During a June 8 meeting, Akron City Council voted unanimously to approve a resolution declaring racism a public health crisis.
The City Council declaration is an official acknowledgement of the social and systemic inequity Black Americans have faced for centuries; of the local, state and federal government’s role in intentionally upholding and deepening those inequities; and of the city’s intention to directly address racial justice and inequity moving forward.
Though the resolution doesn’t institute immediate policy change, it does call for the support of future equitable policies, and “[urges] the Mayor to create a Special Taskforce to develop a five-year Equitiy and Social Justice Strategic Plan,” which should be ready to present to Akron City Council, Mayor Daniel Horrigan and Summit County Health Commissioner Donna Skoda by June 2021.
The resolution officially recognizes racism as “a social system of multiple dimensions,” and names systemic and institutionalized racism as the root cause of disproportionately high rates of chronic disease, mortality, homelessness, poor education, incarceration, poverty, economic distress and negative health outcomes in Black communities.
Per regulations issued by the Centers for Disease Control and Prevention, once a public health crisis is declared, lawmakers are required to take identifiable steps to address the inequities that contributed to the crisis’ emergence.
For city councilmember Russ Neal and other officials, the resolution acknowledges a stark reality that has long been avoided by white lawmakers and elected officials: Black Akronites have suffered deeply because of intentionally racist policies and practices.
“To address that, you really have to take a step back and allow those who are feeling it every day to tell you how the present engagement has adversely impacted them,” Neal says. “We have to engage those who have been adversely impacted by our past practices to help come up with the solutions.”
Summit County Health Commissioner Donna Skoda agress, and says there are far more factors that determine the health and well-being of Black Akronites than most people realize — and they increasingly overlap and compound, deeping inequities in the process.
“We have been taught to believe that if you get healthcare, that is what determines how long you’re going to live or what is going to happen,” Skoda says. “But what we’ve realized is that there are social conditions that play just as big a role.”
For example, historic development practices, such as highway construction and “urban renewal,” have demolished majority-Black neighborhoods and forced people to move out of familiar, safe communities. Further, segregated public housing, redlining and other discriminatory housing policies have made Black Akronites more likely to rent older homes in older neighborhoods, which makes them more likely to encounter poor air quality, lead paint and other serious health risks in their own homes. These neighborhoods are more likely to be “food deserts,” lacking grocery stores that carry fresh produce and healthy staples.
“[Black people] have higher [rates of] hypertension, diabetes, obesity, asthma,” says Tamiyka Rose, the City of Akron’s Health Equity Ambassador.
Additionally, due to a historical lack of access to educational and economic opportunities, Black Akronites are more likely than their white peers to earn low wages at high-risk, frontline jobs in the service industry, Rose says.
Presently, these conditions make Black Akronites disproportionately likely to contract COVID-19. According to U.S. census data, Black Americans make up just 15% of Summit County’s population, but they account for nearly 24% of Summit County’s confirmed COVID-19 infections.
Because Black Americans are less likely than their white counterparts to have access to affordable healthcare, and more likely to live in older homes or congregate settings, the likelihood of spreading the virus among family members is often high, Rose says.
Even when Black Americans do have access to affordable healthcare, Rose says their symptoms are more likely to be dismissed or ignored by doctors.
“There’s an inequity in who’s providing the healthcare,” says Rose, citing research that found white doctors, on average, spend far more time with white patients than they do Black patients. “There’s that implicit bias there” — which may discourage Black Americans from seeking preventive care.
If we’re serious about addressing the centuries-long racial inequities in the U.S healthcare system, Skoda says, state and local governments need to build a better approach.
“We need to stop thinking about whatever is happening in the same way, change the direction, and try to respond and make significant changes,” says Skoda.
Racist policies and practices exist in all institutions, but Skoda says there are policies that can and do increase equity. Our communities become healthier when people have access to adequate educational programs and funding, make livable wages, and are able to access affordable, culturally competent healthcare, Skoda explains.
But locally, she suggests something more specific: pursuing policy that could bridge access gaps for everyone, not just Black Akronites.
“For young families, social supports are critical,” Skoda says, pointing to nations that offer free daycare or after-school care so parents can work. “But that is a policy choice,” Skoda adds, “and all of those things cost money.”
In addition to money, implementing programs and policies that yield identifiable improvements in the overall health and well-being of Black Akronites takes time and commitment.
“We have to do that kind of deep-dive discussion,” says councilmember Russ Neal. “And it’s not just about discussion — [It has to] lead to policy that will change that inequitable practice.”
Still, Neal says that government and private institutions alike can’t always be relied upon to deliver just or equitable solutions on their own.
“We’re asking those who have always been a part of the problem to come up with the answer,” Neal says.
Addressing how racist systems and institutions affect the health and well-being of Black communities isn’t easy or simple work, Neal says. In fact, it requires a deep and lasting shift in community consciousness.
“I think, sometimes, what has to happen is just acknowledging that these institutions are broken—[that] education, government, the church, the business community [all have] these flaws. As a city, and as a county, we need to admit that we’ve allowed racism to exist too long and that it has a grip over society.”
City of Akron Health Equity Ambassador Tamiyka Rose, too, calls the resolution part of a much longer process toward more equitable and restorative models of justice. But Rose, Neal and Skoda are cautiously optimistic.
“The beautiful thing,” says Neal, “is that if you look at history, when you address the issues that are impacting [the most vulnerable people] — and you address them properly —you improve the quality of life of our whole society.”
H.L. Comeriato covers public health at The Devil Strip via Report for America. Reach them at HL@thedevilstrip.com.