California needs to recognize racism as a public health crisis

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The Declaration of Independence proclaims “We hold these truths to be self-evident, that all men are created equal,” but despite our aspirations, all Americans do not enjoy equal opportunity. 

The COVID pandemic underscores ongoing disparities in health, education and wealth afforded to different Americans depending on their race. The coronavirus doesn’t discriminate based on race, but the virus’ spread and severity depends on the circumstances of its victims. 

Black and Latino Americans are twice as likely to test positive for COVID-19 and are almost three times more likely to be hospitalized for COVID, while Native Americans are three and a half times more likely to be hospitalized. Native Hawaiian and Pacific Islanders are three times more likely to contract COVID as white people and have the highest death rate of all racial and ethnic groups. Asians with COVID are 57% more likely to be hospitalized and 49% more likely to die compared to whites with similar socioeconomic characteristics and underlying health conditions.

But I believe Californians wish to achieve the ideals of America’s Declaration of Independence and seek to create a more perfect union. That is why I am authoring Senate Bill 17, calling on California to recognize racism as a public health crisis and establish an Office of Racial Equity and a Racial Equity Advisory and Accountability Council to hold ourselves accountable. 

The office will analyze outcomes data to identify racial and ethnic disparities, and inform the council which will make recommendations to the governor and Legislature to address structural racism in state policies and budgets.

As a physician with expertise in public health, I recognize that health is strongly influenced by the social and physical environment. Racism causes chronic stress and disparities in chronic disease prevalence and severity and in infant, maternal and overall mortality beyond socioeconomic factors.

Racial disparities are not limited to health and trace their roots to the founding of our country. Numerous government policies disadvantage Americans by race, beginning with the continuation of slavery in the Constitution until the 13th Amendment. While many such policies have been removed with great effort over our history, many others persist and new discriminatory policies are proposed.

Institutional and systemic racism permeates our communities in insidious ways. An example of how inequities don’t just disappear with inclusive policies is the passage of the 1968 Fair Housing Act which made redlining, or designating Black neighborhoods as poor investments for lenders, illegal. 

Redlining was common in California, and even though it has been illegal for decades, its legacy continues. Previously redlined neighborhoods became targeted for undesirable development like freeways or industrial factories, which led to lower life expectancy and higher incidence of chronic diseases in children and adults from pollution. These communities of color have persistently lower housing values, reducing property taxes to fund neighborhood public schools resulting in fewer educational resources, which lowers wealth for families in the community.

According to Advancement Project California’s RACE COUNTS COVID-19: Statewide Vulnerability and Recovery Index, people of color are less likely to have access to early childhood education programs, have health insurance, own a home, vote and feel safe in their neighborhood.

Throughout our nation’s history, racist government policies and practices have marginalized, disenfranchised and prevented all Americans from equal opportunities for success and independence. The system has quite literally been rigged against communities of color and the impacts have been profound in creating stark disparities in housing, public health, incarceration rates, employment and education.

America was founded on the ideal of equal opportunity for anyone willing to work hard and the California Dream is the promise of opportunity and good fortune. California funded free education and infrastructure to give more equal opportunities to the people moving to the Golden State from across our country and around the world. We now need to strive for equity for all Californians to have a fair chance to succeed in our great state and country. We need to pass SB 17 so we are identifying racial inequities in our state and working to remove them.