The symptoms are heart disease, diabetes, cancer, premature birth disorders.
The disease is racism.
The toll is premature death.
The Color of Health: The Devastating Toll of Racism on Black Lives, makes it clear that racism is a public health crisis.
The report from Common Ground Health released July 9 dissects the structural, institutional, interpersonal and internalized racism that negatively affects the economic stability, neighborhoods education, social and community life and health care access and quality in the Black community.
The effects are not felt only by the poor. “Even among those with high incomes and advanced education, Black people in our region face an unfair burden of disease and die earlier than their White neighbors,” the report states.
The language is blunt, calling the rate of chronic illness, mental distress and premature mortality among African Americans “reprehensible.”
This will not surprise people who live with a higher rate of hospitalization for high blood pressure, diabetes and asthma or who die early from homicide or chronic illness.
In fact, The Color of Health builds upon the work of Common Ground Health’s African American Health Coalition and a report issued in 2019 called Overloaded, which looked at the health toll of poverty.
“Reducing illness and early death for communities of color is within our reach, but the science of health improvement is clear: Community health is not determined primarily by biology or the medical system, but rather by the social constraints in which we live,” the report states. “With collective action, we can build a region in which race-based health disparities are relics of a bygone era and wellness is a birthright for all.”
The Color of Health gives several answers to the question, “What can we do?”
But the responses are general, such as supporting the training and hiring of Black health professionals, pushing for racial equity to a strategic priority of boards of directors, and supporting Black-owned businesses and cultural events.
Ways to measure institutional or individual change are not stated.
Wade Norwood, chief executive officer of Common Ground Health, said at a news conference that the ultimate metric is to reduce premature death among Black people. However, the report did not spell out intermediate measures to a goal that could take years. Norwood said continued work in decreasing rates of chronic disease among people of color will translate into longer life expectancy.
The long- and short-term goals require institutions and organizations acknowledging implicit bias and building their policies, practices and procedures on the principle of equity.
Norwood said Common Ground Health would “barnstorm” the region, presenting the facts that he believed make a compelling argument for change.
The solution may lie in getting the institutions and organizations to acknowledge implicit bias and build their policies, practices and procedures on the principle of equity.
Dr. Yvette Conyers, chair of the African American Health Coalition and assistant professor at St. John Fisher College, issued a challenge.
“What are you willing to stand for?” she asked. “What are you willing to be uncomfortable for? From who you’re supporting and businesses in your professional lives, who you’re engaged into at home when your social support circles, are you having the conversations?”
The Color of Health explores each of the levels of racism and how it damages health. One example is internalized racism – defined in the report as an individual’s conscious and unconscious acceptances of negative attitudes about themselves and their racial group. It creates a toxic stress that erodes mental and physical health and lead to unhealthy coping mechanisms.
The report uses the stories of Alvin Simmons, the first person in Rochester to die from COVID-19, and the mental health distress of Daniel Prude as examples of how institutions affect health of people of color. According to the report, Black residents of the Finger Lakes region in 2018 identified mental health as their major concern.
Mental health services, along with maternal and infant health, and diet and nutrition were identified as spotlight issues.
Each — and all, because there is connectedness — must be addressed in context.
“Health equity strategy for Black residents must look beyond the four walls of the medical clinic or hospital and include what happens in the classroom, on the way to school, on the job and in the home,” the report states. “Policies and practices that ensure African Americans equitable access to employment, education, housing and the other social determinants of health are not just good social policy, they are essential investments in public health.”
Rev. Sebrone Johnson, senior vice president of the Urban League, said organizations, institutions and businesses should be challenged to change the name of the report.
“Health shouldn’t be Black or brown or white,” he said at the news conference. “It should not have to be a color at all. It should be a liberty and expectation and assurance, but not with color because as soon as health becomes a color, the ugly and elusive hand of racism touches and destroys everything in the beloved community.
“So the Color of Health report is a clarion call to the community that our very survival and that of our children is dependent on more equitable systems, practices and policies,” he said. “Health should not be a color, but read the report that you will discover that sadly, … it absolutely is. So every organization has gatekeepers. Every community has gatekeepers. Find yours, share this, let’s work to take the color out of health.”