Opinion: California Must Take Action on Chronic Disease Among Children of Color

Small black boy receiving asthma treatment while doctor is vising him at home due to COVID-19 pandemic.
Photo by Drazen Zigic/iStock

An alarming number of children (one in four) suffer from chronic health conditions such as type 2 diabetes, obesity, asthma, depression and cavities — all of which are preventable. These chronic illnesses are robbing our children of their well-being and the ability to thrive. In addition, children of color are more likely to suffer and die from chronic diseases; for example, Black children are 40 percent more likely to have asthma, five times more likely to be hospitalized, and three times more likely to die from asthma-related causes than their white counterparts.    

The upward trend in childhood chronic disease in California is threatening the health of the next generation, and racial disparities in those diseases are stark evidence of the deep impact that racism has on health. In California, not enough preventative measures have been taken to eliminate the racial disparities that fuel high rates of long-term illness in children of color. But a groundbreaking Senate Bill 682, authored by California State Senator Susan Rubio coined “End Racial Inequities in Children’s Health in California Initiative” (EnRICH CA), could help the state begin to change course by prioritizing and investing in prevention of childhood chronic illnesses and creating actionable steps for implementation.  

By setting specific targets, timelines and metrics, SB 682 will ensure that California state agencies have an explicit directive from the Legislature to take action on eliminating racial disparities in childhood chronic disease. To implement the EnRICH CA initiative, SB 682 is also accompanied by a related $11 million budget ask to provide three years of support for staff and implementation activities. This investment pales in comparison to the lifelong personal and systemic costs of racial health disparities for chronic conditions. 

The childhood costs are just the beginning of the lifelong effects of chronic disease. During childhood, chronic conditions often cause school absenteeism and frequent medical and emergency room visits. This impacts parental employment and income, not to mention saddling families with health care costs. Furthermore, childhood health is a strong predictor of adult health and financial status. Children in poorer health earn lower incomes in adulthood and have higher healthcare utilization and costs. SB 682 takes a much-needed approach toward eliminating racial disparities in childhood chronic conditions by 2030 and sets the state on a path to significant savings.  

COVID has laid bare the deep-rooted challenges that exist in communities — lack of adequate and affordable housing, lack of access to healthy food and jobs, lack of access to adequate mental health supports — all of which are risk factors for chronic disease in children. We must recognize, though, that just within the past year, children of color have faced the disproportionate impact that the COVID pandemic has had on their family, friends and schooling, all while enduring the more overt racial injustices such as biased and aggressive policing in their communities and civil unrest following the presidential election.   

The state has dedicated significant resources to manage the acute pandemic of COVID–19; now three organizations—Children Now, California Children’s Hospital Association and Public Health Advocates — have joined together to sponsor SB 682 to inspire the state to take bolder action on the pre-existing “chronic condition” of racial injustice that puts children’s health at risk every day. With the CDC recently declaring racism a public health threat, along with 29 cities and counties statewide, California has an obligation to disrupt these patterns by prioritizing racial equity in children’s health to ensure that young people can thrive and grow into healthy adults. SB 682 can help us chart that path. 

Dr. Flojaune Cofer, senior director of policy at Public Health Advocates, is an epidemiologist and works to advance state policies that foster equity by addressing some of our state’s leading public health issues, such as childhood chronic diseases.

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