Clark County declares systemic racism a public health crisis

CLARK COUNTY — The Clark County Board of Public Health on Wednesday voted to approve a resolution declaring systemic racism a public health crisis.

Not all of the County Council members were on board with the resolution

“This is a really important first step,” said Councilor Temple Lentz, who introduced the resolution in October. “I don’t think any of us are under the impression that passing this resolution magically changes anything.”

The Clark County Public Health building in Vancouver. File photo
The Clark County Public Health building in Vancouver. File photo

What the resolution does do, Lentz said, is provide a framework to “really intentionally take on this work.”

“I know this can be a sensitive topic for some,” added Councilor Julie Olson, “but the data is there, the science is there to support this, that systemic racism is a determinative of health.”

Not all of the council members agreed.

During a Nov. 4 Council Time meeting, both Councilor Gary Medvigy and Council Chair Eileen Quiring O’Brien expressed skepticism about the need for such a resolution, especially since the full council already approved a resolution condemning systemic racism earlier this year.

“The nexus between structural racism and health outcomes is nebulous,” Medvigy said at the November meeting. “I think it’s just passing a resolution that isn’t based on science.”

Medvigy and Quiring O’Brien were absent from Wednesday’s Board of Health meeting, though Quiring O’Brien said it was due to a long-planned trip, and not an attempt to avoid the issue. Medvigy said he was under the weather.

“My presence would not have made a difference as there were apparently 3 necessary votes,” Quiring O’Brien said via text. “It was at the insistence of Lentz and (John) Blom that this was on the agenda.”

The resolution was born out of a request made by the Southwest Washington League of United Latin American Citizens (LULAC) to the mayors of Clark County cities.

“The roots of racism impacts the health of people of color in every aspect of their lives, including access to education, housing, and job opportunities,” that letter read, in part. “We are seeing this play out during the COVID-19 pandemic, with communities of color being infected with the virus at disproportionately high rates due to lack of access to adequate health services, including coronavirus testing and treatment.”

LULAC noted that Hispanics account of 10 percent of the Clark County population, but 34 percent of confirmed cases. The disparity statewide is even larger, with 44 percent of cases versus 13 percent of the population.

That letter prompted the mayors of Vancouver, Camas, Washougal, La Center, and Ridgefield to send a letter to the Clark County Board of Health and Washington Secretary of Health John Wiesman, urging them to look into the issue of systemic racism as a public health threat.

“Our Cities do not have Health Departments,” the letter reads. “We therefore lack the expertise and the authority to declare a ‘Public Health Crisis.’ That expertise resides in the Health Departments and Authorities of Washington State and Clark County.”

In response, Clark County Public Health Officer and Health Director Dr. Alan Melnick put together a six-page report, detailing some examples of racial disparity in public health outcomes, along with potential benefits of approving a resolution declaring the situation a public health emergency.

“Racism is an ongoing public health crisis and we need to address it now through new and improved policies, community engagement, improved and affordable access to healthcare, physical activity and healthy eating,” that report reads, in part, “in order to reduce the health disparities we see in communities of color.”

With regards to COVID-19, the report notes that Latino populations may especially be at risk due to the types of jobs they often work in, and multi-generational living situations.

“OK, it’s their job, not their race,” Quiring O’Brien said to that information last month.

The report also points out that life expectancy for white males in Clark County is nearly five years longer than for black men, and 15 years longer than people of Hawaiian or Pacific Island ancestry.

Uninsurance rates for communities of color are also three times higher than among caucasians, the report found.

Councilor Blom, who has a background in history, said Jim Crow laws and “redlining” in the 1930s through the ‘50s which prevented many black families from buying homes near job centers has created much of the current problem.

“With lesser opportunity to wealth comes less opportunity to education, comes lesser opportunities for health care,” Blom said Wednesday. “And all of these things have now contributed to what we have today in disparate results and disparate impacts.”

While admitting that the resolution, on its own, will have little immediate impact on those issues, Blom said it represents “one very small step at shifting that balance to trying to spend money on the front end of the problem.”

Medvigy said in November that he agrees with data showing many minorities face difficulties, but that he didn’t believe there was a clear connection with systemic racism in existence today.

“I’m not ignoring (that data),” Medvigy said, “but nor is there any nexus with structural racism.”

Medvigy added that Dr. Melnick and other public health officials have repeatedly told him the county is working hard to provide health services to everyone, no matter their race, gender, or income level.

“Nothing different would happen from having a different resolution,” he said. “Whether people are undocumented, uninsured, they have all received the help that the community caregivers can give them.”

But Olson pointed to the annual ACE, or Adverse Childhood Experiences survey, which is an effort to track how childhood trauma impacts a person’s health later in life.

A 2018 study by the Centers for Disease Control and Prevention (CDC) showed 61 percent of black children and 51 percent of Hispanic children have faced at least one trauma during their childhood, compared with 40 percent of children in white families. 

Childhood trauma is linked to long-term health impacts, such as behavioral issues, drug and alcohol addiction, obesity, heart disease, and mental health problems.

“Clearly systemic racism has an impact on these populations,” said Olson, “ and adds to these ACEs scores.”

The resolution, said Olson, Lentz, and Blom, will help to focus the public health department’s efforts to research and address those disparities.

“This is a step and a symbol that we’re recognizing that in many ways our system is out of balance, it has been for centuries,” said Blom, who leaves office at the end of the month. “For me, this is a good way to be wrapping up four years.”