It’s been over a year since the COVID-19 pandemic began. A severely underfunded public health system, pervasive health disparities and systemic racism left many Black, Brown, and Indigenous communities devastated. Even though mask mandates are now only in effect in select California counties, communities of color in the state are far from full health and economic recovery.
Community-based organizations (CBOs) have been a critical anchor in historically marginalized neighborhoods. With limited funding, they work tirelessly on the frontlines with public health departments to get important, timely information about COVID safety measures, testing and vaccines out to community members. Now that the 2021-22 state budget has recently received approval, it’s imperative that Gov. Gavin Newsom and the state Legislature understand the importance of investing in public health, health equity and racial justice.
A June budget proposal included an investment of $200 million annually beginning 2022-23 for public health and another $100 million to address health disparities through building health equity, a critical priority area for over 300 organizations that have supported a California Health Equity and Racial Justice Fund. However, the latest bill language on public health and health equity is still unclear. Organizations are pushing for the Governor and legislators to commit to the funding proposed in June in a trailer bill once the legislature is back in session later this month.
While we appreciate the governor’s proposals to strengthen California’s health care services for our most vulnerable residents, there was a lack of understanding about the critical role of public health when the budget was under review. It’s important that the Legislature understand the difference between public health and health care and that in order for the hardest hit communities to recover from the pandemic, there needs to be adequate and collective investments in public health, health equity and racial justice. These three critical areas commonly get overlooked, but they are all interconnected.
Public health and healthcare are very different. The healthcare system treats individual people who are already sick. Public health, on the other hand, focuses on the health and safety of the whole community, with a focus on preventing injury, disease and disability by creating communities that foster health and wellbeing for everyone. Public health professionals monitor births and deaths; illness and injury at the community level and address them at their source, establishing policy and system changes to help the whole community be healthier. Since its inception, more than a hundred years ago, the core of public health work has also been to control the spread of communicable diseases, like COVID-19.
Public health is not just state and local public health departments. Public health departments work closely with the community-based organizations that are trusted messengers and service providers in their neighborhoods. CBOs help people access support, such as transportation to vaccination sites, safe and affordable housing or healthy food, that they desperately need. Many of these trusted partners live in and resemble the communities they serve and have established relationships with residents.
A critical focus for the public health system is addressing social, environmental and economic factors that limit peoples’ opportunities to be healthy, such as poverty, violence and trauma, environmental hazards and inaccessible healthcare, housing and healthy food. Addressing these persistent inequities, greatest in our Indigenous, Black and Brown communities, requires policies and programs that focus on health equity and turn the promise of racial justice into a reality.
Full pandemic recovery will require that we finally address the public health crisis of structural racism that is at the core of the disparate burden borne by Black, Brown and Indigenous communities and that has been well-documented for years. Public health departments, CBOs and other key stakeholders are critical to this recovery. Success in recovering from COVID-19 and becoming resilient against future threats requires that California’s leadership fully understand the importance of the public health system and invest in the critical services that both public health departments and CBOs provide.
Equally important is the investment in addressing health disparities and racial injustices that have directly and disproportionately contributed to illness and shorter lives in people of color. All three priorities—public health, health disparities and racial injustices—must be collectively addressed for us to truly rise and root out inequities causing harm in communities of color and historically marginalized communities.
Kimberly Warmsley is a Stockton city councilmember. Karen Smith is founding partner of Healthy Community Ventures Inc. and a former state public health officer and director for the California Department of Public Health. Both Warmsley and Smith serve as steering committee members for California COVID Justice, an initiative of Public Health Advocates.