In DeKalb County, racism has been declared a public health crisis.
Led by District 3 representative Larry Johnson and spurred on by a group of Emory University medical students, the Board of Commissioners adopted the resolution last week.
DeKalb is believed to be the first government in Georgia to make such a declaration, but joins about five dozen other states, counties and cities across the country that have taken similar actions in recent months.
The idea has gained momentum thanks to the confluence of the coronavirus pandemic — which has disproportionately affected Black people and other minority groups — and nationwide protests over the police killings of Black Americans.
But what, exactly, does it mean? And what happens now?
DeKalb’s resolution, like the others, is predicated on scores of studies that have documented how the discrimination long-ingrained in American society produces disparate health outcomes for Black people and other minorities.
Per the Centers for Disease Control and Prevention, Black Americans also have shorter life expectancies and are more likely to be diagnosed with conditions like heart disease, stroke and diabetes. Black babies are more likely to be born underweight and more likely to die. In Georgia, Black mothers are up to four times more likely than white mothers to die during child birth.
Much of the disparity can be tied to a legacy of policies and practices limiting Black Americans’ access to housing, education, jobs, food and health care itself, experts and scholars say.
“Racism attacks people’s physical and mental health,” Dr. Georges Benjamin, executive director of the American Public Health Association, said in a recent statement. “And racism is an ongoing public health crisis that needs our attention now.”
Mere acknowledgement of the issue is not inconsequential. After all, governments and government leaders have historically played significant roles in perpetuating the cycle through discriminatory policies.
But Johnson said the current movement is about a lot more than lip service. The idea is both simple and potentially seismic. Take a closer look at things, re-evaluate how you do them and why, follow the data and be more intentional about addressing inequities, he said.
“We’re a billion-dollar-budget agency,” the commissioner said. “And all of these institutions that build our quality of life, we have some decision-making in the process. So how do we use our influence to make sure these things come from a equitable standpoint?”
DeKalb’s resolution includes a renewed commitment to keep racial equity and communities of color in mind while making policies, and to encourage partners — including community organizations and government contractors — to do the same.
It urges DeKalb leaders to “support community efforts to amplify issues of racism and engage actively and authentically with communities of color wherever they live.” It pushes for “enhanced educational efforts” and racial equity training for county employees.
Eventually, more specific goals and objectives will be identified. There will likely be some sort of “equity study” to clearly identify disparities and potential solutions.
But Johnson said there are plenty of obvious issues to tackle. He envisions exploring initiatives like increased funding for the county health department and community service board, more assistance for first-time home buyers, more deescalation training for local police — and a renewal of the years-long call for MARTA rail in the southern end of DeKalb.
Johnson’s resolution has the backing of the DeKalb NAACP, which described it as “a catalyst for other authorities to look at racism in a different light.” The resolution was also co-sponsored the DeKalb Board of Health and district health director Dr. Elizabeth Ford.
Ford, who is also the newly minted president-elect of the National Association of County and City Health Officials, said that racism “absolutely” qualifies as a public health crisis. COVID-19 has made that apparent again, she said.
Like elsewhere in Georgia and throughout the country, DeKalb’s COVID-19 data is incomplete. But in cases where race is known, Black DeKalb residents outnumbered white residents two to one. Hotspots have also popped up in areas with large Latino populations.
Ford said there are several potential reasons: Many of the industries considered “essential businesses” during the pandemic are largely staffed by members of minority communities, increasing their risk for exposure. They’re also less likely to have a place to self-isolate once diagnosed. And many pre-existing conditions — like those minority groups are more susceptible to — can produce more dire outcomes for those infected.
“If we don’t get to the root cause of why we saw the numbers so uneven in our community, if we don’t address that, I think we’re going to continue to have that level of disparity,” Ford said. “And we’ve been seeing that for generations.”
‘Even if it’s not for you, you still push’
If efforts in other communities are any indication, progress may come slow. Big changes take time.
Last spring, Milwaukee County, Wisconsin, became the first county in the country to declare racism a public health crisis. County executive David Crowley said the focus is on viewing everything -- from staffing and training to budgets and bus routes -- through a lens of promoting equity.
It’s about being more deliberate and less reactionary, he said.
“We want to change how we fundamentally do business,” Crowley said.
Joanne Pierce works as Durham County, North Carolina’s “general manager of public health and community well-being.” Durham County declared racism a public health crisis in June but has been focusing on racial equity for several years.
Pierce said progress is still hard to quantify, but the discussion has changed. It’s no longer about convincing people that systemic racism exists, but about how change can be made.
The short answer? Slowly.
The long one? By analyzing the data, by looking within, by getting everyone involved, by coming up with a plan, and by acting with intention and ambition. And by not being overwhelmed by the scope of it all.
“It’s hard to fight for and work toward something that you don’t believe will happen,” Pierce said.
The Student National Medical Association at Emory University lobbied for DeKalb County to adopt its recent resolution. It has also submitted drafts of similar declarations for consideration by the Fulton County commission and the Atlanta City Council.
The association’s president, second-year medical student Jasmin Eatman, said the effort is a continuation of the group’s legacy. The National Medical Association was originally formed by Black doctors who were prohibited from being members of the existing American Medical Association.
Eatman is hopeful and energized and passionate about the cause and the changes that could come. But she’s not naive. She knows that she may never see true change. Her children might not.
That doesn’t change anything.
“Even if it’s not for you,” Eatman said, “you still push.”