Hospital staff (photo: Michael Appleton/Mayoral Photography Office)
The new director of the Centers for Disease Prevention and Control said the quiet part out loud last week – racism infects our public health system.
“What we know is this: racism is a serious public health threat that directly affects the well-being of millions of Americans,” Dr. Rochelle P. Walensky, the CDC director, said, citing disparities and inequities long-known to those of us who work to increase access to quality, affordable health care in Black and brown communities.
Dr. Walensky was blunt in her honesty, saying the COVID-19 pandemic had “revealed for all Americans a known, but often unaddressed, epidemic impacting public health: racism.”
It is especially gratifying to hear her words now during what has been designated Minority Health Month. We have seen as the pandemic took its toll in lives and health across the country that the highest percentages of disease and death occurred in vulnerable communities where disproportionate numbers of minorities live, where essential workers live, and where chronic diseases such as diabetes, hypertension, obesity, asthma, and kidney disease afflict residents far more than in the overall population.
And it is why we cannot have as our goal coming out of the pandemic to return to ‘normal.’ We know what that normal was, and it’s the result of structural barriers that limit access to everything from fresh produce to safe streets to educational opportunity and, of course, to access to the quality, affordable health care that must be a right for all.
Our goal has to be a new normal, where hotic approaches to health care replace the disjointed and unequal system under which the color of your skin or the zip code you lived in determined your opportunity to access that quality care.
It includes requiring, among other things, public and private insurance plans to cover mental health care, tackling the environmental racism that sees polluting infrastructure such as asthma-causing bus garages sited in poor neighborhoods, and jump-starting the scandalously slow removal of lead paint from public housing buildings, which stunts the educational and life potential of so many children.
For those of us across the country at Black Health, the organization I head, the pandemic brought us into contact with thousands of vulnerable residents through test and tracing programs early in the pandemic, and confronting vaccine hesitancy in the current phase. We learned that it takes trusted local voices – pastors, community leaders, educators, and others – to reach people where they are to press upon them the urgency of the moment in trying to defeat this greatest public health threat in our lives.
But we cannot stop at vaccines, as clearly essential as they are in trying to move beyond the moment of public health threats. It is more than the urgency of now. We have to turn it into the opportunity of now.
We are encouraged that the new administration in Washington, D.C., as evidenced by the long-overdue words of Dr. Walensky, has moved to separate access to health care from a person’s ability to pay. Expanding coverage under the Affordable Care Act to include a public option that can drive down the cost of health insurance is a critical, albeit insufficient step towards that goal.
Breaking the grip of the “sickness industry” – the interlocking financial interests of hospitals, drug companies, and the like – requires aggressive support through funding of preventive programs. It is no surprise that Medicaid, the primary funder of state-managed health coverage for the poor, will cover $50,000 to $60,000 per year for diabetes-related dialysis – a $35 billion a year business, with squads of lobbyists protecting their financial interests over the interests of sick patients – but will not cover the estimated $900 per patient for evidence-based, peer-education programs that help vulnerable residents drive down their blood sugar levels.
And studies have shown as the pandemic has progressed that blood sugar levels are directly correlated with higher complications and death rates for those with chronic diseases such as diabetes who contract COVID.
People don’t have to be that sick but under the “old normal,” far too often they were. And until we recognize the role that racism has played in skewing the public health system across the nation, we cannot create the “new normal” we need and deserve.
As we continue the struggle to conquer COVID-19, we can no longer ignore the social virus of racism. We stand with Dr. Walensky in her acknowledgement of what should be obvious to anyone paying attention. And we will hold her at her word as we work to rid the health system, and society at large, of that racist virus.
C. Virginia Fields is the Founder and CEO of Black Health - the National Black Leadership Commission on Health. On Twitter @CVirginiaFields.