On May 25th, public attention shifted away from the COVID-19 pandemic when George Floyd was killed by a policeman kneeling on his neck for almost 9 minutes during an arrest. The recent killings of Breonna Taylor and Ahmaud Arbery, and a video clip of a white woman falsely accusing a Black man of assaulting her in Central Park, demonstrate the racial injustice that persists throughout the United States. These recent events have resulted in a groundswell of collective outrage and grief across the country and again brought the issue of systemic racism to the forefront of America’s consciousness.

SJBPH shares in the outrage and grief expressed by local, regional, and national communities and we commit to having the hard conversations needed to not only acknowledge the public health impacts of systemic inequities, but to take real action to counter the processes and systems in place that support these injustices.

While white people built wealth equity in this country, people of color have had to fight for basic human rights. From slavery to the Indian Removal Act to the New Deal era housing loans to minimum mandatory sentencing laws, racial inequity has been consistently written into U.S. law. These are but a few examples of the inequity of U.S. law and illuminate how it is not just individuals but institutions that further the issues we see today. Racism is foundational to the United States distribution of power and mandates a racial hierarchy that shows up in policing, immigration, education, housing, and healthcare.

Public health agencies witness the very real impacts of racism evidenced in the health disparities experienced by Black, Indigenous, and People of Color (BIPOC) populations. Achieving health equity, defined as everyone having the opportunity to reach their highest potential of health, is a foundational goal of public health. The entire population achieving optimal health requires the recognition that there are barriers such as race, sexual orientation, gender, income, and geographic location that make it harder for certain people to achieve equality than others. Working to achieve health equity means supporting systems and services that address inequality and actively work to dismantle ideologies or programs that result in the unequal treatment of people.

Biological factors do not create disparities. Individual and institutional racism is what perpetuates inequality. BIPOC are more likely to experience lower-quality healthcare, have less access to resources such as education or housing loans, and to experience prejudice in their workplace. These experiences create toxic stress in people of color, directly impacting their health by leading to high blood pressure, heart disease, and strokes. A recent study from Auburn University found that the sustained stress of racism experienced by Black Americans can even lead to cellular aging.

The current COVID-19 outbreak further illustrates patterns of racial disparities. Black Americans experience the highest overall mortality rates and the most widespread occurrence of disproportionate deaths from COVID-19. The latest overall COVID-19 mortality rate for Black Americans is 2.3 times as high as the rate for whites. In May the Navajo Nation had the highest per capita COVID-19 infection rate in the country, attributed to issues of disparity such as lack of access to testing and health care resources, high rates of poverty, and lack of running water and electricity.

It is not surprising for those of us in public health to see COVID-19 data revealing racial disparities that exist in this country. Addressing these disparities requires a two-pronged approach.  Reducing the spread of the virus requires public health tactics of communicable disease prevention and investigation that bear resemblance to what was done during the 1918 pandemic. Ensuring that COVID-19 does not impact people differently based on their race though requires more innovative, long term tactics that confront embedded systems of oppression.

“Not everything that is faced can be changed, but nothing can be changed until it is faced.” James Baldwin