Racism as a Public Health Crisis: A Qualitative Case Series of Public Health Responses in the Washington, DC/Maryland/Virginia Area

Abstract

Background The recent growing awareness of racism as a public health crisis has been hailed as a step in the right direction to addressing racial health disparities. However, the contemporary nature of these declarations and the diversity of responses pose important challenges. Objective: To evaluate whether declaring racism a public health crisis is mere rhetoric or a true catalyst for change. Materials & Methods Four public health officials in the Washington, DC/Maryland/Virginia area were recruited to participate in a series of in-depth interviews. Collected interview data were subsequently analyzed qualitatively for common themes. Results Participants across interviews emphasized the importance of naming and defining racism and characterized racism as an upstream root of racial health disparities. Participants described public health as a framework for achieving health equity by building trust with the community and collaborating with non–health sector partners. Local health agencies have examined new strategies to address health disparities, such as increased hiring into health equity initiatives, expansion of community and non–health sector involvement, and internal workplace inclusivity and unconscious bias training. Future challenges to progress include lack of control over policy as well as funding, staffing, and time constraints. Conclusions The results of this study indicate a shared understanding among participants regarding the influence of racism on disparate health care delivery and medical outcomes. In their efforts to improve health equity, local health agencies have implemented a variety of strategies, but progress remains incremental. Further, without the engagement of policymakers, non–health sector partners, and the community, public health organizations face substantial obstacles in their efforts to dismantle structural racism.