointed to an article in Stateline, a publication of the Pew Charitable Trusts, in which Dr. Leana Wen, an emergency physician and a public health professor at George Washington University, said that after the death of Freddie Gray in Baltimore police custody in 2015, “I said routinely that poverty was a public health issue, and most people understood.
“Then I talked about violence as a public health issue and about half of the people I spoke to agreed. But when I talked about racism as a public health issue, almost no one agreed.”
Three years ago, Milwaukee County became the first to declare racism a public health crisis, swayed by experts at the University of Wisconsin Population Health Institute, Ramirez said.
The American Public Health Association says that between 2017 and June of this year, 24 city councils, mayors, governors, statehouses and school boards adopted resolutions like the one before San Antonio City Council.
The list now stands at 120.
“It’s the right thing to do,” said Rogelio Saenz, a professor of demography at the University of Texas at San Antonio who has tracked the under-counting of COVID-19 cases among Latinos. “If the city goes back to business as usual, we haven’t accomplished anything.”
Getting a direct return from the well-intended resolution won’t be easy.
It would help if voters, in November, approve Mayor Ron Nirenberg’s proposal to use $154 million in sales tax revenue to pay for job training and college education for people thrown out of work by the pandemic.
Another way to advance the resolution’s aims would be to redirect some of the money now spent on policing to community-based service programs. Saenz said they should focus on basic needs, including affordable housing and blunting the threat of gentrification.
Five months into the coronavirus pandemic, San Antonio residents — regardless of color — feel weighed down by business closures and job losses.
Others feel the weight of working from home while also serving as their children’s teachers.
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Imagine that weight compounded by constant “racial battle fatigue,” Saenz said, using a phrase meant to describe the mental, emotional and physical stress that racial discrimination inflicts upon people of color every day. It has been linked to hypertension and heart disease.
In San Antonio, the genesis of the council resolution lies with Councilwomen Jada Andrews-Sullivan of District 2 and Ana Sandoval of District 7.
Sandoval said the concept of racism as a public health problem was solidified for her in bold statements in an alumni email from Michelle Williams, a renowned epidemiologist and dean of the Harvard T.H. Chan School of Public Health.
Sandoval, who holds a master’s degree from the Chan School, invited Williams to speak with her during a Facebook forum. The dean obliged because her husband, aviation safety expert Todd Curtis, has San Antonio roots.
Racism as a public health issue may still be relatively new, the councilwoman said. “But it’s a sleeping giant.”
A resolution won’t solve it. “But it states we have an issue.”