Addressing racism as a public health crisis: next steps

The Minneapolis City Council, led by Council Vice President Andrea Jenkins and Council Member Phillipe Cunningham, is following other cities and counties in declaring racism a public health emergency. Approving this resolution [PDF] was a first step in acknowledging pervasive structural racism within Minneapolis institutions as a driving force in the lack of safety, premature loss of life, and health inequities experienced by Black and brown communities.

A deep body of research links experiences of racism and the associated stress and trauma to changes in the body and brain that profoundly impact the well-being of Black people in particular. Racism contributes to health disparities in Minnesota between Blacks and whites, including early death, doubled infant mortality rates, and a heavier burden of chronic diseases. It is clear that, while individual microaggressions and explicit racism are a piece of this, racist policies and institutional practices perpetuate inequities at a structural level.

For example, Minneapolis has a troubling history of racial covenants on property deeds and redlining policies, which made home ownership for Black Americans unattainable. This intentional disinvestment led to racial and residential segregation, lower wealth accumulation, under-resourced schools, fewer parks and underfunded community and material resources. Racial inequities compounded across these social determinants directly impact the health and vitality of all our communities. These inequities are not limited to Minneapolis or the metro region.

Communities across Minnesota are continually being asked to do more with less, while the wealth and opportunity gaps further divide us. The Minnesota Legislature has failed to support necessary systemic changes, but we cannot ignore an international outcry to re-imagine a collective system of community safety and care. These injustices are fueled by silence and inaction. Therefore, we must take action and start by naming racism as a public health emergency. Doing so is a necessary yet insufficient step that commits us to the long-term work of dismantling those structures, policies and practices that contribute to, and sometimes directly cause, senseless and tragic loss of life.

The impact of racism on the health and well-being of the nation is not new, but we need to be more intentional in our response to yield deeper self-reflection and commitment to action.

The COVID-19 pandemic shows us that when we allow structural racism to go unrecognized and unchallenged, health and wealth disparities increase. The murder of George Floyd at the hands of Minneapolis police officers and violent militarization in response to protesters, locally and nationally, exhibit deep structural inequities in our institutions.

Members of the Program in Health Disparities Research (PHDR) Community Academic Board stand with Black, Indigenous, and People of Color (BIPOC) leaders, and applaud the City Council for passing the resolution identifying structural racism as a public health emergency. We need to then take the next steps to enact anti-racist policies that actively advance equity, prioritizing resources to:

• Ensure everyone is able to exercise their right to physical and mental health, and access to quality health care to sustain the well-being of one’s own body without discrimination.

• Develop, improve, and reaffirm education and training that prepare students and professionals with knowledge and skills to expose the role of inequity as it relates to each discipline under study.
• Dismantle and re-imagine the current criminal justice system and militarization of public servants that lead to mass incarceration of children and teens, Black, indigenous and people of color, people with mental health disorders, and impoverished people.

Communities across the state have shown deep compassion and willingness to come together in response to recent state sanctioned violence – we now must turn that compassion into action. We recognize that racism prevents everyone from achieving their highest quality of life. We know racism is dehumanizing. Anytime we allow a person or group to be treated as less than human, it becomes easier for the next group to be harmed. Our humanity is attacked, even as bystanders.

We cannot be complicit. May we all realize that we are in this together and act accordingly.

Andrea Jenkins is the vice president of the Minneapolis City Council. Sida Ly-Xiong is the chair of the Program in Health Disparities Research Community Academic Board. Michele Allen, M.D., is the director of the Program in Health Disparities Research at the University of Minnesota Medical School.

The following members of the PHDR Community Academic Board also contributed to this commentary: community members Maria Arboleda, Deatrick LaPointe, Antonia Wilcoxon, Tamiko Ralston, Luis Ortega, Clarence Jones, Huda Ahmed, and Bilal Alkatout; and U of M members Sue Everson-Rose, Maiyia Kasouaher, Mikow Hang, Carolyn Bramante, Sarah Gollust, and Rachel Hardeman.

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