“I have to tell you that as a person of color who has actually, firsthand received racism as normal [thing], – we would be remiss to say that things in this state are not racist”, said State Rep. Geraldo Reyes in his support of the recently passed House Bill 6662 declaring racism a public health crisis in Connecticut.
Many of us agree that structural racism shapes the persistent healthcare disparity in contemporary America, yet some may speculate that the mere declaration of this fact is another political performance, a symbolic recognition of our social ill that will probably remain unsolved. In a skeptic’s enervated exasperation, they ask, “what good could a symbol do? As an aspiring public health professional, I, in my earnest hope and sincerest aspiration, strive to bring to light the significance of the successful passage of this bill. It is indeed a symbol, nonetheless one whose symbolic power can ground and ripple into practical and systemic implications for pro-equity public health efforts.
The symbolic power of the declaration, first and foremost, has concrete implications in creating urgency and public impetus for equity-oriented public health reforms. The power of a symbol lies not only in its meaning, but the myriad actions that it could inspire. Any social enterprise requires a vocabulary and frameworks to illuminate the urgency, purpose, and trajectory of its action. In the collective enterprise of public health, the central tenet of equity and justice demands the critical challenge of structural racism to be pushed to the forefront of the public’s attention.
By centering structural racism as a crisis of health, we highlight the salience of racial inequality concomitant to the violation of our fellow citizens’ equal rights to health and bodily integrity. The urgency to correct this crisis through equity-oriented reforms now comes from the principle of “life, liberty, and the pursuit of happiness” ingrained in the American psyche, and the duty of the democratic institution to defend men’s inalienable rights. Now there is no excuse but to acknowledge health equity as a matter of principle, a matter of visible urgency.
Moreover, framing racism as a public health crisis is not a baseless rhetoric but grounded in evidence. Ample literature has emphasized the multitude of pathways between racism and health, including “adverse physical, social, and economic exposures, maladaptive coping behaviors, and stereotype threats”, as argued by social epidemiologist Zinzi Bailey and her colleagues. Likewise, research by Dr. Diane Lauderdale, Public Health Professor at University of Chicago, has highlighted racism as a cause for minority mothers’ chronic exposure to ethnicity-related stress which is shown to affect birth outcomes. With its premises grounded in scientific research, declaring racism a public health crisis must not be brushed off as merely a political slogan, but recognized as an exemplar of evidence-based decision-making.
Beyond the consideration for public policy, the declaration carries the tremendous power of social discourse. Public and academic discussion on the impact of racism on public health is legitimized on an institutional level and in turn given the power to legitimize and empower. In simpler words, the discourse of racism as a public health determinant can now help justify health equity interventions, catalyze social discussions on health equity, and ferment social movements towards health justice.
The optimism in this bill aside, I must acknowledge the scathing concern for political inaction. Regardless of the significance of its symbolic power and implication, a declaration will remain an empty slogan if no concrete actions are taken to actualize its important message. The power of this bill was born in its symbolic, practical, and discursive significance, yet can only be fully realized in the effective implementation of equity-driven interventions. Currently, HB 6662 stipulates specific actions to be implemented under the declaration, such as the demand for better data collection on racism in healthcare and the mandate on hospitals to conduct implicit bias training. These actions must be implemented thoroughly for the Bill to be an effective step towards health justice.
To conclude, I’d like to quote my favorite philosopher, Michel Foucault, who famously said, “power is something exercised, put into action, in relationships.” The declaration of racism as public health crisis in HB 6662 gains power and salience from and beyond the scope of its rightful message.
It puts into action the collective power and capacity for equality.
It carries the appeal to our moral and civil obligations;
It carries the urgency and impetus for change;
It carries the discursive power of truth;
It carries the disruptive power to challenge status quo;
It carries the practical salience of evidence-based decision-making;
It carries the signal and direction for social progress;
And above all, it carries for many people the hope for a safer and more just future for public health.
It is a symbol that’s more than just symbolic.
Mary Lihong Peng is a MPH Candidate at Yale School of Public Health.