Opinion: Where is the City of Philadelphia’s urgency in response to racism?

As legal services advocates and activists, we join public health experts to demand that the City of Philadelphia declare racism a public health crisis.

To make this declaration meaningful, the city must reallocate substantial funding to dismantle systems of oppression and address racial health disparities.

In the predominately Black North Philadelphia neighborhood of Nicetown, we can expect a woman to live 13 years fewer than if she was from a much whiter neighborhood in Center City. Research also shows that she’s more likely to face bias and subtle intimidation even when she goes to her doctor, who is sworn to do no harm. The homes in Nicetown and other North Philadelphia neighborhoods also have the highest rates of housing code violations in the city and more North Philadelphia children have unsafe levels of lead in their bloodstream than children in Center City.

Black Philadelphians in neighborhoods like Nicetown are more likely to be unlawfully stopped and frisked than white residents — a hurt compounded by the revelation that at least 72 Philadelphia police officers were publicly making racist posts and comments on social media, and later faced discipline.  Living in a targeted neighborhood has both psychological and physical impacts on health.

Although these neighborhoods are only a few miles apart, systemic racism and policies that oppress people of color place them worlds apart.

Every day, we see clients dealing with serious medical issues exacerbated or caused by poverty and racism, from people of color with serious disabilities who have been denied the support they legally qualify for, to women of color who do not have access to safe, walkable community spaces or wellness tools to heal and thrive.

At CLS [Community Legal Services of Philadelphia] we help people with disabilities who apply for urgently needed Supplemental Security Income (SSI) to help keep them afloat. Black Philadelphians are more likely to be disabled than any other demographic because of policies that push Black children into underfunded education systems; Black workers into hazardous working conditions; and Black families segregated neighborhoods where they suffer from food insecurity, unsafe housing conditions, and polluted air and water.

Yet, they receive lower quality medical care and less aggressive treatment to manage these disabilities. In turn, people with disabilities who are unable to support themselves through work — the very people for whom the SSI disability program was created — cannot access the medical treatment they need to obtain SSI.

The COVID-19 pandemic has further intensified negative health outcomes along racial lines. Black Philadelphians have the highest rate of COVID-19 deaths in city. One of the major reasons why we are the poorest big city in the country is that, for over half a million Black Philadelphians, systemic racism undermines every effort to live a healthy life, and health consequences can drive many people into deep poverty.

Racism affects the health outcomes of every Black person in America regardless of income, class, or education, starting in utero through adulthood. If there was any doubt, systemic racism qualifies as a public health crisis.

Where is the City of Philadelphia’s urgency in response to racism?

We cannot wait to take action. Although a true remedy for racially discriminatory policies requires federal and state intervention, we cannot wait to take action. City governments are already responding: Milwaukee and Madison declared racism as a public health crisis last year and our sister city, Pittsburgh, passed an ordinance in January.

Multiple other cities followed suit. Some have gone further: Asheville created a reparations commission, Minneapolis moved to defund the police and instead implement public health programs, and Boston pledged to reallocate $3 million from police overtime to programs meant to tackle racism’s impact on public health. Recently, Pennsylvania State Representative Jack Wheatley called on the Commonwealth to form a commission to study this issue.

Philadelphia’s Department of Public Health should allocate funds to community leaders of color already addressing this crisis, such as Dr. Ala Stanford, Soil Generation, West Philadelphia Skills Initiative, and others.

Policymakers must also address the root causes of health problems by adopting a racial equity response to systemic racism. As legal scholar Dorothy Roberts writes, we need structural interventions to close racial gaps in health: guaranteed high quality health care; the elimination of unequal living conditions that disadvantage communities of color; and training for healthcare workers in structural competency.

For the City of Philadelphia to address the public health crisis caused by racism, we recommend:

• Funding for the Black Doctors Consortium, and grocery and medication delivery to address racial inequities in COVID-19 prevention, testing, and treatment;
• Divesting from criminal-legal responses to public health needs;
• Protecting the health and safety of workers, starting with providing personal protective equipment, hazard pay, and overtime compensation to the city’s sanitation workers, and providing direct payments to domestic workers and other at-risk workers who did not receive federal stimulus checks due to immigration status;
• Supporting community gardens and urban farms threatened by gentrification;
• Promoting racial equity in education through fairly and adequately funding public schools; investing in teachers, behavioral health supports, and special education services; and incorporating antiracist pedagogy into curricula;
• Protecting people from illegal evictions, particularly people who are undocumented, and following CDC guidance on protecting people who are unhoused;
• Investing in clean energy, living wage green jobs, and access to clean and affordable housing and utilities to mitigate the effects of environmental racism;
• Training public servants and healthcare workers in racial equity, including implicit bias and structural competency;
• Increasing funding for Philadelphia’s Office of Diversity and Inclusion and the Department of Public Health’s community health centers and chronic disease and injury prevention units; and
• Advocating alongside the Commonwealth to enact measures for economic stability and food security, including:
  • implementing universal health care statewide;
  • increasing Temporary Assistance for Needy Families cash assistance;
  • reinstating the General Assistance cash assistance program;
  • extending USDA waivers to allow Women Infants Children (WIC); and
  • increasing the state supplemental payment for SSI recipients.

Implementing these recommendations will take time, but declaring racism a public health crisis will immediately show Philadelphians of color — and Black residents in particular — that the City is committed to change. Advocates can use the declaration to hold City leaders accountable to implementing these recommendations.

The City of Philadelphia must protect the health and wellbeing of Black families and people of color. Declaring racism a public health crisis is a vital step towards this goal.