To solve the health crisis caused by racism, Americans must speak out about its history, say African American leaders in northeast Ohio

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In 2020, Cleveland was among many cities nationwide to declare racism a public health threat. As municipalities grapple with the implications of their statement, African American community leaders in Northeast Ohio urge residents, health care administrators, civic leaders and public policy experts to revisit the history of racism to better understand its impact on the health of the northeast. Ohios today.

With the advent of slavery, and chattel slavery in particular, what we saw was that race was associated with how you looked, and so that created this caste system with African Americans or dark-skinned people still downstairs, said Yvonka Hall, executive director of the Northeast Ohio Black Health Coalition. When you look at how these systems are built, these systems were built on the backs of slaves. These are people who have never been seen as having the opportunity to rise because they have always been seen as possessions.

Racism and white supremacy are so ingrained in American society that those with privileged status often don’t even recognize it, said Mwatabu S. Okantah Kent State Universitys Acting Chair of Africana studies.

Enslaved Africans were redefined as something other than human beings, and that legacy is still with us…and it’s hard because the country never really recognized it, Okantah said.

Racism as a public crisis really underscores the importance of everyone participating equally in our democracy, and that it is fair and just that we do so. If we don’t, our democracy is in danger.

Claude Jones, President and CEO of Care Alliance

In order to address the public health crisis created by racism, it is essential that the community as a whole understands and develops policies that take into account the 400 years that African Americans suffered under slavery, oppression or discrimination, said Greg Brown, executive director of Policy Bridge, a Cleveland-based think tank that studies public policy issues affecting African Americans.

It is very, very important that the community begins to understand and develop policies, practices and procedures and have accountability measures that begin to hold our community accountable and accountable for how we deal with all people in the community. community, especially people from communities of color, he said.

First, said Hall of the Northeast Ohio Black Health Coalition, society needs to be clear-headed about the problem.

I think when you look at inequality and how the African American community is disproportionately impacted here, we have to look at the cause of inequality and the main culprit is racism, Hall said.

Once racism has been officially labeled a public health crisis, the next step is to look at the social determinants of health, things like access to green spaces, good schools, and reliable transportation that fuel disparities. racial differences in health in Cleveland, said Alan K. Nevel, MetroHealths Chief Equity Officer.

If you look at this just in terms of zip codes in Greater Cleveland, there are areas in our community where four in 10 people don’t know where their dinner is coming from tonight, he said. This will naturally make someone unhealthy.

When you think of health as dependent on a person’s economic viability, mobility, housing, and environmental conditions in addition to their access to transport, good schools, and healthy food, what you are looking at is a broad societal system that also needs to be assessed in terms of race, said Brown of Policy Bridge.

“When you think about all of these things, you have to think about them not just in how a community deals with them, but whether there are structural barriers based on long-term racism and discrimination that prevent certain populations from progressing. reaching their maximum and ultimate potential, he says.

This means that solutions to racism as a public health crisis can be practical in nature.

Individuals therefore find it difficult to come and receive their medical care, whether by public transport or personal transport, said Dr. Claude Jones, president and CEO of Care Alliance, Federally Qualified Health Center in Cleveland. . So can we change policy to increase bus routes in areas where there may be a shortage of routes?

Hall said his group is looking at more than health outcomes as it tries to address health disparities.

Our team has worked to ensure we address these issues as well as many things that disproportionately affect our community, she said. We look at the air, we look at the land, we look at the water. We look at each system and its impact on our community and how we can work to educate the community on these systems.

This includes understanding how these systems were built even decades or centuries ago.

Redlining was a practice by banks, insurance companies, and federal housing programs that denied black neighborhoods access to loans in the mid-20th century. But today, the term is understood as any practice that deprives black communities of resources.

Through that lens, Hall said today that she sees a continuation of the redlining that existed in the 1930s and 40s in Northeast Ohio’s health care system.

We have hospitals closing in urban areas, and we have suburban areas that were once not African American and are transforming into those communities, she said. What we’ve seen are hospital systems pulling out of those areas.

The theory of a rising tide lifts all boats, in my opinion, is very true. We all have a responsibility to change that. We all have a responsibility when it comes to the declaration that racism is a public health crisis.

Alan K. Nevel, Equity Director of MetroHealths

The epicenter of redlining is not just central cities and urban areas, but now includes once-white suburbs that now have large black populations, she said.

Perceptions of treatment can also be affected by race. Some Care Alliances patients say they feel overwhelmed and poorly treated by large hospital systems, Jones said.

A lot of our patients are of lower socio-economic status, they have lower education, so when they go to one of the big hospitals, they can feel overwhelmed, he said. Many of them come back and feel like they were treated differently because of their insurance status or that they didn’t have insurance or that they might have chronic pain where they were perceived as seeking medication, so they felt like they were automatically put into a category.

Nevel of MetroHealth said his system has reviewed its policies to ensure it treats people of all races and ethnicities with respect.

I shouldn’t have to wear my badge to enter one of our facilities to be treated with dignity and respect, said Nevel, who is black. I shouldn’t have to walk in a suit and tie.

Nevel also stressed the importance of working with organizations outside the health sector and having community discussions to better serve the most vulnerable.

Okantah in Kent State has another recommendation.

In this historic moment, this reckoning, which is happening in this post-George-Floyd-Breonna-Taylor world, there is a need for white people to sit down with each other and talk about the negative impact that living in a white supremacy system has had on them, he said.

Hall, of the Northeast Ohio Black Health Coalition, said that while racism and the public health crisis it has created affects people’s well-being, it’s important to remember that it’s unacceptable.

Racism shouldn’t follow me into the doctor’s office, into an educational institution, it shouldn’t follow me into a job, it shouldn’t follow me anywhere, she said, because racism shouldn’t to exist.

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