March 16, 2021 – Leaders from California county associations join federal, state, local, and community partners across the country today to affirm and declare racism as a public health crisis. The County Behavioral Health Directors Association of California (CBHDA), County Welfare Directors Association (CWDA), and California Association of Public Hospitals and Health Systems (CAPH) join the County Health Executives Association of California (CHEAC), along with local county boards and public health officials throughout the state and the nation in our shared commitment to protect and improve the lives of Californians served by local jurisdictions by both acknowledging the long-standing historic and ongoing harms of systemic racism, the role of county governments in choosing to actively repudiate those harms or perpetuate them through inaction, and upholding a newly focused commitment to taking actionable steps to address those harms across the various branches of county government, with communities at the center of this work. Each of our organizations serves populations that are disproportionately people of color who suffer from the effects of systemic racism and are overwhelmingly living in poverty in often-underserved communities.

The events of 2020 sparked by the tragic deaths of George Floyd, Breonna Taylor, Ahmaud Arbery, and too many others, combined with the disproportionate impacts of the COVID-19 pandemic on Black, Indigenous and People of Color (BIPOC) elevated a national dialogue on the negative impacts of systemic racism throughout the nation. These challenges have intensified in 2021 with the ongoing pandemic and political and social unrest, all of which disproportionately impact BIPOC.

Studies have shown that racism is a social determinant of health that results in an unfair lack of access to adequate housing, education, and employment and an elevated risk for justice involvement and reduced access to healthcare and public health services, often resulting in early mortality. In fact, Black Americans have the lowest life expectancy of all racial/ethnic groups in California. Simply put, structural, systemic racism kills. Local governments share in the responsibility for addressing those harms within local communities and disavow acceptance of these long-standing institutional failures.

California counties play a crucial role in serving BIPOC communities in key county-run safety net systems, including, but not limited to local public health, county public hospitals, county behavioral health services, social services and public safety. Through these programs, many counties serve disproportionate numbers of BIPOC communities. While the pandemic rages on throughout California, county staff literally put their lives on the line as frontline essential workers, many whom are themselves BIPOC, committed to serving their communities in this time of crisis.

CBHDA, CWDA, CAPH, and CHEAC affirm that counties can address racism and racial inequality in California county government and communities with a shared commitment to:

  1. Normalize discussion on race and racial equity.
  2. Support the collection of data and other robust measures of accountability in order to track and assess progress on achieving racial equity.
  3. Strengthen community engagement to ensure equity work empowers the voices and experiences of BIPOC communities, particularly those that are within our systems of care.
  4. Eliminate policies and practices that facilitate or allow discrimination and
    violence against specific populations (including laws criminalizing these
    populations) and elevate policies and practices in our member agencies that
    bolster access to services aimed at overcoming the trauma caused by these
  5. Prioritize investment in promoting racial and economic equity to address social
    determinants of health.
  6. Implement community-based alternatives to address harms and prevent trauma.
  7. Work with law enforcement agencies to promote better documentation of incidents involving law enforcement and BIPOC; support the expansion of training and accountability aimed at monitoring and improving such interactions with the goal of reducing violence and injuries to BIPOC; support and engage with law enforcement agencies making efforts to improve the use of de-escalation strategies; institute proven approaches to working with BIPOC and individuals with behavioral health issues and disabilities; and create linkages to agencies that address these needs and help promote healing.

Milwaukee County was the first county in the nation to declare racism a public health crisis in 2019. Their leadership sparked a national movement of local government declarations. Here in California, the San Bernardino Board of Supervisors led several other counties in also adopting resolutions to declare racism as a public health crisis, including the counties of, Santa Clara, Contra Costa, Mono, Riverside, Sacramento, Santa Cruz, Yolo, and Ventura.

The historic mandates of 2020 did not end there. The work outlined in this statement, including the ongoing disproportionately negative impacts of the COVID-19 pandemic on Black, Indigenous, Latinx and Pacific Islander communities within California will take continued effort as well as investment, and our organizations commit to working with federal, state, and community partners to create ongoing and meaningful changes to the role of county governments in addressing systemic racism at all levels.