To: Sonoma County Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Tina Rivera, 707-565-4774
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Declaring Racism as a Public Health Crisis in Sonoma County
End
Recommended Action:
Recommended action
Adopt a Resolution Declaring Racism as a Public Health Crisis in Sonoma County
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Executive Summary:
In 2020, the role of racism in health outcomes was thrust into the spotlight through the co-occurring crises of the COVID-19 pandemic, with its disproportionate impact on people of color, and the national racial reckoning catalyzed by the consecutive murders of Ahmaud Arbery, Breonna Taylor, and George Floyd, by law enforcement. As a nation, and as a county, we faced an increased sense of urgency to understand and address the role that racism plays in poorer health outcomes and, in the worst case, lower life expectancy rates for people of color and, in particular, Black people.
The 2021 update to the Portrait of Sonoma County highlighted the specific and pernicious ways in which racism impacts health and the social drivers of health here in Sonoma County, including: lower life expectancies for Black people in Sonoma County; lower rates of educational attainment among Latino, Black, and Native Hawaiian/Pacific Islander community members; and lower median earnings among Latino, Native American, and Native Hawaiian/Pacific Islander people in Sonoma County. These inequities are unacceptable within a thriving, healthy community.
Further, these inequities are not organic. They are the result of the cumulative effects of racism that is baked into our institutions and structures. Structural and institutional racism consists of the policies, practices, and systems within and across institutions in a community that disadvantage people of color and create and perpetuate outcomes that are inequitable (source: Race Forward). But these inequities are not intractable. Institutions can and must examine, amend, and update their policies, practices, and systems to eliminate bias and racialized impacts. In recent years, one increasingly common approach institutions have taken to their commitment on this front is explicitly naming racism as a crisis and committing to eliminating racism in institutions and structures. As such, and with the outsized and critical impact racism is demonstrated to have on health and well-being, Department of Health Services staff are presenting a resolution to declare racism a public health crisis in Sonoma County to further our County’s work and commitment to antiracism work.
Discussion:
Staff and leaders within the County of Sonoma have long understood the impact that racism has on the health and well-being of a community. In 2018, the County launched its inaugural cohort to participate in the Government Alliance for Racial Equity (GARE) and followed with a second cohort in 2019. In 2020, in the throes of the COVID-19 pandemic and its disproportionate impacts on communities of color, as well as amid large-scale international protests in response to racialized police violence, the County of Sonoma established an Office of Equity and the Department of Health Services established an Equity Manager to oversee equity within the COVID-19 response. In 2021, the County adopted its latest Strategic Plan, with a Racial Equity and Social Justice Pilar to “ensure racial equity in County service provision and ensure a workforce reflective of the community we serve.” In the same year, the Office of Equity launched its Core Team and provided training, support, and modeling to staff across the County who wanted to be more engaged in actively addressing racism.
The Department of Health Services, in 2022, established a centralized Health Equity team to provide the needed staff resources to support the department’s equity work. Working in concert, and alongside many other County Departments and Agencies, these staff and teams have begun to create the infrastructure Sonoma County needs to address racism and the disproportionate health impacts and outcomes in our local communities of color.
One of the important results of these efforts is the increased data we have as a county to help us understand the ways that racism impacts our community. The 2021 update to the Portrait of Sonoma County called out some key, and alarming, inequities within the social drivers of health locally. Specifically, it found that:
• Black people in Sonoma County have a life expectancy at birth that is ten years shorter than white people in Sonoma County (71 years compared to 81.6 years);
• 13.3% of Latino adults and 10.4% of Native American adults living in Sonoma County have at least a bachelor’s degree, compared to 41.5% of white adults;
• The median earnings for Latino, Native American, and Native Hawaiian/Pacific Islanders fall nearly $15,000 less annually than the median earnings for white people in Sonoma County.
The DHS Community Health Dashboard disaggregates local health and well-being data by race/ethnicity where possible. Some key datapoints about local inequities from that dashboard include in the following:
• Sonoma County Black and Hispanic/Latinx children are about 2.5 times more likely to live in poverty than their White counterparts;
• Black people are 2.3 times more likely to be without health insurance and Hispanic/Latinx people are 4.1 times more likely to be without health insurance than White people;
• People of color are overrepresented in our county’s unhoused population, with 12% of unhoused persons being Native American/Alaska Native and 8% Black compared to the county population of which 2% is Native American/Alaska Natives and 2% is Black.
These outcomes are the result of centuries of laws, policies, and systems that disadvantage people of color. They contribute to poorer health outcomes within these communities because they prevent people from gaining access to the programs, services, resources, and opportunities they need to live and thrive.
In 2018, Milwaukee County Wisconsin was the first jurisdiction to declare racism as a Public Health Crisis. In the wake of the murder of George Floyd in spring 2020, and the mass international protests that followed, many other jurisdictions have adopted similar declarations detailing the national and local impacts of racism on health. These resolutions are important steps in calling attention to the impacts of racism on a local level, changing narratives, creating will, and developing strategies to eliminate racism in local systems and institutions. According to the American Public Health Association, 265 state, county, city and other jurisdictions have passed resolutions declaring racism a public health crisis to date, including at least 38 jurisdictions in California.
With this in mind, Department of Health Services staff present a Resolution to Declare Racism in Sonoma County a Public Health Crisis. This Resolution complements the equity work already being undertaken across Departments and by our community partners to eliminate racism in our systems and local institutions and was developed with input and support from the Office of Equity. The Resolution commits the County of Sonoma and its Board of Supervisors to the following actions:
1. Foster a County organizational culture that supports the commitment to achieving racial equity by investing and continually developing an ongoing racial equity learning and leadership program to build antiracist skills and capacity in the county.
2. Identify and deploy best practices that promote racial equity and address institutional, structural, systemic and interpersonal racism in all Sonoma County's community facing services and the internal facing services that support County operations.
3. Adopt and implement a Health Equity Action Plan, Community Health Assessment, and Community Health Improvement Plan that specifically address structural racism.
4. Advocate for, prioritize, and fund efforts that distribute and allocate resources and time toward antiracist goals and the needs of communities of color.
5. Strengthen relationships and partnerships with community-based organizations that are confronting racism.
6. Promote early and ongoing community involvement by engaging the community members and stakeholder groups most impacted by racism to advance racial equity.
7. Implement strategies to ensure that the County of Sonoma workforce reflects county demographics, especially the demographics of people utilizing County safety net services.
8. Ensure the consistent collection, analysis and reporting of disaggregated demographic data, including race/ethnicity, socioeconomic, health, workforce, and other data to assess, evaluate and measure progress towards eliminating racial inequities.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Racial Equity and Social Justice
Goal: Goal 1: Foster a County organizational culture that supports the commitment to achieving racial equity.
Objective: Objective 4: Develop a shared understanding of key racial equity concepts across the County and its leadership.
Declaring Racism as Public Health Crisis serves to deepen and further the county’s understanding of the intersection between race, racism, and health and well-being. This resolution does not ask for additional investment, resources, or re-direction of existing funds.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
February 6, 2024-Received a report on the DHS Community Health Assessment and Community Health Improvement Plan progress.
February 7, 2023-Received Strategic Plan annual update and approved Year 2 funding recommendations.
June 13, 2022-Authorized the Office of Equity to execute a Professional Services Agreement to establish the Equity Steering Committee and support the development of a Racial Equity Action Plan.
February 1, 2022-Received a Strategic Plan update, accepted Objective Implementation Plans, and approved Strategic Plan Funding recommendations.
March 2, 2021-Adopted the 2021-2026 Sonoma County Five-Year Strategic Plan.
July 7, 2020-Established the County of Sonoma Office of Equity and appointed an Interim Equity Officer.
Fiscal Summary
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Narrative Explanation of Fiscal Impacts:
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Narrative Explanation of Staffing Impacts (If Required):
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Attachments:
Attachment 1 - Resolution
Related Items “On File” with the Clerk of the Board:
None