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Advocates: Racism Requires Public Health Response

Patti Singer

Jerome Underwood speaks at a news conference in June of the Black Agenda Group and La Cumbre about racism as a public health crisis. Photo by Patti Singer/Minority Reporter Media Group

During the Black Docs for Black Lives rally on June 13, Dr. Linda Clark called out a litany of ills that erode Black health and shorten Black lives.

She cited problems with housing and transportation, and chronic stress contributed to higher rates of diabetes and high blood pressure. She added jobs that are on the front lines of the COVID-19 pandemic and the disproportionate toll of the disease in the Black community.

“We’re tired,” Clark told the crowd at Washington Square Park. “And we’re sick. We’re sick and tired and we want equity.”

The demand is not new, but the approach to changing systemic and institutional racism has a different tack: addressing inequity in health.

In May, the Greater Rochester Black Agenda Group issued a declaration titled Racism is a Public Health Crisis.

For decades, public health has been thought of as making sure communities have clean drinking water, restaurants are inspected and schoolchildren are vaccinated.

The eight tenets of the Black Agenda Group’s declaration expand expectations.

Racism is a Public Health Crisis states that public health’s responsibilities to addressing racism include “reshaping our discourse and agenda so that we all actively engage in anti-racist and racial justice work.”

Problems that affect large numbers of people, that threaten health over a long period of time and that require large-scale solutions are considered the realm of public health. Racism and its effects on physical and mental well-being are not among the 10 most important health problems listed by the Centers for Disease Control and Prevention. Those problems include heart disease, motor vehicle injuries, teen pregnancy, tobacco use and nutrition, physical activity and obesity.

Since release of the Black Agenda Group declaration, organizations such as Foodlink, the College at Brockport and the Breast Cancer Coalition of Rochester have pledged support for change.

“The declaration hopefully is not a surprise to anyone,” said Jerome Underwood of the Black Agenda Group. “What spurred us was the disparate impact of COVID-19. But the disparities have existed for a very, very long time.”

African Americans continue to make up a disproportionate number of those hospitalizations, according to the Monroe County Department of Public Health. As of June 15, African Americans had an age-adjusted hospitalization rate of 255.2 per 100,000 population. As for deaths, African Americans had an age-adjusted rate of 60 per 100,000.

The age-adjusted hospitalizations among Latinos was 143 per 100,000 population and the death rate was 55 per 100,000.

The age-adjusted hospitalization rate among Whites was 48 per 100,000 population and the death rate was 23.8 per 100,000.

Data on illness and death among Black and Latinos have been reported by Common Ground Health’s in What’s Going On? and Nuestra Salud respectively from the African American and Latino health coalitions. In November, Common Ground released Overloaded, a report that laid bare the toll of poverty on health – an effect described as death by ZIP code.

Underwood said the Black Agenda Group expected individuals and organizations “to see this as a pivotal moment. For people to look inside their own chest, inside their own organization and say what am I doing or what are we doing that either directly or indirectly assists systemic and structural racism.”

Black Agenda Group has been advocating for several years. Underwood, chief executive officer of Action for a Better Community and co-chair of the Rochester-Monroe Anti-Poverty Initiative, said it’s not about creating another organization.
It’s about intensifying efforts for change. Health is seen as a result of policies that affect housing, employment, education and transpo rtation.

“You can’t legislate somebody’s love and care for somebody else,” he said. “But you sure can hold them accountable if they lead an institution in this community and they’re doing a disservice by allowing the kind of disparate impact.”

The declaration states that race is a social construct and that racism “is a system that creates structures of opportunity and assigns value based on the social interpretation of how one looks, that unfairly disadvantages some individuals and communities, while unfairly providing advantages to other individuals and communities, and saps the strength of the whole society through the waste of human resources.”

Signing onto the declaration is a start, Underwood said. “But what are you doing to commit to … change practice, policy and advocate on behalf of bringing down the walls of racism.”

Seeing racism through a health lens focuses on the fact that where people live, work and play is reflected in their overall health. The declaration states, “Racism causes persistent racial discrimination in housing, education, health care, employment, criminal justice, business, and economic mobility. There is an emerging body of research that demonstrates racism as a social determinant of health.”

Dr. Edith Grannum, president of the Monroe County Medical Society, said that signing onto the declaration should not be an act of political correctness but one of moral imperative.
She said that people likely know what needs to be done, but they fall back into implicit bias and comfort in the familiar. “We need to change the system in the community and … act on the right things.”

Wade Norwood, chief executive officer of Common Ground Health, said having the Black Agenda Group address health differences is another way to bring attention to racism. He said most people in the city already know about the issue.

“How do you change hearts and minds of the outer ring suburbs to do this? … My daddy used to say, ‘if people knew better, they’d do better.’ What we have is a whole bunch of folk who still don’t know.”

COVID-19 may have brought long-needed attention to differences in health related to social and economic status. People working to promote awareness of disparities said it’s not the first and won’t be the last.

“When the next thing comes, are we going to have disparate impact to Black and Brown people again?” Underwood asked. “Probably, if we don’t do something right now. What fundamentally are we going to change? Is someone going to say, listen, next time here’s where we’re going to deploy our resources first because we know the most vulnerable people are on the northeast side of Rochester?”