Racism Has Always Been A Public Health Issue
By Hani Mohamed
“ The strain of racism that Black, indigenous and other people of color in our community live with every day leads to differences in health and well-being, opportunities for employment, education, and housing, and truly is a public health crisis. Our action today places anti-racism, already a cornerstone of the work of Seattle-King County Department of Public Health, at the foundation of the Board’s policies and programs that reach across every community in Martin Luther King Jr. County.”
King County Board of Health Chair, Joe McDermott, released this statement as a result of the approved resolution which declared racism as a public health crisis. This declaration honors and recognizes the impact of racism on our community and provides an opportunity to center the conversation on identifying solutions that can improve equity and end racism. Oppressive systems and racism continue to create disparities in access to services, education, economic attainment, and life expectancies for communities of color. In 2020, COVID-19 intensified this spotlight to highlight how communities of color are disproportionately impacted by COVID-19 - often driven by underlying disparities, including the degree to which communities of color experience higher rates of underlying health conditions and are less likely to have access to quality health care.
COVID 19 is an example of racism as a public health issue. As of December 13, 2020, King County has a total of 54,632 confirmed cases. This can also be understood as an age-adjusted rate of 2,453.9 cases per 100,000 residents. Testing is recommended to anyone with mild COVID-19 symptoms. The Daily COVID-19 Outbreak Summary provides testing data in King County. At one point, due to shortages across the nation, COVID-19 tests were only available for residents who were at higher risk. It is important to consider questions such as: Who has access to COVID-19 tests? Is racial bias impacting COVID-19 testing? Are testing sites located in neighborhoods where communities of color also receive the necessary supplies needed to safely administer tests? The rates of positive cases for communities of color in King county are higher than the rate among whites (1,014.1 per 100,000). The rate of confirmed cases is the highest among Native Hawaiian/Pacific Islanders (5,239.8 per 100,000), Hispanics (4,875.1 per 100,000), American Indian/Alaska Natives (278.6 per 100,000) and Black/African American (240.9 per 100,000). Through December 13, 2020, there have been a total of 935 deaths due to COVID-19 (1.7% of positive cases) and deaths are highest among Native Hawaiian/Pacific Islanders (139.3 per 100,000) and Hispanics (85.8 per 100,000) compared to Whites (35.5 per 100,00). Furthermore, people of color are more likely to be essential workers, this coupled with the prevalence of underlying health conditions puts these communities at higher risk compared to Whites.
Disparities by health and income for communities of color compared to white populations are not new. America has a long history of racism which is outlined in the following blogs:
· Tracing the Roots of Difference: A Blog Series
· Fredrick Douglas Fourth of July
Unfortunately, data has often been used as a tool to perpetuate harm. Historically, data was used against communities of color through practices such as redlining which limited black residents' access to housing in certain neighborhoods by allowing mortgage lenders to deny loans due to the racial identity of the applicant. In addition, hiring practices based on algorithms make it difficult for communities of color to seek employment. Redlining led to the deterioration of urban minority communities with impacts that are reflected in neighborhoods today that lack safe housing and are less likely to have access to quality food as well as other health and social resources. Data algorithms can also perpetuate harm. For example, some hiring is informed by software that determines qualifications based on applicant characteristics. In addition, data and tools that police use are based on demographic information such as age, gender, race, material status, and criminal record to help determine the likelihood of criminal activity in a neighborhood. Many of these tools rely on data sets with a racial bias and using these types of tools extends that bias to many individuals and communities. While data can be used to harm, data can also be used to break down silos and issues to light. The killing of George Floyd sparked protests all over the United States and the rest of the world. One person tracked the protests following the murder of George Floyd and this data helped convince some journalists to view local protests differently.
It is important to include community narratives and historical context with quantitative data for a more comprehensive understanding. For example, quantitative data can show that people of color are disproportionately represented in the criminal legal system. However, this data alone does not show the systemic reasons why people of color are over-represented. This data should include narrative that also describes the oppressive systems, historical practices, and individual stories (such as how policing and other oppressive practices impact communities) to help contextualize data about disparities in the criminal legal system. Equipping communities with the knowledge and resources to advocate for more access to high-quality data can help support a community’s journey and effort to further equity and champion for social justice.
Photo Credit: Nasrin Afrouz