Michelle A. Williams, SM ’88, ScD ’91, Dean of the Faculty at the Harvard T.H. Chan School of Public Health and Angelopoulos Professor in Public Health and International Development (Left), and Jeffrey R. Sánchez, former Massachusetts state representative and lecturer at Harvard Chan (Right).

Enough is Enough: Dean Michelle Williams and Representative Jeffrey Sánchez on the Need for a Public Health Lens in Addressing Systemic Racism

The COVID-19 pandemic has claimed the lives of nearly 180,000 people in the United States. As the pandemic rages on, it has magnified the vast inequities that exist in our world. Early observations coupled with narratives from healthcare workers indicated that Black and Latinx individuals were being affected by COVID-19 at alarmingly higher rates. An overview of the racial inequities of the pandemic only further echoes this and finds that Black and Latinx people are at greater risk of contracting coronavirus than white people due to systemic conditions that have created environments where COVID-19 can spread. In the midst of the present pandemic, the public consciousness of those in the United States and around the world has been captured by the murders of Black people by the police. The combination of the disproportionate impacts of COVID-19 and anti-Black police brutality has recently rekindled a broader reckoning about systemic racism.

Incomplete Celebrations

Both Dean Williams and Representative Sánchez admitted that their initial impulse upon being invited to Voices in Leadership was to decline. The difficulty of discussing their thoughts about events and rhetoric that so personally affect them and their communities, coupled with being conditioned to have these invaluable conversations away from the table in favor of doing what has to be done to succeed, proved difficult to ignore. Yet, their personal anecdotes and reflections shared over the course of their conversation with Dr. Bleich illustrate how their proposed solutions to moving forward to address systemic racism from a public health lens are informed by their own lived experiences.

Looking Upstream

Dean Williams articulated exactly how tenuous the very existence of Black and Latinx individuals is in the U.S., stating that “for this country, Black and Latinx people’s lives are incredibly impacted in complex ways, from birth to death, by a network of racist, anti-Black, anti-Latinx systems that costs us our lives”. Police brutality is only one of the many systemic racism tools used by those in power to abridge and hinder the lives of Black and Latinx individuals. When looking upstream, the myriad social determinants of health that threaten the lengths and qualities of their lives become evident.

Michelle A. Williams, SM ’88, ScD ’91, Dean of the Faculty at the Harvard T.H. Chan School of Public Health and Angelopoulos Professor in Public Health and International Development (Top Left), and Jeffrey R. Sánchez, former Massachusetts state representative and lecturer at Harvard Chan (Top Right) were virtually interviewed by Dr. Sara Bleich, Professor of Public Health Policy in Department of Health Policy and Management and Carol K. Pforzheimer Professor at the Radcliffe Institute for Advanced Study (Bottom Center) for the Voices in Leadership web series for the Harvard T.H. Chan School of Public Health.

Fixing the Ratio

Clinical care and services provided by the healthcare system only account for approximately 10–20% of our health, whereas social determinants of health overwhelmingly account for the rest. Our health is determined by our physical and built environments, social and economic factors, health behaviors, and clinical care. Our health status is predominantly determined by the quality of the air we breathe and water we drink, housing in which we reside and its affordability, modes of transportation we use to commute, education systems accessible to us, jobs we work and income we receive, social and familial support networks we have, types of nutritious food to which we have access, the parks and green spaces we can frequent, and far more. The lengths and qualities of our lives are far more influenced by these social determinants of health than they are by access to clinical care.

Action-based, Outcome-based

Representative Sánchez expressed that he remains hopeful. He shared that he feels encouraged by the mobilization we have seen in recent weeks. Protests centering the Movement for Black Lives have occurred in major cities and rural towns across the United States as well as in Brazil, Trinidad and Tobago, Germany, and in many other corners of the world. Sánchez shared how the movement to defund and abolish the police is actually rooted in redistribution of resources. Dean Williams concurred and warned that the goal of achieving health for Black and Latinx communities goes beyond defunding the police and fighting against police brutality. She outlined that the defund the police movement should serve as a gateway to reimagining how we secure public health and safety. For example, the BREATHE Act calls for divesting taxpayer dollars from discriminatory police practices and instead investing in solutions that secure public health and safety.

Voices in Leadership webcast series enhances leadership, connecting high-profile leaders with the Harvard School of Public Health community. hsph.me/voices