Five years after Cleveland declared racism a public health crisis, a coalition to address the problem has issued its first report, drawing a mix of praise and criticism from the community.
The 52-page report, developed by the Racism as a Public Health Crisis Coalition, a public-private partnership, touches on issues previously discussed in public feedback sessions. It examines systemic barriers in education, housing, workforce development, public health and criminal justice.
It recommends tactics for improving infant health outcomes, addressing lead exposure, expanding affordable housing and boosting economic opportunity.
For example, to improve equity in heart health, the report calls for new laws that limit smoking and vaping, and that place limitations of the marketing of those products. It also calls for longer clinic hours so people can more easily access their primary care providers.
Cleveland Commissioner of Health Equity and Social Justice Lita Wills said at at recent Cleveland Health, Human Services & the Arts meeting that the coalition is using data to measure results and guide policy.
鈥淲e look at social determinants of health to measure equity and the impact of our work. It ends up being a very good way to measure something that鈥檚 kind of nebulous,鈥� she said.
Using that information, Willis said, 鈥渨e can legislate... change policy... (and) change procedure (in the areas of) health, education, financial mobility and stability.鈥�
But some community leaders said the report does not go far enough. D谩na Langford, founder of Village of Healing Center, a culturally-sensitive care clinic, said while the report acknowledges the need for more Black providers and those that practice culturally competent care, it does not address challenges in retaining those caregivers once they enter the workforce 鈥� or the structural racism patients may experience.
鈥�(The issues in the report are) taught in school. However, when people get into the actual health care system, because it is an institution filled with structural racism, it continues to create barriers for Black patients,鈥� Langford said.
She suggested expanding the pipeline of Black providers and investing in community-based care.
Mark Joseph, a professor of community development at Case Western Reserve University, said the report effectively addresses the ways racism shows up in society 鈥� in racial disparities in health, education and finances, for example. He also applauded the report's inclusion of data to back up those issues. But he said the recommendations miss a crucial step.
鈥淭he report treats racism and its challenges as a technical issue that can be solved through the right tools, programs and policies, when in fact racism is both a technical and an adaptive issue鈥� 鈥� meaning that all of society must adapt to make real change, Joseph said.
He said to truly reduce racial inequities, the city and its systems also need to address underlying biases, power imbalances and how people make decisions.
Joseph said ongoing community engagement and accountability could help address those inequities.
The coalition had faced criticism for taking too long to devise specific strategies and make final recommendations, but leaders defended the group鈥檚 pace of work, pointing to its complexity.
As a next phase of work, the coalition plans a public presentation of the report 鈥� on a date yet to be determined 鈥� community listening sessions and progress scorecards to track results.
Council recently approved up to $400,000 more to support the coalition鈥檚 next steps.
