Communities Across the State Declare Racism as a Public Health Crisis, the State Considers It

Milwaukee County in Wisconsin was likely the first local government entity in America to declare racism a public health crisis in April of 2019, citing the health gap between Black and white Americans. Record-setting unemployment, a global pandemic, and a nationwide reckoning with racial justice has now prompted many communities nationally to follow Milwaukee County’s example. In Ohio, several cities and counties recently adopted resolutions attesting that racism is a public health crisis, and both the Ohio House and Senate are considering non-binding resolutions in this vein. Here is an overview of what these resolutions mean and more detail on what is happening in Ohio communities.

How is Racism related to Public Health?

Multiple public health studies have reached the same conclusion: you are more likely to have health problems if you are Black; the root cause of these health inequities is racism.

No matter how you slice health data, there is a racial component that demonstrates a worse outcome for Black residents, even after accounting for class and poverty. Nationally, Black women are up to four times more likely to die of pregnancy related complications than white women. The average life expectancy of African Americans is four years lower than the rest of the U.S. population. Black children are twice as likely as white children to develop asthma. Although African Americans represent only 13% of the U.S. population, they account for nearly half of all new HIV infections. Studies have even begun to identify negative health effects from the accumulated stress caused by racism and discrimination, like this editorial from the New England Journal of Medicine which notes that discrimination and racism produce “disproportionate burdens of disease on Black Americans and other minority populations,” in regard to the effects on the human brain.

Recently, new data shows that Black and Latinx residents have been three times as likely to become infected with COVID-19, and nearly twice as likely to die from the virus as white people.

In Ohio, the poverty rate for Black Ohioans is more than double the rate for white Ohioans. Black Ohioans are more likely to die of heart disease, stroke, diabetes, and cancer compared to other racial groups. Black infants die at nearly three times the rate of white infants, and the infant mortality rate (the number of babies that die before reaching their first birthday) has been increasing among African Americans.

Health inequities are largely caused by unequal distributions of power and resources, which manifest in unequal social, economic, and environmental conditions, also called social determinants of health. Racism comes in to play because racism is a systemic and institutional driver of the inequal distribution of power, which unfairly disadvantages Black populations. The results of generations of racist policies go beyond the assumption that health disparities result simply from a lack of resources; studies have found that at all socioeconomic levels, people of color suffer poorer health outcomes. Recent statements from the American Public Health Association and the American Medical Association add to the legitimacy and timeliness of this issue.

What does Declaring Racism a Public Health Crisis Accomplish?

Under guidelines from the Centers for Disease Control and Prevention, cities who declare a crisis are required to act to eliminate disparities in public health. Supporters of resolutions declaring racism a public health crisis argue that the resolutions set the tone for local leadership. Acknowledging racism as the underlying cause of health disparities puts a name to the problem and creates an avenue to hold leadership accountable.

Many of the ordinances/resolutions identify the need to address generational disparities in education, jobs, housing, health care, home environment, transportation, and quality of life. For example, in Montgomery County, their resolution reaffirmed funding commitments that go towards programs that tackle racial equity and income disparities. Yet beyond commitments to forming work groups, which create the opportunity for impacted community members to work alongside experts to guide future investments and planning, these declarations haven’t prescribed any specific actions.

Nevertheless, immediate action isn’t the primary intention of these declarations. In Milwaukee County, leaders took time to get the infrastructure built to begin crafting policies to reduce the racial health gap in their community. To date, top and middle managers in county government have undergone training to address racism and bias. They county has also designed a “racial equity” budgeting tool to frame investments by their impact on racial equity. The tool was implemented nearly a year after the county’s declaration.

Which Ohio Communities Have Acted?

Below is a list of cities and counties in the state who have declared racism as a public health crisis, in chronological order by the date the resolution passed. At the time of publication, Knox County, and the cities of Green and Mansfield are considering their own resolutions.

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Franklin County (May 12, 2020)

  • Commits to create an equity and justice-oriented organization to identify specific activities, policies, and procedures to embrace diversity and incorporate anti-racism principles across the agency, leadership, staffing, and contracting

  • Continues ongoing racial equity training with the goal of reaching all Board of Commissioner agency leadership and staff, while also encouraging the same training among all community partners, grantees, vendors, and contractors

Columbus (June 1, 2020)

  • Committed to honestly and directly addressing minority health inequities, including a systematic, data-driven focus on poverty, economic mobility, and other factors that impact the social determinants of health

Cleveland (June 3, 2020)

  • Declares racism to be a public health crisis and announces plans to establish a working group to promote racial equity in the City of Cleveland

Akron (June 8, 2020)

  • Creates a task force, whose chair is selected by the mayor and Summit County Public Health Commissioner. The task force will develop a five-year “Equity and Social Justice Strategic Plan”

South Euclid (June 8, 2020)

  • Commits to remove some discriminative laws and makes adjustments and penalties to actions related to law enforcement and racial justice

Summit County (June 14, 2020)

  • Creates a Special Review Committee, which will determine how best to promote racial equity

Montgomery County (June 16, 2020)

  • Promote equity and health equity through all policies approved by the Board of Commissioners and enhance educational efforts aimed at addressing and dismantling racism, and understanding how it affects the delivery of human and social services, job training and employment access, and economic development through:

    • Development of a new stand-alone “Career and Innovation Center” at the Westown Shopping Center on West Third Street in Dayton

    • Commit existing and additional resources to the Montgomery County “Micro-Enterprise” Grant Program targeted to small, minority, women, and veteran-owned businesses

    • Commit targeted Economic Development resources to minority and disadvantaged neighborhoods in Montgomery County

    • Commit to address safe, affordable housing opportunities in the Black community

    • Continue to address food insecurity, nutrition and food access

    • Commit existing and additional resources to reducing infant mortality and increasing maternal vitality in the Black community

    • Continue to, within applicable state law, provide greater access to local and diverse contracting, wherever possible

  • To always promote and support policies that prioritize health and wellbeing of all people, especially racial and ethnic minorities, by mitigating exposure to adverse childhood experiences

    • Continue and expand the Male Leadership Academy, which was established as a pilot program in 2019

    • Establish a Female Leadership Academy to serve young women in the community

  • Continue already existing racial equity and implicit bias training with the goal of reaching all Board of Commissioners staff

Canton (June 16, 2020)

Dayton (June 17, 2020)

  • Commits to adopting an “anti-racist lens” in creating new city policy

  • City Commission will work with regional entities to create plans of action addressing a variety of issues where racism negatively impacts the outcomes of Black and brown city residents, including food access, education, economic opportunities, and law enforcement

Lorain County (June 17, 2020)

Youngstown (June 19, 2020)

Lima (June 22, 2020)

Warren (June 24, 2020)

  • Commits to initiative a racism task force to deal with racial disparities in the city, looking at employment, education, health care, housing, and crime

Elyria (June 24, 2020)

Piqua (July 7, 2020)

  • Commits to the formation of a Diversity Committee to better engage in research and information sharing on social, economic, and health disparities between different racial populations

Cuyahoga County (July 7, 2020)

  • Requires an Equity Commission to review county policies and programs, and a Citizens Advisory Council on Equity to review and provide recommendations to reduce disparities between Black and white residents in the county

Hamilton County (July 16, 2020)

  • Includes several enhancements within the branches of Hamilton County, including active bystander, implicit bias, and crisis intervention training for the Office of Hamilton County Sheriff

  • Changes the name of the Hamilton County Office of Economic Inclusion to the Office of Economic Inclusion and Equity, and expands the office’s cultural engagement with underprivileged communities

What about the State of Ohio?

Both the Ohio House and Senate are currently considering non-binding resolutions to declare racism a public health crisis. The Senate Health Committee has held two hearings so far, and the House State and Local Government Committee has yet to start hearings. Wisconsin is so far the only state to have declared racism as a public health crisis.

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