Over the course of the past year, local and state governments have urgently declared racism as a public health crisis. On Aug. 5, 2020, Gov. Gretchen Whitmer signed an executive directive to this end and created the Black Leadership Advisory Council as an advisory capacity to develop and direct racially equitable policies and actions in Michigan. These declarations were long overdue, and both the COVID-19 pandemic and the surge in state-sanctioned violence in 2020 brought to light the historical failures of our institutions which serve as a constant threat to the health of marginalized populations.
Health inequities, or systematic differences in the health status of certain population groups, are driven by social determinants of health. “Healthy People 2020,” a federally supported prevention agenda, describes social determinants of health as “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health … outcomes and risks.” In other words, if an individual is born into a neighborhood that has poor access to health care, they do not have the appropriate means to maintain their health. These kinds of barriers are man-made, enforced by legislation that has been historically exclusionary. Thus, stark disparities across these factors must be traced back to their root cause: systemic racism.
Systemic racism is the foundation for the nation we live in today, but what does this ultimately mean for public health? What does this mean for future public health professionals as we strive toward a more equitable world for all? This past weekend, Public Health Awakened (PHA)’s Michigan Chapter hosted its first-ever public webinar promoting community education and engagement in a two-part series to discuss “Anti-Racist Public Health: What it is, What it is not, and What it Could/Should be.”
PHA is a grassroots organization that came together in response to the 2016 election. Since then, it has grown into a “national network of public health professionals organizing for health, equity and justice” — all the way from California to Washington, D.C., to Michigan. As a national project of Human Impact Partners, PHA focuses on incorporating the skills and backgrounds of its members as people in public health to social justice movements across the nation. Locally, the Michigan chapter has been actively involved in voting initiatives, harm reduction programs and the development of educational toolkits.
Importantly, PHA practices anti-racist public health to move beyond performative measures and create true, lasting change. For the organization, this entails an explicitly abolitionist agenda, which involves conscious re-education and coalition building, as well as a transformation of prison and policing systems from the inside out. Chapter members Jannah Bierens and Vanessa Fry kicked off the first part of this series by discussing the importance of historical context when considering health today. By raising awareness of the dominant narratives that justify current policies, Bierens encouraged attendees to dig deeper into the root causes of population health.
“History does not end,” Bierens reflected, “If we don’t know our history … We are missing a large part of our narrative.”
Re-education demands critical analysis of past legislation and how it continues to affect population outcomes. For example, FDR’s New Deal aimed to stimulate the economy through mortgage loans, but this aid only extended to the white population. Ultimately, the federal program legitimized housing segregation and left predominantly Black neighborhoods divested from further widening the racial wealth gap. The policy’s aftermath is still present in cities today that have poor access to nutritious food, high exposure to pollution and unsustainable infrastructure for natural and man-made disasters. Addressing public health is acknowledging racist history and power dynamics. At its most fundamental level, holistic public health must be actively anti-racist.
In the second part of the series, PHA invited guest panelists Maria Thomas and Jordan X. Evans to speak about their fieldwork in a Q&A moderated by Jannah Bierens. Thomas is a public health activist who works with the Washtenaw County-based organization Liberate Don’t Incarcerate, whereas Evans is a racial equity consultant and former Black Lives Matter organizer from Lansing.
Bierens guided the panelists through reflective questions about anti-racist public health and how they engage with it from a social justice perspective. Both Thomas and Evans expressed the need for a rejection of surface-level politics and called for active abolition within public health. However, as the two speakers noted, this requires practitioners to recognize the ways in which public health itself indulges in police-like logic within its systems like in the case of medically unnecessary drug testing, homelessness criminalization and HIV prosecution. These kinds of funneling methods disproportionately criminalize populations and further legitimize police states, bringing to light the need for abolitionist public health practice: public health practice that is present.
When asked how to personally and professionally connect to this kind of work, the two speakers imparted their wisdom.
Evans encouraged people to think about the global community: “What’s impacting us is impacting the world.”
The struggle for liberation extends across borders in culturally distinct realms, and in public health specifically, Evans highlighted the importance of stepping back and giving space to the communities we wish to uplift. Thomas spoke to this end signifying the need to understand how to show up, drawing inspiration from Robin DG Kelley’s philosophy of “Love, Study, Struggle.”
“It’s one thing to say ‘be in relation with communities’ but it also matters how you do it,” She explained, “(Kelley’s) words really help me orient myself to the work.”
Anti-racist public health is a deliberate effort that Bierens described as reliant on intention, commitment and a grand consideration of impact. She additionally made the distinction of what it is not. Anti-racist public health is not street murals whose funding would be best allocated elsewhere, nor is it blanket declarations without policy to back it up. Pursuing a career in public health means connecting with and listening to our communities — especially the ones that have been legally ignored — and this group urged individuals to find their political home as a first step in the process.
For students in public health, it is imperative to get involved in the same issues we are learning about in the classroom. Public Health student Lyric Kleber took the time to engage with his community this past year by joining Public Health Awakened. Intrigued by the political and social factors related to health, he was eager to get to work with the organization.
“This is the kind of work I need to do,” Kleber realized, “What I find really inspiring about being a part of this group is that most of the members are actively engaged in public health or advocacy work in their daily lives … and everyone brings a unique and critical perspective.”
Kleber’s experience with PHA demonstrates the capacity of the collective to empower each other while individually leaning into one’s own strengths. In confronting anti-racist public health, we must turn to grassroots organizations like PHA to understand and support the health needs that communities are fundamentally deprived of. It is quite reductionist to write off this kind of work as political well-wishing when there are greater systems in place that have maintained unjust power dynamics to dismiss entire populations. Instead, we must draw from this culture of support and attentiveness for our communities within the realm of public health to enact effective change. As the saying goes, “culture eats policy for lunch,” and there is power in organized culture.
MiC Columnist Easheta Shah can be reached at firstname.lastname@example.org.