Advocates, lawmakers press for health equity measures as legislative session heats up
A month into the legislative session, advocates are turning a spotlight back on an issue that failed to gain traction at the state level last year, even as the coronavirus pandemic exposed stark disparities in health care: declaring racism a public health crisis in Connecticut and passing reform to address long-standing inequities.
In June, following the death of George Floyd at the hands of police and amid a health crisis that has disproportionately harmed communities of color, cities and states across the country took the symbolic step of declaring racism a public health crisis. In Connecticut, 20 municipalities, including Hartford, Bridgeport, New Haven, Simsbury and West Hartford, have adopted the declaration, along with the Mashantucket Pequot Tribal Nation. Ninety-nine cities and 72 counties nationwide have done the same, as have four states: Michigan, Nevada, Minnesota and Wisconsin, according to Health Equity Solutions, which has been tracking the declarations.
The pronouncements are designed to spur a deeper analysis of systemic issues and ultimately drive policy change. But while local leaders have begun to wade into those problems, the state has yet to take similar action. Calls by advocates last summer to declare racism a public health crisis were brushed aside by Gov. Ned Lamont. A spokesman for the governor has said Lamont’s ability to take action by executive order is restricted and that any mandate he imposes would be limited in duration.
With the legislature back in session, proponents of the effort are turning to lawmakers. Reps. Matthew Ritter and Brandon McGee, both Democrats from Hartford, are working on a bill that would address health equity. Their plan includes forming a commission, composed of advocates, representatives of various state departments and others, to exchange ideas, discuss challenges, offer input on policy and provide recommendations to state agencies and legislators on health equity.
“Until we fully understand the racial and ethnic impact of the policy and budget decisions we make, we’re operating in the dark,” McGee said. “Health inequities and the social determinants that drive them must be addressed purposefully and urgently, and with full knowledge of the consequences of our actions as policymakers.”
“We went through an entire year of seeing what many Black and brown people have been telling for years – inequities,” he added. “Now’s the time for us to go beyond the marches and the protests … now is the time I believe that there’s an appetite [for reform]. And this conversation is being supported not just by people of color but their allies as well.”
The measure being drafted by McGee and Ritter, the House Speaker, would also facilitate training for people in certain state agencies, possibly the Office of Legislative Research or the Office of Fiscal Analysis, to produce racial and ethnic impact assessments – analyses that examine the impact of a bill or policy on specific racial or ethnic groups. Connecticut has a law in place allowing legislators to request such an assessment, though proponents say training is needed for those reports to be produced.
The bill may include education for existing staff or funding for additional workers to handle the assessments, Ritter said.
“The thought right now is that there is sometimes not enough attention paid to the policy decisions from the standpoint of people of color,” Ritter said. “That’s what this bill ultimately will try to address, is that there’s another lens to look at policy.”
The health equity commission may also review what data is gathered by medical providers on race and ethnicity and make suggestions for standardization and improvement, Ritter said.
Sen. Saud Anwar, D-South Windsor, a physician, has introduced his own bill on the issue. The measure would declare racism a public health crisis and establish a commission to study institutional racism in Connecticut’s laws and regulations; racial disparities in the criminal justice system and their impacts on health; disparities in access to fresh food, public safety and other social determinants of health; disparities in access to health care and health outcomes; and the impact of zoning restrictions on the creation of housing disparities.
The commission would also provide recommendations to lawmakers and other state officials.
Anwar recently criticized Lamont’s budget proposal as not doing enough to address equity.
“We need to recognize health-equity challenges before the pandemic were among the highest in the country, and the pandemic has only further shown this disparity is impacting residents of our state, and it may become a scar on them forever,” he said. “Asset-limited, income-restrained employed are increasing rapidly in the pandemic, and who will speak for them?”
A spokesman for Lamont pointed to recent remarks made by Melissa McCaw, secretary of the Office of Policy and Management, on equity provisions in the proposed budget.
McCaw told the legislature’s Appropriations Committee last week that the administration is investing more than $230 million in federal pandemic relief in affordable housing and rent relief. Additional investments were made in social service agencies to reflect higher caseloads, if not to raise rates.
Max Reiss, Lamont’s spokesman, said the administration also is addressing equity in its rollout of the COVID-19 vaccine, including sending out mobile units to deliver the shot in underserved areas.
“We take the issue of equity incredibly seriously, as evidenced by our efforts directly in communities to try to do vaccine outreach,” he said. “We know that there’s probably no such thing as enough when it comes to trying to cross that health care disparity divide, but the administration is committed to trying to correct that as much as possible.”
Advocates say they support legislators’ efforts to declare racism a public health crisis and take steps to confront disparities, but they expressed disappointment in Lamont for not doing more.
The Rev. Ashley “AJ” Johnson, pastor of the Urban Hope Refuge Church in Hartford and an organizer with the Greater Hartford Interfaith Action Alliance, said the governor should not wait on the legislature to take action. GHIAA, a coalition of 38 congregations across Connecticut with thousands of members, called on Lamont in November to declare racism a public health crisis, and members have renewed those calls since the legislative session began.
“A lot of people will say a declaration isn’t enough, but this is something he can do,” Johnson said of Lamont. “So do it, and then follow up” with more action, he said.
He has also called on the state to form a commission that examines the intersection of racial impact and health disparities.
Melinda Johnson, an activist who organized a funeral procession in Hartford last summer in honor of Floyd, called Lamont’s inaction on the issue “disheartening.”
“You want to believe in your leaders, and you want to believe that your leaders care about your wellbeing,” she said. “And while we see that the governor has made a lot of progress in our state showing that he cares about our wellbeing in the space of COVID-19, it does not ring the same way when it comes to racism. It does not feel like, when we talk about prioritizing communities of color, that that is a priority for him.”
Leaders of Health Equity Solutions, a research and advocacy organization, also asked Lamont last summer to declare racism a public health crisis. They recently outlined a series of recommendations for legislators tackling bills on the topic.
Along with training for agencies to create racial and ethnic impact assessments and a commitment from the General Assembly to consider those reports when drafting legislation, the organization has also suggested that state officials come up with a strategy to ensure equitable distribution of COVID-19 relief funding and resources.
Health Equity Solutions also supports a measure that would standardize race, ethnicity and language data for providers participating in Connecticut’s new health information exchange but has requested that state agencies be included in the bill.
“You can’t create a strategic plan for promoting equity without the data,” said Karen Siegel, director of policy for Health Equity Solutions.
The organization has recently been working with other groups, including GHIAA, on these proposals with the aim of spurring action this legislative session.
“We have shared goals,” Siegel said. “If this isn’t the moment to address structural racism, I’m not sure what it is. I’m hopeful that we are going to see some movement. It would be disappointing to not take some significant, meaningful action this session.”
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