Opinion: California Must Step Up to Address Racism as a Public Health Crisis

Black Lives Matter signs left by community members on the gate of Daniel Webster Elementary in San Francisco’s Potrero Hill neighborhood in August, 2020. Photo by James Rice/iStock

Governor Gavin Newsom and other California lawmakers took an important step toward improved public safety and racial justice this fall by passing the CRISES Act to fund community-based emergency response programs.

Police violence disproportionately victimizes people experiencing mental health or substance use crises. Solutions such as the CRISES Act provide funding to community groups to respond to emergencies in ways that provide better care and reduce harm. Newsom vetoed the bill in 2020 even after police officer Derek Chauvin murdered George Floyd and nationwide protests brought widespread recognition to the often-fraught role of police as first responders. 

The growing movement for racial justice – often described as a “racial reckoning” – intensified during a pandemic where Black, Latinx, Native American and Pacific Islander communities were hit the hardest due to various factors, including enormous health and economic disparities created by historical underinvestment and systemic oppression. These harmful circumstances illustrate that structural racism is a public health crisis.

In California, 34 jurisdictions have declared racism a public health crisis. Governor Newsom, unfortunately, has failed to do so at the state level, just as he failed to support broader investments supported by the legislature to advance health equity last year, even as the state of California had an $85 billion surplus. His inaction seems to be rooted in two issues: failure to prioritize racial equity and conflating investments in health care with investments in prevention and public health.

The Legislative Analyst’s Office has estimated that the state will have a $31 billion surplus in the 2022-23 fiscal year. We hope that Newsom will use this opportunity to rectify his erratic record and make critical investments that address racism as a public health crisis.

To their credit, we commend Newsom and the legislature for expanding Medi-Cal coverage to undocumented individuals over 50 and reducing burdens for seniors looking to get Medi-Cal coverage and for enacting Senate Bill 65, the California Momnibus Act, which expands data collection on racial disparities in maternal health and expands access to CalWORKS and new Medi-Cal benefits such as midwifery and doulas.

These bills prioritize critical gaps in health care service delivery, but the disastrous effects of COVID-19 must serve as a reminder of the critical role of our public health system – which is much broader than health care and hospitals – to prevent disease and promote population health.

We are confused and disappointed that Newsom vetoed Senate Bill 682, which required the state to craft and execute a plan to reduce racial disparities in chronic diseases among children by 50 percent. And we are frustrated that Newsom slow-tracked the Health Equity and Racial Justice Fund, a budget request connected with Assembly Bill 1038 that would distribute at least $100 million in annual funding to help community-based organizations (CBOs), clinics and tribal organizations reduce health disparities.

Along with public health departments, CBOs are a vital component of public health infrastructure. Using their trusted relationships with their communities, they have stepped up to provide critical services throughout the pandemic. They have pivoted toward new services based on the needs of their communities – food delivery, vaccine administration, informing residents about economic relief, and much more in a culturally and linguistically competent way. Many of these organizations, especially those led by and serving low-income communities of color, lack funding. This fund would allow many CBOs to strengthen their critical work, by and for the community.

Our organizations are supporting the Health Equity and Racial Justice Fund as part of a broad statewide coalition. The legislature included the fund in its budget proposal, but after negotiations with Newsom’s office, it was not included in the final budget. Instead, Newsom delayed that funding and another request for annual funding to public health departments, saying it was not needed this year due to an influx of federal funding. There is also no guarantee the money for CBOs and public health departments will be in next year’s budget.

Another opportunity for Newsom to show support for racial equity advancement in the new year is Senate Bill 17, which would declare racism a public health crisis and establish an Office of Racial Equity governed by a Racial Equity Advisory and Accountability Council. This office would coordinate with state agencies and local governments to set benchmarks and goals that put California on a path towards being anti-racist.

We must convince Newsom and the legislature to stop using equity as a talking point while rejecting critical efforts to address institutional racism. California has often been viewed as a national trendsetter, so it is time for our state to finally address structural racism and health equity. We need commitments and measurable actions to undo the racism that has prevented Black, Brown and Indigenous communities from attaining optimal health and wellbeing.

DeAngelo Mack is the Director of State Policy for Public Health Advocates, where he directs state campaigns through a racial equity lens to better support community inclusive public safety and public health measures.

Ron Coleman is the Managing Director of Policy at the California Pan-Ethnic Health Network, where he leads the organization’s legislative, budgetary, and administrative advocacy to advance health equity and improve health outcomes in communities of color.

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