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How to treat Marion County’s newest public health crisis: Racism

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On June 9, the city-county council unanimously passed a resolution declaring racism a public health crisis in Marion County. According to the American Journal of Public Health (AJPH), a public health emergency is instituted when a situation becomes emergent; when its health consequences have the potential to overwhelm routine community capabilities to address them. It is vital to our community’s health for us to understand precisely how racism affects one’s health and what can be done to begin the healing process.

Let’s begin by looking at the data that convinced the city-county council that the mental health of Marion County was “at risk” and therefore needed to pass Proposal 182:

• Health equity is defined as all residents having the opportunity to attain their highest level of health. The American Public Health Association finds racism to be a barrier to health equity and has named racism a driving force of how these social determinants of health are distributed.

• The American Academy of Pediatrics has declared that racism is a barrier to wellness that has a profound impact on the health status of children, adolescents, emerging adults and their families, and that the continued negative impact of racism on health and well-being through implicit and explicit biases, institutional structures, and interpersonal relationships are clear.

• The American College of Physicians has found that African-Americans, in particular, are at risk of being subjected to discrimination and violence against them because of their race, endangering them and even costing them their lives.

• The non-partisan National Partnership for Women and Families has found that in the United States, health and racism are inextricably linked, creating a harmful impact on individuals and communities of color, including unequal access to quality education, employment, livable wages, healthy food, stable and affordable housing, and safe and sustainable communities.

• On a local level, Black residents are 29% of the Marion County population but account for 37% of COVID- 19-related deaths to date. The life expectancy in some Indianapolis communities of color is as many 14 years less than that of their white neighbors. These factors alone would appear to be at crisis levels for our community in particular.

People of color are at greater risk for damaging their mental health, physical health and financial health due to circumstances beyond their control. Now is the time to purposefully deconstruct the social constructs that engineered our belief systems so that we may better understand how racism impacts the mental health of our community.

Now that racism has been declared a public health crisis, what are we going to do about it? Corporate America has addressed racism and discrimination in familiar practices such as: diversity training, implicit bias training and anti-racism training. However, one must question after all of this time, “What are the long-term effects of these well-intentioned efforts?”

A study of the cumulative effects of diversity training noted that it has a positive effect on attitudes, behaviors and actions in the short term. However, after the training time passes people will remember the new knowledge, but their beliefs and behaviors tend to revert back to how they were before the training.

The missing component necessary to make lasting transformational change, is one that addresses our core racial belief system taught to us from childhood from parents, family, teachers, churches and friends. When strategically addressing a public health crisis, the AJPH prescribes a three-factor response strategy: prevention, mitigation and recovery.

Preventing the health endangering impact of racism entails addressing belief systems such as the ideology of white supremacy. Mitigation of the current and continuing practices associated with systemic racism requires self-evaluation of individual and organizational environments potentially causing harm. Upon awareness of these harmful practices, they must be immediately terminated as to not cause further and continual damage. Recovery addresses the psychological, physiological and economic harm that has been inflicted on the respective members of the public health concern. The acknowledgment of these damages inflicted is necessary, and the commitment to make them whole mandatory.

The status quo no longer works. It doesn’t make sense to spend taxpayer resources on practices that have continually failed. Unfortunately, many of these organizations in regular receipt of these monies are unknowingly perpetrators of the very crisis that they are trying to address. There are local organizations already addressing these issues.

In response to COVID-19, the Indy Black Chamber of Commerce (IBCC) launched the Mental Health Disparities Initiative. Through a collaboration of business and mental health professionals, a program was designed to address the impacts of racism using a therapeutic cognitive behavioral approach.

Cognitive Behavioral Therapy is an evidence-based and highly effective intervention eliciting genuine behavioral change in clients. Workshops focus on race ideology, racism and the disproportionate outcomes and disparities resulting from it. The IBCC membership boasts a talented pool of qualified mental health professionals.

The Mental Health Disparities Initiative takes place at 7 p.m. each Tuesday via Zoom and is free and open to the public. Registration is required. Churches, community organizations, businesses and service provider agencies are encouraged to join us and participate in this unique solution to our current public health crisis. Please contact IBCC President Larry Williams Jr. for details.

George Middleton is a mental health counselor who holds a Bachelor of Arts from the School of Music at Indiana University, a Master of Science in Management from Indiana Wesleyan University, and a Master of Science in Human Services from Capella University.

He is author of three books, addressing the connection between mental health and the social impact of the race construct. He regularly presents workshops to service providers with the goal of increased culturally relevant services.  

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