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

In 2020, Cleveland was among many cities in the country to declare racism a public health threat. As municipalities grapple with the implications of their statement, leaders of the African-American community in northeastern Ohio are urging residents, health care administrators, civic leaders and public policy experts to look back at the history of racism to better understand its impact on human society. health of the Northeast Ohioan is today.

“With the advent of slavery, and chattel slavery in particular, what we saw was the association of race with your appearance, and then it created this system of casting African Americans or people who are dark skinned. always on the bottom,” 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. They were people who were never given an opportunity to grow up because they were always considered property.”

Racism and white supremacy are so ingrained in American society that those with privileged status often don’t even acknowledge it, said Mwatabu S. Okantah Kent State University, acting president of African studies.

“Enslaved Africans have been redefined as something other than being a human being, and that legacy is still with us…and it’s difficult because the country has never really recognized that,” Okantah said.

“Racism as a public crisis really underscores the fact that it is important for everyone to participate equally in our democracy, and it is right and proper that we do. If we don’t, our democracy is in danger.”

Claude Jones, president and CEO of Care Alliance

To address the public health crisis created by racism, it is essential that the community as a whole understands and develops policies that represent the 400 years African Americans have 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 has accountability measures in place that begin to hold our community accountable and accountable for how we deal with all people in the community, especially those in the communities color,” he said.

First, said Hall, of the Northeast Ohio Black Health Coalition, society needs to get its eyes on the problem.

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

Once racism has been officially defined as a public health crisis, the next step is to examine the social determinants of health, things like access to green space, good schools, and reliable transportation that fuel racial health disparities in Cleveland. said Alan K. Nevel, MetroHealth’s Head of Equity.

“If you just look at it in terms of zip codes across Greater Cleveland, there are some areas in our community where four out of 10 people don’t know where their dinner is coming from tonight,” he said. “That will naturally cause someone to be unhealthy.”

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

“When you think about all of these things, you have to think about it not just how a community is dealing with it, but whether there are structural barriers based on long-term racism and discrimination that are preventing the progress of some populations reaching their peak and maximum potential,” he said.

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

“So people are having a difficult time getting their medical care because of public or personal transportation,” said Dr. Claude Jones, president and CEO of Care Alliance, Federally Qualified Health Center of Cleveland. “So can we change the policy to increase bus lines in those areas where there may be a shortage of lines?”

Hall said her group is looking at more than just health outcomes as it seeks to address health disparities.

“Our team has been working to make sure we address these issues and also a lot of things that disproportionately impact our community,” he said. “We are looking at the air, we are looking at the land, we are looking at the water. We’re looking at each individual system and how it affects our community and how we can work to educate the community about those systems.”

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

Redlining was a practice of banks, insurance companies, and federal housing programs that denied black neighborhoods access to loans during the mid-1920sth century. But today the term has come to mean any practice that denies resources to black communities.

Through that lens, Hall said today he sees a continuation of the redlining that existed in the northeast Ohio health care system in the 1930s and 1940s.

“We have hospitals that are closing in urban areas and we have suburban areas that were once not African American that are changing in those communities,” he said. “What we’ve seen is hospital systems pull back from these areas.”

The theory of a rising tide lifts all boats, in my opinion, is very true. We all have a responsibility to change this. We all have a responsibility to declare racism a public health crisis.

Alan K. Nevel, Chief Equity Officer of MetroHealth

The epicenter of the redlining is not just core cities and urban areas but now includes formerly white suburbs that now have sizable black populations, he said.

Treatment perceptions can also be influenced by one’s race. Some Care Alliances patients say they feel overwhelmed and treated poorly by large hospital systems, Jones said.

“Many of our patients are of lower socioeconomic status, have lower educational attainments, so when they go to one of the major hospitals they might feel overwhelmed,” she said. “Many of them come back and feel treated differently because of their insurance status or they didn’t have insurance or they may have a chronic pain condition where they were seen as seeking medication so they felt like they were automatically put in one category.”

Nevel, of MetroHealth, said his system has overhauled its policies to make sure they treat people of all races and ethnicities with respect.

“I wouldn’t have to wear my badge to enter one of our facilities to be treated with a level of dignity and respect,” said Nevel, who is Black. “I shouldn’t come in in a suit and tie.”

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

Okantah, of Kent State, has another recommendation.

“In this historic moment, this reckoning, that’s 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 he living in a white supremacist system had over them,” he said.

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

“Racism shouldn’t follow me into a doctor’s office, into an educational setting, it shouldn’t follow me into a job, it shouldn’t follow me anywhere,” she said, “because racism shouldn’t exist.”

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