14 Mar Bay Area County Declares Racism a Public Health Issue, Resolves to Undo Harm

Sonoma County logo over a vineyard row at Chimney Rock Winery in Napa. (Photo courtesy of Bob McClenahan / Visit Napa Valley; logo courtesy of Sonoma County / both via Bay City News)

By Thomas Hughes
Bay City News

Racism is a public health crisis.

That was the resolution passed Tuesday by the Sonoma County Board of Supervisors, which joined dozens of other California jurisdictions, and hundreds nationwide, in declaring racism responsible for disparities in access to health care and worse health outcomes for Black and other underrepresented Americans compared to white Americans.

The resolution also outlined steps to take to combat the crisis. It comes roughly four years after the COVID-19 pandemic brought to light multiple health disparities in the United States and across the Bay Area, and nearly four years to the day of the killing of Breonna Taylor by police officers in Louisville, Kentucky.

Several high-profile killings that year of Black Americans by police officers, including Taylor, Ahmaud Arbery in Georgia and George Floyd in Minnesota brought attention to health outcomes influenced by structural and institutional racism, including racial profiling in multiple areas of American life that impact physical and mental health and can shorten lives.

A 2016 study from the peer-reviewed medical journal Proceedings of the National Academy of Sciences of the United States of America showed that white medical students still believe racist myths about Black patients, including believing they feel less pain and have other biological differences that they do not.

A more recent study from researchers at the Stanford University School of Medicine showed that disparities in rates of hypertension, preeclampsia and anemia were the result of bias in the medical community. Even when education and economic status are equal, Black Americans receive better health care when being treated by a Black medical professional because of bias from white medical professionals, according to the study.

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In Sonoma County, the county’s health department zeroed in on the fact that Black residents have an average lifespan at birth of 10 years less than white county residents, among other disparities.

Supervisors passed the resolution unanimously after an impassioned and at times emotional speech from Health Services Director Tina Rivera. She noted during her presentation that she was the only Black person who was the head of a county department, which made the effort more challenging.

She said living and working in Sonoma County as a Black woman was “extremely difficult.”

“This is probably the single most important presentation I make before you today,” Rivera told the board. “Because this is not just a presentation. I believe it’s a call to action.”

Following the presentation, three angry, aggrieved white men spoke separately during the public comment period, denouncing the resolution and the county’s anti-racism efforts to improve its health care system. Supervisor Chris Coursey said the men helped prove why the resolution was needed.

Rivera, during her presentation, said silence in the face of this challenge would not serve the county’s goals of implementing antiracist policies to reduce harm from institutional racism.

“Today I stand with those who have felt ignored and erased and abandoned and abused. And I stand with those who, like me, have suffered discrimination, microaggressions, bigotry, physical, mental and emotional harm,” Rivera said.

Besides informing the board that Black Sonoma County residents live an average of 71 years, compared to white residents, who have a life expectancy of 81.6 years from birth, the presentation included data from the 2021 Portrait of Sonoma County report that spotlighted multiple disparities.

Among them, it said that over 13% of Latino adults and over 10% of Native American adults living in Sonoma County have at least a bachelor’s degree, compared to 41.5% of white adults.

Sonoma County Black and Hispanic or Latinx children are about 2.5 times more likely to live in poverty than white children. People of color, especially Black and Native American residents, are overrepresented in the county’s unhoused population, according to the county’s data.

Black people are more than twice as likely not to have health insurance and Hispanic or Latinx people are four times more likely to be without health insurance than white people in the county.

“These outcomes are the result of centuries of laws, policies, and systems that disadvantage people of color,” Rivera wrote in her report to the board. “They contribute to poorer health outcomes within these communities because they prevent people from gaining access to the programs, services, resources, and opportunities they need to live and thrive.”

The resolution included eight areas for the county to focus on, including investing in learning and leadership programs to help change the county’s organizational culture and ensuring the county’s workforce reflects its population.

The resolution directs the county to create a Health Equity Action Plan, Community Health Assessment, and a Community Health Improvement Plan focusing on structural racism.

Staff across departments will identify best practices to promote racial equity in community and internal county services.

The resolution also calls on the county to advocate for and prioritize more allocation of resources and funding to antiracist goals and the needs of communities of color.

Other actions include better collection of data, youth engagement, and working with community partners already involved in combating the effects of racism.

In 2018, Milwaukee County in Wisconsin was the first jurisdiction in the United States to declare racism a public health crisis. Similar declarations have been made by 265 organizations and jurisdictions around the country, with at least 39 in California, including Sonoma County.

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