Now that the director of the Centers for Disease Control and Prevention has called racism a “serious public health threat,” public health experts are watching closely for the impact.
“It’s an appropriate statement but some might say it is overdue,” said Paul Halverson, founding dean of the Richard M. Fairbanks School of Public Health at IUPUI.
The declaration’s premise may not be offering any new revelations. But the fact that the CDC is saying it out loud is what’s new and promising, according to experts like Halverson.
CDC Director Dr. Rochelle Walensky made the declaration earlier this month. She said the agency would boost resources to address health disparities that affect Black Americans and other groups.
Her statement came after 1,400 CDC employees signed a letter asking the agency to declare racism a public health threat last year. The employees also called the agency out for what they described as lack of diversity and inclusion within its own ranks.
According to Halverson, statements by public health officials -- especially the high-profile CDC director -- usually serve as a compass for agency priorities. Walensky’s statement could also reflect how much funding the federal government will designate for key issues.
Indiana ranks near the bottom in public health spending, studies show. In turn, Hoosiers have some of the nation’s highest rates of chronic diseases and preventable health conditions.
John Auerbach, president and CEO of Trust for America’s Health, said using a racial equity lens to direct spending on preventative public health measures is crucial. And it’s one way to tackle long-standing health disparities facing Black and Hispanic communities.
“We see a disproportionate impact that's affected people of color, largely as a result of the barriers to optimal health that result from systemic racism and multi-generational poverty,” he said. “Where even when people are doing their absolute best to live a healthy life, it's challenging... because of the obstacles they face.”
Another important step is developing systems that collect up-to-date, accurate demographic data, Auerbach said. A recent CDC report shows that race and ethnicity data is known for only 55% of vaccine recipients nationwide.
“Similarly, the data that are routinely collected for public health, reportable illnesses around the country, often does not include the race and ethnicity of the person even though that's a required field in all of the materials,” he said.
Data collection is one of the most important steps in knowing where funding needs to be directed, both on a federal and local level according to Auerbach.
Locally, there have been similar declarations about racism. In June 2020, as Black and brown communities were being hit hardest by the pandemic, the Indianapolis City-County Council declared racism to be a public health crisis.
Dr. Virginia Caine, director of the Marion County Public Health Department, said that declaration shined a bright light on systemic racial barriers. And that meant local officials were committed to “frank and open discussions of race … and racial inequities in our communities.”
“We are hoping that these discussions will be integrated into the daily work of companies and agencies,” Caine said.
She wants to ensure that local officials work to eliminate policies and procedures with “any implicit and explicit racial bias and develop, instead, policies and procedures that will build up racial equity.”
Similarly, in October 2020, three major health systems -- Community Health Network, Eskenazi Health and Indiana University Health -- pledged to “do more to end health disparities.”
Since then, IU Health has set up training for healthcare providers on racism and inclusion and piloted programs aimed at increasing healthcare access. One of those programs offers free transportation in collaboration with ride-hailing apps, so Hoosiers in underserved communities can get a COVID-19 vaccine.
Community Health Network is working with churches and community groups to provide information on vaccines. It also set up vaccine clinics in neighborhoods hit hardest by the pandemic, where healthcare access is a challenge.
Eskenazi Health, meanwhile, is expanding its primary care sites to neighborhoods with the highest health disparities.
Local declarations help give researchers and academics direction when studying the pandemic’s impact and its relation to race and socioeconomic conditions. For instance, Halverson said last year IU studied the prevalence of COVID-19 and public health officials allowed researchers to work with minority communities to understand the pandemic’s impact.
“It was a very, very important study," he said. "In fact, it was sort of groundbreaking because it was the first study in the country that actually measured the actual true prevalence of the disease.”
Still, these declarations are no guarantee that a certain issue will receive more funding or lead to changes in Indiana communities.
For the most part, Congress establishes how the CDC and other federal agencies allocate their funding. They have some discretionary money and Auerbach said states like Indiana need to make sure they are “applying for as many federal grants as possible.”
In the meantime, public health experts believe that such declarations by leaders are a step in the right direction -- and the first thread in unraveling a complex, multi-layered web of problems.
This story was reported as part of a partnership between WFYI, Side Effects Public Media and the Indianapolis Recorder. Contact Farah Yousry at fyousry@wfyi.org. Follow her on Twitter @Farah_Yoursrym.