This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

Racism has demonstrable negative effects on the health and wellness of people of color. African-Americans have the highest death rate and shortest survival for most cancers. About twice as many Black adults develop diabetes as white adults. Black mothers are 4.5 times more likely to die during pregnancy and the postpartum year. And in perhaps the most heart-wrenching statistic of all, in Michigan, more than three times as many Black babies die before their first birthday as white babies.

In times past, health care providers may have chalked up these grim disparities to genetics or lifestyle choices. But as science is proving – and the COVID-19 pandemic made clear — the real cause of these disparities is structural, institutional, and interpersonal racism. On the bright side, the state of Michigan and many of its municipalities have not only recognized racism's role in making Michiganders of color sick, but are also taking action to address the situation.

On Aug. 5, 2020, Michigan Gov. Gretchen Whitmer signed Executive Directive 2020-9, recognizing racism as a public health crisis, and asked the Michigan Department of Health and Human Services (MDHHS) to make health equity a major goal. Nearly 20 Michigan municipalities have since passed similar resolutions of their own. Here's a look at the actions three Michigan communities have taken since passing declarations that racism is a public health crisis.

Grand Rapids builds partnerships to fight crisis

Grand Rapids' "Resolution Declaring Racism a Public Health Crisis in Grand Rapids," passed in September 2021, states, "While our services are not direct health or medical services, we do bear influence on the health and wellbeing of our residents." Stacy Stout, director of equity and engagement for the city of Grand Rapids, says the city sought to follow Whitmer's lead.

"We thought it was important to support that momentum, that movement to recognize racism has very deep roots in our country and is the root cause of so many disparate health outcomes experienced by the Black, Indigenous, and people of color in our state and, definitely, locally here in Grand Rapids," Stout says. "... Part of this equity work is speaking the truth. Racism truly does negatively impact all of our health. The resolution is a way to honor those lived experiences."   
Stacy Stout.
Grand Rapids' resolution supports the city as well as local groups and organizations who have been steadfastly working to undo racism by providing data, leveraging grant monies, and forging partnerships. While Kent County Health Department officially oversees public health in the county, Grand Rapids is partnering with Spectrum Health Healthier Communities and community-based organizations like LINC Up, Invest Health – GR, and Access of West Michigan to build health equity within Grand Rapids' neighborhoods of color. The goal is to increase equitable health outcomes by advancing policies and practices that create capital and improve the built environment as a long term-strategy to improve community health. Focus areas include environmentally based health problems, access to nutritious food, economic security, infant and maternal mortality, and access to health care.

"Racism is deep and pervasive in so many systems, whether it's education, housing, transportation, or environment," Stout says. "Equity is one of the core values of our organization. And it's defined as leveraging city influence to intentionally remove and prevent barriers caused by systemic and institutional injustice. So, by passing this resolution, it really speaks to that definition of how equity shows up in our work." 

Washtenaw health and county boards align against racism

The Washtenaw County Board of Health declared racism a public health crisis in June 2020, and the Washtenaw County Board of Commissioners passed its own resolution to the same effect on July 1, 2020.  

"Our health department, for many years, had been prioritizing our work around advancing health equity in our county," says Jimena Loveluck, Washtenaw County Health Department health officer. "We knew from data that we've collected from community health assessments that we have health inequities in Washtenaw County. We really wanted to engage with community members, community leaders, and other stakeholders to work in partnership to address those health inequities."
Jimena Loveluck.
This collaboration, the Community Voices for Health Equity Group, aims to ensure that Washtenaw County practices public health from an anti-racist perspective.

"We had a major role in responding to a pandemic. We really were able to prioritize equity in our emergency response," Loveluck says. "We ensured that information was getting to people in a culturally responsive manner and that resources were allocated and distributed in a way that addressed the disparate impacts that we were seeing, whether it was COVID vaccinations, N95 masks, or home test kits. We really prioritized that resource distribution to areas and communities that were hardest hit by COVID."

Racism work was not new to the Washtenaw County Board of Commissioners. The county's Racial Equity Office guides the county in centering equity in all of its work.

"It involves us naming the problem. Truly, how we name the problem determines how we go about solving it," says Washtenaw County District 5 Commissioner Justin Hodge. "We want to be truthful and acknowledge that racism is a serious issue in our public health system but also in government in general. By acknowledging that this is a problem that we're working towards solving, our county is taking a bold step in moving forward on it."
Justin Hodge.
In addition to supporting equity-focused initiatives within the county health department and office of community and economic development, the board of commissioners created a new position of director of diversity, equity, and inclusion within the county sheriff's department.

"We're definitely making progress, and policy is a tangible piece of that progress," Hodge says. "Allocating funds to these initiatives that are really focused on anti-racist work is something that I see as a success of our county. Not only did we make this proclamation, but we're also committing the necessary resources to combat the issue, putting the money behind it. That's the part that doesn't always come."
 
Ingham County and the long haul

The Ingham County Board of Commissioners unanimously passed a resolution to declare racism a public health crisis in June 2020. Ingham County Health Officer Linda Vail sees the county's equity focus as an issue of power building and power sharing. She says that communities need to realize that sharing power does not mean losing power, and that gains made in equity are not losses for anyone else, especially when it comes to public health.
Linda Vail.
"We've long known that racism is a public health issue and have worked on racism as a public health issue," Vail says. "We've seen, over the last several years, a little bit more normalizing of racism and it really got to a crisis level. [With public health] in our community, we see a disproportionate impact on our people of color. And that is happening nationally."

Ingham County has since established a Racial Equity Task Force, and in 2022, hired a director of diversity, equity and inclusion. Vail suggests there's still lots of work to be done, however.

"I don't think progress is being made fast enough, and I don't say that in a derogatory way to the people that are working on it. This is a long history. It's going to take a long time to overturn it," Vail says. "We have groups of people who still are experiencing really unacceptable things. You'd like to flip a switch and make it happen overnight. But it's way too late. It's been way too long. The systemic and structural racism, the interpersonal racism, has been shown throughout the history of this country and continues to be shown today. Progress is slow but it is beginning."

Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at Estelle.Slootmaker@gmail.com or www.constellations.biz.

Stacy Stout photos by Autumn Johnson. Justin Hodge photo by Doug Coombe. All other photos courtesy of the sources.