Ending Structural Racism’s Impact on Health in Communities of Color – Public Health’s Role

Dr. Martin Luther King, Jr. called health injustice “the most inhumane form” of inequality.

As the nation recognizes Dr. Martin Luther King Jr., Day and the National Day of Racial Healing, Trust for America’s Health (TFAH) is reflecting on how the public health sector has and can continue to overcome barriers to optimal health caused by the historical and contemporary effects of structural racism. These barriers include long-standing policies, investment and funding patterns, and laws that continue to limit access to safe housing, quality education, employment, healthcare, and even healthy and nutritious food in many communities of color. The result is, on average, higher rates of chronic disease and lower life expectancy for people of color. These inequities will continue to have serious health and economic consequences for the entire country if not fully confronted.

Changing this narrative starts with anchoring discussions with the truth about the impact of racism and working collectively to heal and advance racial equity. Increasingly, the public health field is acknowledging the negative effects that racism has on individuals’ and community health and is working across communities to find solutions, including:

• Making explicit declarations and official policies addressing racism’s impact on health. The Centers for Disease Control and Prevention (CDC) and more than 200 states/cities/government agencies have adopted resolutions recognizing racism as a public health crisis.
• Implementing health-promoting programs with a particular focus on communities at high risk for poor health outcomes, such as strengthening maternal health for Black women and increasing vaccine access for communities of color.
• Advocating for comprehensive, privacy-protected health data collection and data that can be disaggregated to understand the health status and needs of specific populations.
• Developing and advocating for policies and programs that target the social determinants of health, such as strengthening the Health Equity and Accountability Act, ensuring universal access to school meals and making them more nutritious, and expanding access to healthcare.
• Taking steps to design and implement climate change adaptation programs that are grounded in environmental justice and focused on people and communities at the highest risk of exposure to environmental hazards and poor health outcomes.

Still, more needs to be done to end the vestiges of structural racism and this country’s longstanding public health crisis. Here are five ways to help fully realize that vision:

• Center communities and people of color when developing health promoting strategies. Agencies and organizations should work with communities that are disproportionately impacted and incorporate their voice and lived experience in decision-making wherever possible.
• Invest in the public health system, including building a larger and more racially and ethnically diverse and inclusive public heath workforce. Public health authorities should also be protected so that health officials can implement science-based, nonpartisan health measures routinely and during emergencies.
• Increase and consistently fund public health measures, rather than allocating money only in response to emergencies. Communities that are historically under-resourced and marginalized should be a priority in funding decisions.
• Modernize technology for disease monitoring systems for improved, disaggregated health data collection and sharing that will lead to tailored approaches for specific populations.

TFAH is committed to partnering with organizations of color and advocating for and supporting policies that advance health equity.

“Public health, collaborating with its multi-sector partners, is uniquely positioned to address structural racism’s impact on health. As the nation observes Dr. Martin Luther King Jr., Day and the National Day of Racial Healing, TFAH commends the efforts of the public health community striving toward the goal of optimal health and well-being for all people, while we also recognize that more work must be done in our journey to health equity,” said TFAH President and CEO Dr. J. Nadine Gracia.