Tuesday’s National Public Health Week theme is “Advancing Racial Equity.” Racism has long caused physical and mental harm to people of color in the U.S. The systems and structures that perpetuate racism have contributed to a public health crisis, which the U.S. must dismantle if we are to move toward racial healing. 

Aletha Maybank, MD, MPH, is the American Medical Association’s inaugural chief health equity officer and group vice president. She discusses how to work toward racial equity in communities and beyond. 

We know racism is a public health crisis. What can individuals do about it?
Dismantling racism will require acknowledging race is a social — and not a biological — construct. As Dorothy Roberts teaches us, “Race is a social category that has staggering biological consequences...because of the impact of social inequality on people’s health.” 

This impact operates through the system of racism — a system of power that structures opportunities and assigns value based on skin color. As a system, racism operates on several levels: structural, institutional, interpersonal and internalized. At all of these levels, racism works to advantage some groups and disadvantage others. 

It is imperative that individuals, but also institutions and systems, do the work of investigating how racism operates in their daily practices, how racism permeates and shapes our beliefs and ideas. Only by doing that can we challenge racism at all levels and disrupt the status quo that is so harmful to so many. 
Sometimes this will mean advocating for change to systems, other times it may mean not standing in the way of change, and especially not contributing to the creation of new systems that will further block people from accessing resources or giving advantage to one race over another. 

Hate crimes have risen against Asian Americans. What can public health do about this? 
It’s first important to acknowledge that anti-Asian sentiment is not new in this country. From the “yellow peril” days after the passage of the Chinese Exclusion Act of 1882 to the forced removal of thousands of Japanese citizens into concentration camps, Asians have been targeted throughout the history of this country. It’s also important to remember that Asians are not a monolith and that the commonplace grouping of all across the diaspora into one category is not only damaging but irresponsible. 

Recently and early in the pandemic, the AMA urged individuals and organizations within health care to denounce xenophobia and racism — interpersonal and structural — as both are root causes of ongoing health inequities. The AMA also urges physicians, and the organizational bodies that represent them, to adopt a health equity lens in public health and clinical settings, particularly in the face of great health care system strain.

Where are we winning in the fight against racism, and where can we find some hope?
Historically, and in the not-too-distant past, AMA policies have not always been well-aligned with a health equity imperative. In recognizing our power and influence in medicine and health both historically and contemporarily, our American Medical Association is demonstrably and accountably committed to eliminating systemic, preventable and unjust differences in health, quality of health care and associated health outcomes for historically marginalized and oppressed populations, such as people of color, women, people with disabilities, the LGBTQ+ community and other underserved and marginalized communities. 

President Biden in his first days of office signed several executive orders, including one to advance racial equity and support for underserved communities through the federal government and an order creating a COVID-19 Health Equity Task Force. The task force is part of the government-wide effort to identify and eliminate health and social disparities that result in disproportionately higher rates of exposure, illness, hospitalization and death related to COVID-19.

How can we maintain the momentum gained during recent protests for social justice?
The momentum can be maintained and escalated by remembering the spirit and actions of people dedicated to the protests. People should not disregard the discomfort that comes from talking about racism, and find ways of incorporating it more frequently in their daily lives, especially when there are examples of interpersonal or systemic racism that can be seen but aren’t acknowledged. Recognize the long historical arc of this work.

We stand on the shoulders of those who have come before us: generations of people who have fought for a fairer and more just society, people who recognized the injustice of racism in all its forms and who struggled to overcome that injustice. We must also recognize the centrality of activism from outside of the health care system that has brought about change.  

This interview was edited and condensed.

Learn more about advancing racial equity on the NPHW and APHA websites. 

Watch and share: Aletha Maybank’s NPHW message on racial equity

(Photo by Pixelheadphoto, courtesy of iStockphoto)