Re: Declaring Racism to Be a Public health Crisis in California

Dear Governor Newsom,

I write on behalf of the California Pan-Ethnic Health Network (CPEHN) and the undersigned organizations to urge you to immediately issue an Executive Order to declare racism to be a public health crisis in the state of California. We appreciate the remarkable leadership that you have demonstrated in California’s COVID-19 pandemic response, uplifting and uniting a cross-sectional group of leaders and experts: the very leadership that is needed for a broader anti-racism conversation in the Golden State.

CPEHN was founded in 1992, following the Rodney King police beating and subsequent outcry in Los Angeles, to unite African Americans, Asian and Pacific Islanders, Latinx and Native Americans in our fight for health equity. Over the last 28 years, our organization and partners have worked to reduce health disparities for Black, Indigenous, and Persons of Color (BIPOC) and to improve health systems for all Californians. Since the onset of the COVID-19 pandemic, we have witnessed the brunt of the COVID-19 pandemic fall on Black, Native American, Latinx and Pacific Islanders in California. In these past few weeks, we have joined the nationwide outrage over the deaths of Breonna Taylor, Tony McDade, George Floyd, Ahmaud Arbery and countless more Black lives lost to police violence, white supremacy and systemic racism. We are outraged at the lack of progress in racial, economic and health equity in the last nearly three decades, but also are hopeful that this is a historic moment for all of us to implement the bold and broad changes that will finally make a difference.
 
Prior to 2020, the impacts of systemic racism, not race, on public health and health disparities have been well-documented. For instance, amongst all race/ethnic groups in California, African Americans have the lowest life expectancy, the highest burden of disease from preventable cause, and the poorest access to mental health care. Compared to their white counterparts, Black children are five times more likely to have an emergency department visit due to asthma, Black women four times more likely to die from childbirth, and Black men ten times more likely to be imprisoned. Our communities have been exercising their right to public assembly and protest against the same racism that perpetuates inequities in our physical and mental health. Meanwhile, racism is attacking and threatening our already underfunded public health infrastructure, putting all Californians at risk during the COVID-19 pandemic. Our communities need justice, reform, and healing now. We urge the state declare racism to be a statewide public health crisis, which would serve as an important first step in the state’s acknowledgement of its own racist history through the present day, and would establish specific commitments and measurable actions for beginning to undo the racism that prevents all Californians, especially BIPOC, from achieving optimal health and well-being.

California should follow in the footsteps of local governments and public health leaders nationwide.
A growing list of city and county jurisdictions across the nation are declaring racism to be a public health emergency or crisis. In responding to the nationwide civil uprising following the murder of George Floyd on May 25, 2020 by former police officers in Minneapolis, Minnesota, many local governments have made declarations and/or passed resolutions on racism as a public health emergency and/or crisis. These include the cities of Columbus, Cleveland, Akron, Canton, Dayton, Mansfield and the counties of Summit, Montgomery, Lorain in Ohio, the cities of Sommerville, Medford, Boston, Worchester, Everrett, Springfield, Holyoke, and Chicopee in Massachusetts, the city of Indianapolis and the county of Marion in Indiana, Anne Arundel County and the City of Montgomery in Maryland, the cities of Flint and Port Huron, and the counties of Ingham, Genesee and Jackson in Michigan, Jackson County in Missouri, the city of Denver in Colorado, Hudson County and Leonia Borough in New Jersey, King County in Washington, Dallas County in Texas, Mecklenberg County in North Carolina, and the City of Windsor in Connecticut . Statewide resolutions have been introduced in the Ohio and Michigan state legislatures. Even prior to current civil unrest, counties of Madison, Dane and Milwaukee in Wisconsin, the city of Pittsburgh and Allegheny County in Pennsylvania, Cook County in Illinois, and Franklin County in Ohio already had made declarations that racism is a public health crisis and committing to anti-racist actions.

Here in California, following the current civil unrest, the City Council of Goleta, the City Council of Santa Barbara, the City Council of San Luis Obispo, and the San Bernardino County Board of Supervisors have also passed resolutions declaring racism as a public health crisis. This list increases every week.

Common elements across these declarations and resolutions include:
  • acknowledging the effects of intergenerational racism on population health, especially anti-Black racism,
  • assessing governments’ internal policies and procedures with a racial equity lens,
  • advocating for laws and regulations that center and promote racial equity,
  • ensuring inclusivity and diversity in leadership, workforce, hiring and contracting,
  • promoting educational efforts to address and dismantle racism,
  • identifying clear goals and objectives including specific benchmarks to assess progress, and
  • securing adequate resources for anti-racism activities.
It is also worth highlighting that Franklin County, Ohio, Flint and Port Huron, Michigan and Denver, Colorado have passed resolutions that include:
  • building partnerships and alliances with local organizations that are actively confronting racism,
  • engaging actively and authentically with communities of color, and
  • promoting all policies that prioritize the health of people of color.

We encourage California to review, adapt and adopt similar action steps as part of a statewide declaration of racism as a public health crisis.

Public health and health care leaders around the nation have also spoken out and issued statements about racism and public health in response to police violence and protests. For instance, the Director of Public Health in Los Angeles County expressed that racism is a public health issue and that “injustices play out every day” with the COVID-19 death tolls she reports. The American Public Health Association stated discrimination lies “in all aspects of life, including housing, education, the criminal justice system and employment,” and urged the dismantling of systemic racism through “brutally honest conversations, policy changes and practices.” The American Medical Association Board of Trustees vowed to “actively work to dismantle racist and discriminatory policies and practices across all of health care.” The American Academy of Family Physicians spoke about the costs of racism in generating tens of billions of excessive medical costs and loss in productivity every year, and vowed to develop “a family medicine workforce as diverse as the U.S. population.” The Institute for Healthcare Improvement acknowledged that it would be “in a state of ‘becoming’ anti-racist because this work requires lifelong commitment and vigilance.”
The Golden State should strive to be bold, unequivocal, and strong through a declaration that racism is a public health crisis and committing to specific and measureable anti-racism actions.
 

We thank you for stating the need for institutions to change and that California is “capable of being more and doing better” than merely issuing a statement. We hope California continues to lead the way for the nation in its fight against systemic racism. While we hope such declaration will lead to a broader conversation engaging all sectors of our society, CPEHN and partners do not wish to know or provide all the “solutions” at this time, given that real solutions for anti-racism should take much deeper self-reflection and deliberation and ongoing investigation for and consultation with those directly impacted. However, we do hope to offer a few strategies that we believe are urgent to consider now.

  • Put people first by engaging with directly impacted communities: A top-down strategy in racial justice reform will miss the point as it overlooks the experience, history, voice and power of community members and leaders. The state’s reflections and actions must include directly impacted communities at the table in order not to further perpetuate systemic racism and harm. We urge the state to actively and effectively listen to and consult with directly impacted communities, including building allyship with organizations such as the Movement for Black Lives, when debating decision-making around police, jail, housing, public education and health reforms in California. Conversations around police reform should eliminate inherent conflicts of interest such as police and police unions. The “people first” principle should apply to all steps in the state’s journey to becoming anti-racist, as well as in ensuring an equitable and effective COVID-19 recovery.
  • Prioritize public health by recommitting its purpose and securing resources: The current moment will be a chapter break in history books for California, and a particularly urgent and critical time for our public health system. California’s public health system now has a dual crisis intervention job, not just in fighting a deadly global pandemic, but in fighting to “ensure the conditions in which people can be healthy,” which remain fundamentally under threat from systemic racism. The state’s public health and health systems have a moral and ethical obligation to intervene when the life and basic security of Californians are under attack, as well as when broader systems and conditions such as public education, employment and housing security are jeopardized. As an urgent first step, we call on the state’s public health system to immediately intervene on violent, racist and discriminatory acts at all levels. The state must denounce such acts including those currently being perpetuated by institutions such as by law enforcement, and acknowledge and remediate the acute and long-term adverse health consequences police violence has caused Black and Brown Californians, who are simultaneously living through a deadly global pandemic. Additionally, we urge the state to ensure that local public health departments are equipped with adequate funding and resources while they work around the clock to protect and promote the right to health for all Californians.
  • Reflect on internal and external policies and procedures with an anti-racism lens: In almost all established resolutions and declarations, the local governments resolve to undergo an assessment and examination of their own policies and procedures with a racial justice lens. We recommend that the State of California conduct thorough reflections and examinations of its leadership, policies, programs, hiring, workforce development, contracting, and more in order to correct for its complicity in perpetuating racism and advance racial equity across all departments and sectors. We ask the State of California to work with its health departments to conduct a thorough investigation of all forms and levels of racism, discrimination, violence and injustices in California’s past and present. We encourage the state to communicate the process and results with the public in a transparent and timely manner.
  • Re-invest in community health and healing through ongoing budget, legislative and administrative actions: Racism in all of its systemic, institutional, structural and interpersonal forms must be counteracted with resources dedicated to anti-racism efforts at all levels. This does not mean more resources are needed, but rather, the state should divest and redirect its budgetary, legislative and administrative power and resources to racial equity-centered principles, policy changes, and practices. For instance, the state should divest from mass incarceration and policing and reinvest in community health, mental health and public health programs that are proven effective in reducing health disparities for BIPOC Californians. Additionally, the state must call upon all county and local governments to adopt anti-racism principles, and dedicate budgetary commitment to the healing and health of impacted communities.
In conclusion, CPEHN and the undersigned organizations urge you to immediately issue an Executive Order to declare racism to be a public health crisis in the State of California. Such declaration only serves as an important first step to broader commitments and measurable actions towards an anti-racist state. We recommend intentional and transparent consultation with directly impacted Californians and community leaders in decision making around police reform and jail reform that will center racial equity. We call for immediate public health intervention against current racist, violent, and discriminatory acts at all levels including by law enforcement. We encourage deep reflection on the state’s internal and external policies and procedures with an anti-racism lens. We urge concrete state and local budgetary commitments to reinvest in community healing and health. The current moment calls for nothing less.

With respect, 

Kiran Savage-Sangwan
Executive Director
California Pan-Ethnic Health Network

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