“We assert that examining and applying law can accelerate public health efforts to mitigate structural and systemic inequities, including racism,” write Samantha Bent Weber, JD, and Matthew Penn, JD, MLIS, of the Centers for Disease Control and Prevention’s Center for State, Tribal, Local, and Territorial Support. Their paper appears in a JPHMP supplement titled ‘Public Health Interventions to Address Health Disparities Associated with Structural Racism,’ supported by the W.K. Kellogg Foundation. The full supplement is freely available on the journal website.
Toward a ‘far more expansive role’ of law in achieving health equity
Ms. Weber and Mr. Penn outline “a pathway for public health departments and practitioners to incorporate the law into their efforts to advance equity in health outcomes.” They review the illustrative case of Coal Run: a majority-Black neighborhood in one Ohio town that could not access running water for decades, despite the fact that waterlines serving other neighborhoods terminated as little as 50 yards away.
The injustice persisted until residents filed a civil rights complaint alleging a pattern of racial discrimination in violation of federal fair housing law. “It took a little more than a year to accomplish what had been a source of friction for almost a half century,” Ms. Weber and Mr. Penn write. The community later filed a lawsuit for damages, and a federal jury ultimately determined that local public authorities were liable for racial discrimination that disproportionately denied water services to Black residents.
Coal Run is just one example of the intersections among public health, the law, and structural and systemic inequities affecting the health of communities. While equity is an increasingly important area of focus for public health departments and practitioners, they continue to face challenges in pursuing equity-based initiatives.
Focusing on law as a determinant of health is a key first step on the path toward incorporating law into efforts to pursue health equity – followed by examining laws and policies to expand the evidence base on the sources of health inequities, using the law to spread messages about sources of structural and systemic inequities, and identifying new collaborative strategies for change. “Law has always been a central mechanism for carrying out public health policy, but it can play a far more expansive role in pursuing and achieving equity,” Ms. Weber and Mr. Penn conclude.
‘Practice is hard, but it is the purpose of public health’
Mary T. Bassett, MD, MPH, Director of the FXB Center for Health and Human Rights and the FXB Professor of the Practice of Health and Human Rights at the Harvard School of Public Health is Guest Editor of the new supplement. Consisting of three commentaries and 12 original research reports, the special issue provides a nationwide overview of efforts by local, state, and federal public health agencies and academic institutions to engage with communities of color in order to address health disparities related to structural racism.
In a guest editorial, Dr. Bassett discusses the emerging concepts of structural and systemic racism and how the growing evidence of their impact on the health of communities. She notes that most of the articles in the special issue are field reports from local health departments and community organizations – sharing their practical experience with efforts to meet the challenges of public health strategies targeting structural racism. “Practice is hard, but it is the purpose of public health,” Dr. Bassett writes. “It’s a long road, and we have gotten started.”
Read “Public Health Strategies: A Pathway for Public Health Practice to Leverage Law in Advancing Equity” (doi: 10.1097/PHH.0000000000001444)
Read “Tackling Structural Racism” (doi: 10.1097/PHH.0000000000001457)
