Systemic Racism as a Public Health Issue

Hi friends. Dr. Abdul El-Sayed here. I am a physician, epidemiologist, and progressive activist. In my previous life, I had the opportunity to rebuild Detroit's Health Department, a health department that had been shut down when the city of Detroit went through bankruptcy. They made the decision to privatize a 185-year-old health department. But you know it didn't get privatized. What did get privatized is the police department in Detroit. Now ask yourself, a city with threefold the probability of asthma hospitalizations, fourfold the probability of lead exposure, do we need a health department, or do we need to continue to put a quarter of a billion dollars in policing? That was the decision that administrators made back in 2012, and they decided to privatize the health department entirely. Now, when we talk about this present moment, I want to make sure that people understand what it means when we talk about how to invest or disinvest or re-invest in policing. Because here's the thing. It's not just Detroit. If you look at almost every major municipality in the country, there is a disproportionate amount of money spent on policing rather than on public goods that would root out poverty, like public health, like mental health, like public schools, like public libraries, like public parks, in play places. You ask yourself, why are we investing so much in people with guns and less in people with the means of being able to invest in young folks, empower folks through their livelihoods, and empower them to live their best life? When we talk about where we go from here, after having watched the brutal assassination of Breonna Taylor in her home, George Floyd, on the streets of Minneapolis. The question becomes, why is it that we're invested so much in people with the means of killing, rather than investing in people with the means of giving life? So as we think about what we want, as we think about rooting out systemic racism, the question we have to ask ourselves is where do we put our money? Because if we're serious about rooting out systemic racism, we should be investing in folks at every step of their lives, rather than investing in policing the poverty in a very racialized way, that our disinvestment in all of the other things has left people suffering. This is the question. Now, I'm an epidemiologist, and I think about what's best for people's health. What I'll tell you is that when you think about COVID-19, when you think about infant mortality, maternal mortality, think about lead, think about asthma. All of these disproportionately impact black Americans. When we talk about systemic racism, it is about asking, how has racism wrapped itself around the decisions that we make about where we invest? In some respects, it's the criminalization of black people themselves that has left us investing in police rather than investing in public schools, in public health, in public welfare. If we want to root out that racism, it means we have to change the way we invest entirely. But it also means that we have to rethink how we invest, and why we invest. Because the concept of the public to me, is a really sacred thing. The beauty of our democracy is that we get to make choices about who our public leaders are, who is making decisions about where we spend, and how we spend when it comes to that public good, the money that we all pay in for a government that is supposed to sustain us equally, and we know that it's not doing that. As we think about this, take that word public, and ask yourself something. What does it mean that an officer who was sworn to protect the public safety, put his knee on the neck of a man for eight minutes and 46 seconds? What does it mean about how he saw that person? Does he include that person in the concept of the public that he was supposed to protect? Or does he include that person as one of the things from which the public is supposed to be kept safe. But it's not just public safety that black folks have been excluded from, also public health. COVID-19 took two and a half times as many black lives per capita as it took white lives in America. So we've seen that black folks have been excluded from the public in public health as well. Think about public education, and the disproportionate defunding of black schools and black school districts. We're seeing that black folks have been excluded from the public in public education as well. Think about public utilities. I'm not too far away from Flint, about 50 miles. In Flint, the state government made a decision to change the water source to save a couple of bucks, poisoning 9,000 disproportionately black children, 100,000 disproportionately black people. The state itself noted that systemic racism was part of the causal architecture of that choice that poisoned kids in Flint. So even when it comes to public utilities, black folks have been systematically excluded. So what do we need to do when we say we want to root out systemic racism, when we say black lives matter? Is to make sure that in every aspect of public that we are including and even centering black people and their needs. That means not only investing more in the means of a child's brain and a child's development, and adults access to a job, clean air and clean water and good housing, access to the ballot box. But it also means rethinking why it is that we're spending so much money policing one group of people systematically and racially. So we have to ask ourselves, do police departments really need tanks and weapons of war and the material that's coming back as hand-me-downs from the military abroad? Do police really need to use guns? Do we need as much of a police force? If we ask ourselves about how we spend money in the public, where that money goes, where it comes from, we need to make a lot better decisions about investing in the things that root out poverty rather than investing in policing poverty, and we need to understand that these are racialized questions because of systemic racism. When we make a choice to invest in policing in a majority of black community, rather than to invest in public schools, that choice is influenced by systemic racism. So we need to take that on, we need to root it out, and we need to be investing in people, in the communities in which they live, learn, work, pray, and play, rather than be investing in policing them in those communities. When we talk about the question of "defunding the police", it's a question of asking, how do we right-size government away from the racist ideologies that have led us to investing in war material for policing rather than public health for children?