MOUNT VERNON — Before the end of the Knox County General Health District board meeting Wednesday evening, Knox Public Health Commissioner Julie Miller proposed the future passage of two documents related to negative health outcomes for African-Americans in Ohio compared to whites, and doing whatever possible to end those disparities.
One draft document is titled “KPH Statement on Racism, Inequity and Non-Violence” while the other is a proposed 2020 declaration, “Racism is a Public Health Crisis.” The documents may be discussed further and possibly acted on during a future board meeting, and their description produced differing views involving Miller and health board President Eric Siekkinen.
Part of the statement also continues, “Now more than ever, our community including Knox Public Health needs to develop and implement policies and practices that ensure the conditions in which all people can be healthy and thrive. Racism and inequity directly affect all aspects of health and are therefore a public health issue.”
Siekkinen, seated next to Miller during the board meeting, said he believed the inequities described facing African-Americans were “strictly about economics, and not race.” Miller countered that she has the data to back up inequities in health care. Siekkinen responded, “the assumption is it’s not their (African-Americans’) fault for the position they are in.”
The proposed 2020 Declaration, “Racism is a Public Health Crisis,” contains several Ohio-related findings related to racial disparities in health outcomes. One reads, “Whereas, racism, segregation, and socioeconomic gaps in Ohio have exacerbated a health divide resulting in Black Ohioans having lower expectancies than White Ohioans; being far more likely to die prematurely, according to the Health Policy Institute of Ohio. A contemporary example of this is the clear and highlighted data that show African-Americans are dying at a disproportionately higher rate from the COVID-19 (pandemic).”
Siekkinen and Miller discussed the terms surrounding “equality” and “equity,” with Miller offering that equity goes beyond equality. Equality means providing equal access to health care, but Miller emphasized that equity takes it further, basing health outcomes on what happens once African-Americans enter a health facility in terms of quality of care received and the outcome. She noted that African-American infants are three times more likely to die than white infants given the same financial circumstances.
“Something is wrong,” she said. She added that in her view, where it concerns health outcomes, “racism does occur; it impacts health; and it affects us, too.”
Siekkinen asked Miller what policies KPH uses that would show a lack of equity in the treatment of African-American clients seeking healthcare. Miller said that it will require a thorough examination of all KPH policies to ensure equity is prioritized.
The declaration on racism as a health crisis offers, “Whereas, Knox County itself is not especially racially diverse but Knox Public Health recognizes the systemic issues created by an inherently racist system that affects our black residents in Knox County and Ohio. Knox Public Health recognizes the systemic issues created by a racist and classist system and the disproportionately negative outcomes our low-income residents face, especially our black residents.”
Miller noted that the 2020 Declaration on racism came from Franklin County Public Health and was revised for KPH. Its resolved section states that KPH will engage in numerous practices to address health disparities and negative health outcomes affecting black residents, including:
•Assert that racism is a public health crisis affecting our entire community;
•Establish a glossary of terms and definitions concerning racism and health equity;
•Work to create an equity-orientated organization, with the board of health and leadership team identifying specific activities to embrace diversity;
•Incorporate into the organizational structure a plan for educational efforts to understand and address inequalities;
•Promote community engagement on topics like racism and equality;
•Commit to conduct all human resource, vendor selection and grant management activities through an equitable lens;
•Train all board of health members and staff on workplace biases and how to mitigate them;
•Support the use of health equity in all policies and embed equity across the agency’s existing and prospective decision making.
