SDoH: Racism as a Public Health Crisis

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Original story posted on: August 19, 2020

The social determinants of health (SDoH) have been a top news item for several years. Since the advent of the pandemic, however, they’ve been eclipsed by interwoven themes of access disparities, racial injustice, and massive public health gaps. The virus has torn through the world’s poorest communities, and ripped the band-aid off of reactive and short-term efforts to address public health. As a result, one new hot topic is racism as a public health issue, with reports on it being published fast and furiously.

The American Public Health Association lists 20 states that have declared racism a public health crisis: California, Colorado, Connecticut, Georgia, Illinois, Indiana, Massachusetts, Maryland, Michigan, Minnesota, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Vermont, Washington State, and Wisconsin.

The implications associated with this:

  • Elevations in intimate partner violence and child abuse
    • Up 75 percent in some regions
  • Maternal mortality rates for black women are four times higher than whites
  • Life expectancy for blacks is a minimum of four years less than the rest of the U.S. population
  • COVID-19 has been decimating communities with higher rates of poverty, lower socioeconomic status, and higher rates of minorities overall (especially blacks and latinx)
    • Over 75 percent of latinx and 70 percent of blacks are experiencing income loss in metropolitan areas
    • Close to 30 percent are worried about food insufficiency
    • Close to 60 percent are worried about their ability to pay rent
  • Insufficient testing availability in public health sites
    • Insufficient and inaccurate data has the virus moving faster than the data needed to address it! Modernizing the antiquated public health infrastructure to properly address the health of communities mandates more than double the $500 million over 10 years approved by Congress in March, with many workers still relying on pen and paper to do the job.
  • The U.S. Census Bureau’s Household Pulse Survey has tracked COVID-19’s impact from April 23 to present on key SDoH by race and ethnicity, across the states. This particular information on racial and ethnic disparities was overwhelming, with as high as 80 percent of populations impacted by:

    • Unemployment
    • Expected income loss
    • Food insufficiency
    • Health insurance coverage
    • Inability to pay mortgage and rent
    • Mental health challenges

The American Public Health Association calls for swift allocation of resources and clearly defined strategic action. Medical experts are calling for more attention to preventative and community-based care. Even the Institute for Health Metrics and Evaluation and Institute for Healthcare Improvement  have released statements and amped up their actions. The clock is ticking, as more “have-nots” are appearing daily, needing far more resources than available.

For this week’s Monitor Mondays Listeners Survey, we asked our audience their views on this important topic. Over 50 percent of our audience responded to this survey asking whether racism is a public health issue, with results able to be viewed here.

Programming Note: Ellen Fink-Samnick is a permanent panelist on Monitor Mondays. Listen to her live reporting every Monday at 10 a.m. EST.

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management,  Social Determinants of Health: Case Management’s Next Frontier (with Foreword by Dr. Ronald Hirsch), and End of Life Care for Case Management are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk-Ten-Tuesdays, and member of the Editorial Advisory Boards of Professional Case Management, Case Management Monthly, and RAC Monitor. Ellen also serves as the Lead for Rise Association’s Social Determinants of Health Community.

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