One key factor in the decision-making process and adoption of this resolution was community involvement. Members from several groups, including Power Up and the African American and Black Affairs Council, in addition to a diverse number of other community members contacted and shared concerns with the Board of Directors. This included showing up and speaking out at the town meeting, but also through emailing, calling, and protesting. For Secretary Castillo, the protesting and reaching out to show support helped to solidify her commitment to the resolution. “It was really good to see that the community is involved and having a voice,” she said. Support of the community is crucial because the decisions by the Board of Directors are not being made in a vacuum. “We are elected officials, so it’s important to listen to people because that’s who we are serving,” explained Castillo, “I’m very proud of the community input and want it to continue to be part of the process.” For the Board of Directors, it is essential that this work is done together and to know that the community is voicing its opinion on the decisions being made, especially by those who are being most directly affected. 

Mayor Moran echoed these sentiments, recognizing the importance of listening to community members, standing by them as allies, and making some changes. “We have to do this together,” he said, noting that this movement and the responsibility of anti-racism work does not fall only on people of color. “This includes the white community. If you care about people, you will care about this. For myself, not being a person of color, the first skill is to listen,” Moran said. He continued to explain that only then can steps be taken to move forward and create change together. “I want people to know that the protests have been peaceful and non-violent,” Moran said, describing the respectful, heart-to-heart conversations he has had when listening to the voices of community members of color. “There is a great openness to work together for the common good of everyone.”

Several advocates and activists are calling it a good first step to address the long-running, systemic issue. Yes, that’s right. It is a long-running and systemic issue in Manchester, which has a history of racism that can be traced from exclusion of Black families until the late 1800s to a firebombing of a local Black family’s home in the 1980s to just last month when two white men chased and yelled racial slurs at several Black teenagers on Main Street. 

But why a public health crisis? What does racism have to do with public health issues? Well, just about everything. Communities of color are disproportionately affected by diseases and conditions, such as diabetes and high blood pressure. The most recent and clear example is the disproportionate impact of COVID-19, in which the rate of hospitalizations of non-Hispanic Black persons are 5 times that of non-Hispanic white persons according to the Centers for Disease Control and Prevention. The racial gap in death rates for COVID-19 are even more concerning. The disparity is drastic, pointing to less access to health care or greater prevalence of comorbidities for people of color. The structural conditions that cause racial health disparities in America are numerous. Rashawn Ray of the Brookings Institution breaks down these structural factors, including neighborhood quality as a result of redlining, access to healthcare, occupation, climate, and criminalization. Understanding how all of these structural factors operate together to create a racist system of oppression and how greatly it influences the health of communities of color, is essential to understanding why racism is a true public health crisis. 

Racism not only manifests itself on the structural level, but it also can be seen on a more interpersonal level, causing additional stress and trauma for people of color. The most common forms of interpersonal racism are microaggressions. The term microaggression was used by Columbia professor Derald Sue to refer to “brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color.” Microaggressions are more specific and more painful than insults, in that they are targeted at an identity that’s discriminated against or subject to stereotypes. One helpful educational video describes microaggressions as similar to mosquito bites. Although people may see a few mosquito bites as annoying but not that big of a deal, constantly being surrounded and bit by mosquitoes in daily life would create high levels of stress. The same is true with microaggressions, as their effect is compounded over time.

Research has shown that microaggressions can take a significant psychological toll on the mental health of their recipients. This can lead to greater health problems, including stress, anger, depression, and low productivity and problem-solving abilities. Not only is psychological health impacted, but physical health can be compromised as a result of racial microaggressions as well. Stress itself is a cause of medical conditions including high blood pressure, heart disease, stroke, and eye disease. Mistreated or exacerbated physical issues can also result from lower-quality health care. One study found results suggesting that “medical encounters differ depending on characteristics of the parties involved. These differences may not only perpetuate the differential treatment of color but also contribute to health disparities for people of color.” 

If you’re still not convinced, take a look at the definition of a public health issue. According to Georges Benjamin, president of the American Public Health Association, it is defined as something that hurts and kills people “or impedes their ability to live a healthy, prosperous life,”. Racism definitely falls into this category, and for reasons beyond than it’s more direct relation to health and medical care. A disproportionate number of people of color, most especially Black people, are killed or harmed by police violence each year, which is an issue that has sparked protesting throughout the world. People of color are also more likely to have less access to resources or to receive lower-quality education, a pattern that has existed locally. In 2003, Manchester was considered to be the most disproportionate district in the state in terms of over-identifying Black students as intellectually disabled. Police violence and education are just two of many examples of how people of color are impeded from being able to live a healthy, prosperous life. Other examples include redlining and housing, employment, environmental racism and climate change, among many other systemic issues. Recognizing racism as a public health issue “gives some substance and a way forward,” said Benjamin to Popular Science. “I think it gives [people] a reason for changing their behavior or their thoughts,” he said. 

This resolution and decision by the Board of Directors validates and acknowledges how racism not only affects health on an interpersonal basis, but also how it is systemically ingrained in all aspects of public health. Now that the issue has been recognized, the important question to ask is “what steps will be taken as a result?” Local officials from the Board of Directors have provided some additional answers. Secretary Castillo described how the resolution will be implemented, explaining how the plan is to “set up a system in which [the BOD] can look at departments and identify activities to enhance diversity, set principles across the board in leadership, staffing, and contracting.” She explained how this process will rely on research and data collection in order to create better policy that is based on the reality of the Manchester community. At the meeting, Director Floyd-Cranford commented on future steps as well, noting that “this is an action plan that falls in line with what Manchester has already begun.”