June 12, 2020, 10:18 am News Staff – The administration must respond to systemic racism and its threat to public health, the Academy told a top White House official this week, a call to action that has taken on added urgency as emerging data point to the COVID-19 pandemic's disproportionately severe impact on communities of color.
"It is time for the United States to officially recognize racism as a public health issue and declare a public health emergency to address the negative impacts racism is having on the physical and mental well-being of millions of people," said the June 10 letter to Brooke Rollins, J.D., acting director of the Domestic Policy Council.
Signed by Board Chair John Cullen, M.D., of Valdez, Alaska, a copy of the letter was sent to HHS Secretary Alex Azar.
Because racism "dramatically impacts mental health, chronic diseases, maternal and infant mortality rates, and overall health outcomes and life expectancy," the Academy wrote, the council should "convene an interagency task force, comprised of program experts from across the federal government as well as state and local government officials, the private sector, medical professionals and community-based organizations, to develop a federal response to address systemic racism."
"As a first step, the task force should examine ways that federal programs inadvertently perpetuate or exacerbate racism and make actionable recommendations to improve or discontinue them."
The correspondence echoed sentiments in a May 31 statement by AAFP President Gary LeRoy, M.D., of Dayton, Ohio.
"The elimination of health disparities will not be achieved without first acknowledging racism's contribution to health and social inequalities," LeRoy said. "This includes inequitable access to quality health care services.
"Our members see the negative health outcomes of racism in their patients, who are often at an increased risk of heart disease, stroke, diabetes, low birth weight, premature birth and infant mortality."
Decades of research substantiate the role of systemic racism in driving poor public health outcomes. These health inequities are perpetuated today, as black, indigenous and Latino Americans have been particularly hard-hit by COVID-19, with infection, hospitalization and fatality rates far exceeding those seen among white people.
With these concerns in mind, the Academy also offered information and urged legislative action in a June 10 letter to federal lawmakers.
In the letter, which came on the heels of a May 27 House Ways and Means Committee hearing on COVID-19's impact on communities of color and a related request for comments, the AAFP called for the passage of several existing bills -- including the COVID-19 Racial and Ethnic Disparities Taskforce Act -- and for action to stabilize primary care practices threatened by closure even as they are most critically needed.
"Closures will result in an exacerbation of (COVID-19) complications due to chronic conditions, resulting in worse outcomes and higher costs," the letter warned. "This will disproportionately impact communities of color and further the disparities that already exist."
That letter, which also went out over Cullen's signature, was sent to Reps. Richard Neal, D-Mass., and Kevin Brady, R-Texas -- the committee's chair and ranking member, respectively.
As examples of how to work toward eradicating "these differences that have caused harm to generations of Americans and their communities," the letter to Rollins named some of the AAFP's own initiatives, including The EveryONE Project, which focuses on addressing diversity and the social determinants of health, and its Neighborhood Navigator tool, which helps physicians identify social services and community resources that can help address SDOH.
The letter also touted the AAFP's endorsement of inclusive curriculum guidelines for family medicine residents and its Implicit Bias Training Guide.
Health equity must be factored into organizations' decision-making at all levels, LeRoy told Modern Healthcare earlier this month, noting that the AAFP conducts ongoing reviews of its policies to guard against potential bias. "You can't just let your policies become stagnant."
You'll soon have a chance to hear more about the Academy's take on this topic: LeRoy will be among the panelists participating in an all-member AAFP online event on racism on June 22 at 7 p.m. CT. Watch the Academy's social media channels for more details in the coming days.