WASHINGTON — Racism is a public health threat that “affects the health of our entire nation,” the director of America’s top public health agency said Friday.
In a statement, Centers for Disease Control and Prevention Director Rochelle Walensky vowed to invest more in minority communities, though she did not lay out specifics. Racism “directly affects the well-being of millions of Americans. As a result, it affects the health of our entire nation,” she said.
Local and state authorities have also increasingly labeled racism a public health emergency, spurred by the coronavirus pandemic, which disproportionately impacted communities of color.
According to a Washington Post report, Black Americans were 37% more likely to die of COVID-19 than Whites, after controlling for age, sex and mortality rates over time. Asians were 53% more likely to die; Native Americans and Alaskan Natives were 26% more likely to die; and Hispanics were 16% more likely to die.
The outsized impact of the pandemic on communities of color laid bare the disparate health conditions among races in the United States, where White Americans’ life expectancy rates are historically higher than Black Americans’.
A recent study in the Proceedings of the National Academy of Sciences found that White Americans’ life expectancy even amid a pandemic surpassed that of Black Americans during non-COVID times.
Experts said that treating racism as a public health problem would help get resources to the communities that need them.
“When one just looks at social economic status as a filter to decide where to allocate resources, that limits the ability of the problem to be solved, because racism is a substantial contributor to the unequal health outcomes and unequal life expectancy,” said Leon McDougle, president of the National Medical Association, a nonprofit that represents Black physicians and patients.
Racism in health can manifests in a number of ways, at both systemic and individual levels, said Ranit Mishori, chief public health officer for Georgetown University and senior medical adviser for Physicians for Human Rights.
Housing, education and other aspects of systemic racism can contribute negatively to the health of minority populations, she said. Because of segregated housing, Black people are nearly four times more likely to die of pollution exposure than White people, according to recent studies.
The cumulative stress of exposure to microaggressions and biased systems, known as the allostatic load, can also affect a person’s health, Mishori said.
“This ongoing and multigenerational assault causes physiological changes — in how certain hormones are released, for example,” she said, adding that heightened stress can also contribute to obesity, high blood pressure and diabetes.
Mishori said that the CDC’s announcement needs to be the first step of a much deeper multisector approach to the issue, given the depth to which racism plays a role in people’s health.
But, she said, the announcement was an “enormous first step.”
“I can’t overemphasize how important it is for the head of the CDC to come up and say as a message from the U.S. government that this is important, this needs to be dealt with,” Mishori said, adding that racism “has been and is and will continue to be a foundational issue affecting millions and millions of Americans’ lives and health.”
But, she added, “awareness is not enough, statements are not enough, they need to be followed with actions.”
Ron Yee, chief medical officer of the National Association of Community Health Centers, welcomed this week’s announcement from Walensky. Two-thirds of the NACHC’s clients are ethnic or racial minorities, he said.
The agency has been implementing a vaccine distribution program that largely targets marginalized populations. Since Feb. 15, it has given out 700,000 doses — and 70% were to racial and ethnic minorities, Yee said.
He said understanding the race-related barriers to health care gets physicians closer to helping solve a client’s illness. He said the announcement is likely to hit home for many of the NACHC’s clients.
“For the public out there and people in these racial or ethnic minorities, it gives them hope that at least somebody is aware,” he said.