May 21, 2024

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Racism Is Declared a Public Health Crisis in New York City

The New York City Board of Health declared racism a public health crisis on Monday, passing a resolution that directed the Health Department to take steps to ensure a “racially just recovery” from the coronavirus pandemic.

The resolution called on the department to work with other agencies to root out systemic racism within policies, plans and budgets on a wide range of matters that affect health, including land use, transportation and education. It also directed the department to improve data-collection practices and examine both the health code and its own history for structural bias.

Dr. Dave A. Chokshi, the department’s commissioner, is also one of the 11 medical experts who sit on its board. At the meeting on Monday, he noted that the board was founded amid epidemics of yellow fever, cholera and smallpox in the early 1800s. Advances in sanitation and understanding the links between environmental factors and health helped curb those diseases.

He drew a parallel to the current pandemic, and its outsize toll on communities of color.

“Why do some nonwhite populations develop severe disease and die from Covid-19 at higher rates than whites?” he said. “Underlying health conditions undoubtedly play a role. But why are there higher rates of hypertension, diabetes and obesity in communities of color? The answer does not lie in biology. Structural and environmental factors such as disinvestment, discrimination, and disinformation underlie a greater burden of these diseases in communities of color.”

He added, “The Covid-19 pandemic must render unacceptable that which has been condoned for generations.”

The department is one of the largest public health agencies in the world, and one of the oldest in the country. The members of its board, who are appointed by the mayor with the consent of the City Council, serve without pay and oversee the health code.

More than 200 similar declarations have been made by municipalities, health agencies and elected officials across the country, according to a database maintained by the American Public Health Association. The federal Centers for Disease Control and Prevention has also called attention to how racism affects illness rates and life expectancy.

But the New York Health Department said its resolution was one of the first that was tied to specific directives. Those include making recommendations to the mayor’s Racial Justice Commission and establishing a Data for Equity working group, designed to ensure the department applies an “equity lens” to public health data and educates other agencies on how to do the same.

The resolution also called on the department to investigate its own role in “divesting and underinvesting in critical community-led health programs.”

Dr. Michelle Morse, chief medical officer and a deputy commissioner at the Health Department, called the resolution’s passage “a hopeful milestone,” but added that it was only one piece of a much larger puzzle.

She said that strategies like updating the city’s health code and investing in disadvantaged areas were key.

“One of the ways that racism is expressed at a policy level is inaction in the face of need,” she said.

The resolution builds on a statement the department released in June 2020, amid widespread protests after the killing of George Floyd by a police officer in Minneapolis. The statement vowed to address racism “as a social determinant of health as part of our mission to protect the health of New Yorkers.”

Dr. Kitaw Demissie, dean of the School of Public Health at SUNY Downstate Health Sciences University in Brooklyn, welcomed the resolution as a good start.

“I like the idea, that they’re focusing on this issue,” he said. “Now the most important thing is to see its implementation, to see the investment, and to see the changes that are going to come.”

He said the stark differences in disease and death rates seen during the pandemic brought attention to longstanding inequities.

“Covid-19 was like a magnifying glass for us to see what has already been in existence for a long time,” he said. “Racial/ethnic disparities in health have been a pandemic.”