WHPRMS June Blog: Seven Steps for Addressing Racism as a Public Health Crisis

The mass protests in response to the death of George Floyd (and the past history of questionable deaths of persons of color in police custody) have brought hundreds of thousands into the streets. The Black Lives Matter movement has made clearer the omnipresent influence of racism and its deleterious effect on persons of color. Like it or not, healthcare providers of all sizes and geographies are on the front lines of this battle for equity.

Many suggest that this time is different. There appears to be serious interest in Congress to make police departments more accountable and to curb racial violence. NASCAR has banned the Confederate flag from their events and NFL Commissioner Roger Goodell says the league mis-handled Colin Kaepernick’s silent protest against racism. The world’s largest brands, typically wary of conflict, are now taking very public stands against racism and resulting social disparities. Companies like Nike, Twitter and Citigroup have publicly aligned themselves with the Black Lives Matter movement.

We’ve known for years that the significant and seemingly intractable health disparities among groups are closely linked with social, economic, and environmental disadvantage. And it is absolutely true that many healthcare providers have well-lived missions to serve their community in the noblest ways. We offer free clinics, school-based clinics, maternal – childcare programs, affordable housing, charity care, investment in medical research, health education, and a living wage for employees.

Let’s not rest on our laurels.

I was uncomfortable reading the scathing editorial Beyond words: medical institutions must act to support Black lives. The authors argue that “Despite their professed missions to serve society, academic medical centers often cause harm to surrounding low-resource communities of color. Damage has been and continues to be wrought through willful neglect, unethical human experimentation, predatory billing practices, community displacement, class-based care structures, and use of tax-exempt statuses to withhold funds from chronically underfunded communities. Segregation of healthcare access by race and class has exacerbated the disparate impact of Covid-19, contributing to excess deaths in Black and Native Americans.”

Agree or not, the authors provide a litany of grievances that many among the disadvantaged members of our communities believe whole-heartedly.

Recently, hundreds protested in Madison demanding action to better address health disparities. The group marched down West Washington Avenue and then stopped to address nurses and other officials at SSM Health St. Mary’s Hospital and UnityPoint Health-Meriter Hospital, imploring them to find better solutions to the county’s ongoing child and maternal inequities. The Cap Times, in covering this story, wrote this: “We get treated like s*** when we bring our black bodies to these doctors. They treat us like we don’t know s***, that we don’t know what we’re talking about,” said Felica Turner-Walton, CEO of Healing Our Hearts, which also organized the march and offers grief support for African American mothers who have lost babies.

Front line heath care workers in cities across the country have joined BLM protesters, showing solidarity by marching in scrubs and handing out face masks, water bottles and hand sanitizer. Healthcare CEOs and their immediate staff must also show support.

As the brand manager, you must not only encourage your employers to support the Black Lives Matter movement, but also to address the conditions that perpetuate healthcare and socio-economic disparities. You must be able to show the general public that your organization is working to mitigate the long-term impact of this societal scourge through innovative programming and a clear understanding of the issues that cause health disparities among persons of color.

Here’s what you can do:

1) Have your CEO read and sign-on to the Wisconsin Public Health Association (WPHA) declaration: Racism is A Public Health Crisis in Wisconsin and commit to the actions specified.

2) Advocate and work toward an organization that is equity and justice oriented. Enhance your company’s diversity and inclusion programming and improve upon anti-racism principles within and without your organization.

3) Enhance your organization’s effort to address and dismantle racism, expand the community’s understanding of bias, racism and discrimination, including the effects of racism on individual and population health.

4) Provide tools, opportunities and funding to help your employees engage authentically and actively with communities of color in ways that benefit all.

5) Advocate for relevant policies and practices that improve the health of communities of color and supports those causes that advance social justice and help to dismantle systemic racism, including the re-distribution of valuable resources to directly help those in need.

6) Build alliances with other organizations that are confronting racism and encourage other local, state and national entities to call out racism as a public health crisis.

7) Take a stand. Encourage your CEO to publicly state support for the Black Lives Matter movement, especially in the context of health disparities. Support for revolutionary change can easily be made within the context of your Mission Statement, values and the morality of the situation.

As occurred here in Madison at St. Mary’s and Meriter, it is just a matter of time before your CEO will be pressure-tested by community members who want to know where they stand.

Be ready and be sincere.

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James Shulkin has been a member of WHPRMS since 1999. He is the principal at Windflower Consulting.

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