Colorado to declare racism a public health crisis

Colorado will declare racism a public health crisis following a push by staffers inside the state’s health department to respond to ongoing social-justice protests and the inequities highlighted by the coronavirus pandemic.

Since June, employees at the Colorado Department of Public Health and Environment have pressed Executive Director Jill Hunsaker Ryan to make such a public declaration and became increasingly frustrated when she didn’t move faster to do so.

When asked this week about those internal conversations, Hunsaker Ryan told The Denver Post the state will join the American Public Health Association in declaring racism a public health crisis, and that will become formal policy within the health department.

In doing so, Hunsaker Ryan said she has two goals: to increase diversity in the department’s workforce, which is almost 78% white, and make it easier for local community organizations that provide services to people of color to partner with the agency. She also plans to hire an equity and inclusion officer for the department, potentially by the end of August.

“I like it when my employees push me on this issue to go faster and to use language they think is more descriptive,” Hunsaker Ryan said.

Previously, the firmest stance the department had taken publicly was to call racism “a persistent and critical health issue” in an open letter on its website.

Four employees of the health department — three of whom are staffers of color —  told The Post that not only was the letter published weeks after employees first raised questions, but it minimized racism by calling it an “issue” rather than a “crisis.” The latter, they said, more aptly reflects the urgency the agency should have in responding to inequalities that exist both inside the department and in the health of Coloradans.

And the hope, one employee said, is that by having the department declare racism a crisis, it will divert more resources to address inequity.

“I’ve just been kind of dumbfounded as someone who works for the agency,” that employee said. “And just have been really underwhelmed with the stance that they’ve taken and have been really appalled by the fact that CDPHE remains silent about systemic racism.”

The employees who spoke to The Post did so on the condition of anonymity because they feared retaliation. The newspaper also reviewed recordings of agency town halls, emails and other documents.

Hunsaker Ryan pointed to the coronavirus to explain the delay in declaring racism a crisis.

“We are in this COVID pandemic response, which generally sucked the air out of the room,” she said. “It’s so intense. It’s all hands on deck.”

“Pattern internally of dragging our feet”

When employees at Colorado’s health department tuned in to their weekly, virtual town hall on June 25, a national reckoning already was underway that has forced many Americans to re-examine structural racism in society.

And as this national conversation took place, so did one within the state health agency.

In that meeting, Hunsaker Ryan raised the topic of calling racism a public health crisis without answering whether the health department would take such a stance. Instead, she told a story about how roughly two decades ago she compiled data and published a report showing that racism was the root of health inequities.

Hunsaker Ryan said the health department needed to conduct an assessment to “get our arms around the issues” and prioritize what the agency will work on.

“We need a department-wide vision,” she told staffers during the town hall. “I don’t think it should come from me. But I think all of us should craft it together and I think we will know when we get there. I think we should plan to plan.”

The employee who spoke to The Post said the frustration with the town hall stemmed from the department leadership’s lack of action both internally and publicly to address racism

“It’s just kind of a pattern internally of dragging our feet and not really addressing why we have’t done anything,” the employee said, adding, “I would hope that everyone that works at CDPHE would recognize that systemic racism impacts our work and has for longer than the past month.”

Hunsaker Ryan said in the later interview that she envisioned doing an assessment on the topic before creating a plan, but realized in the meeting that employees wanted to see steps the health department would take to address racism.

“I was trying to say, ‘Not only do I think it is a public health crisis, but I was saying this 20 years ago,’ ” Hunsaker Ryan said.

Part of a larger movement

The push inside the state health department to take a stronger stance against racism reflects a larger movement among public health organizations, which have been outspoken about the need to address racial inequalities and have supported the protests that followed the death of George Floyd, the Black Minnesotan killed when a white police officer knelt on his neck for nearly nine minutes.

Last month, the American Public Health Association denounced police violence. And in Jefferson County, public health officials declared systematic racism a public health crisis and passed a resolution that directs the local health agency to take steps to address such inequities.

At least 24 state and local governments have passed or considered declarations that racism is a public health crisis, according to PEW Charitable Trusts.

“We also condemn police violence against community residents who have expressed frustration and despair over day-to-day racism,” the association said in its statement. “This racism, while far too commonplace in our health care system, in housing, in employment and beyond, has rocked this nation and is tantamount to a public health crisis.”

All of this comes as those in public health — including at Colorado’s health department — are responding to one of the most serious global pandemics in decades. In Colorado, as in other parts of the U.S., the novel coronavirus has both sickened and killed people of color at a disproportionately higher rate than their peers.

Black residents make up about 4.65% of the more than 45,700 confirmed COVID-19 cases in the state, and 6.64% of the deaths, despite the state’s Black population being 3.92% of Colorado’s total, according to data from the agency.

Latino Coloradans also are seeing higher rates of infection, making up about 35.62% of cases and 22.23% of deaths despite representing 21.69% of the state population, according to the health department.

Blacks and Latinos are more likely to have underlying health issues, such as high blood pressure, diabetes, asthma and heart disease, that make people more at risk for complications from COVID-19. People of color also make up a large share of essential jobs, which raises the risk of exposure to the disease.

“The pandemic really does expose and exploit society’s vulnerabilities like social inequities,” Hunsaker Ryan said.

“It wasn’t good enough to just say nothing”

Another employee said that while leaders in the state health department discussed Floyd’s death and the Black Lives Matter movement, there was one death they were notably silent on: Elijah McClain.

In August 2019, McClain, 23, was walking home from a store one evening when Aurora police approached him after receiving a call about a “suspicious person.” McClain died days after after police placed him in a chokehold and someone with Aurora Fire Rescue injected him with ketamine to sedate him.

“It wasn’t good enough to just say nothing, or say we feel really bad about these deaths, meanwhile never talking about Elijah McClain” that health department employee said.

“That is a crisis,” the employee added. “It’s been a crisis for a lot longer than the awakening that seemingly happened for white-bodied people in the last month with Floyd. This has been the status quo.”

Hunsaker Ryan said Floyd’s killing was the “impetus for the conversation” about race at the health department and that McClain’s death is “just one more example of this happening here on our doorstep.” The department recently reopened an investigation into the use of ketamine by paramedics to sedate McClain.

“I just feel like we have a lot to talk about and these issues have really risen to the forefront and I want to give employees an opportunity in safe environment to have these conversations,” she said.

“Not a good way to address an issue like this”

On July 2, more than a month after Floyd’s death sparked protests across the nation, Hunsaker Ryan sent a letter to employees, saying the health department would take steps to expand diversity at the agency and “ensure culture competency” in the services it provides.

Then she called racism a public health crisis.

“Those of us in government — especially those in leadership — have an obligation to not only participate in that dialogue but to use it to guide our actions,” she wrote in the letter, which was not distributed publicly, but was obtained by The Post. “It starts with confronting uncomfortable truths — like the fact that racism has been a public health crisis for much longer than COVID-19.”

In her letter, Hunsaker Ryan laid out plans for the department, including a review of hiring practices in an effort to diversify its workforce, and training for leadership and employees on anti-bias and how to be an ally.

Of the roughly 1,554 employees at the Colorado health department, 1,207 are white. There are only 64 Black and 149 Latino employees, according to the agency. The percentage of Black employees in the department is slightly more than their representation in the state’s population, but Latino staffers are significantly underrepresented.

This is also reflected in the health department’s 20 leadership positions, all but four of which are held by white employees, according to data provided by the agency.

Employees said there is a notable lack of diversity among staff, with one telling The Post that “it would be sad if they declared racism (a public health crisis) and then they missed the point and they didn’t have an opportunity to make themselves better.”

On the same day Hunsaker Ryan sent her email, another note arrived in staffers’ inboxes.

The town halls, which were created so Hunsaker Ryan could check in with employees after the pandemic forced most people to work from home, were canceled.

They will be replaced, the email said, with smaller meetings among staff and leadership. Those meetings are expected to start in August.

“You could just tell in the chats how people were feeling,” Hunsaker Ryan told The Post. “Town halls were not a good way to address an issue like this.”

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