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Local efforts to address racism as a public health crisis in Northeast Ohio

Natasha Takyi-Micah
Treuhaft Fellow for Health Planning
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June 6, 2022
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Since 2020, many municipalities across Northeast Ohio either declared racism as a public health crisis or condemned racism. According to an article from The Land, 10 towns and cities across Cuyahoga County declared racism as a public health crisis (RAPHC) and six cities passed resolutions to condemn racism. Cuyahoga County, for example, established the Citizens Advisory Council on Equity (CACE), among other administrative actions. Other government and nonprofit entities across Northeast Ohio have also issued RAPHC declarations. Although passing declarations is a significant step in addressing this problem, actions need to follow.

 Although passing declarations is a significant step in addressing this problem, actions need to follow.

Summit County and the Hospice of the Western Reserve set the bar high

Two of the many organizations that are making efforts after the declarations are Summit County government and the Hospice of the Western Reserve which may serve as an example of the types of approaches we will see moving forward.  

Summit County declared racism as a public health crisis in June 2020. After the declaration, the County created the Special Review Committee (SRC) to determine how to address structural and systemic racism throughout its nine townships and twenty-two city and villages. From there, UPD Consulting was hired to help with the County’s Antiracism, Diversity, Equity and Inclusion (ADEI) agenda. By conducting research on the County employees’ viewpoints about achieving racial equity through surveys, focus groups, reports, and interviews, UPD Consulting released a report to identify its findings and recommendations. Some of the results of the report included that staff of color and contractors are limited to opportunities for advancement and employment because of the lack of accessibility and transparency, a limited shared understanding of the vision to address racism across the agencies/departments and that staff of color have a tighter salary range, with less representation within the higher salary bands.  

As a result of the findings, UPD Consulting listed the following recommendations:

  1. Commit to ongoing, long-term action focused on racial equity.
  2. Institutionalize equity capacity.
  3. Leverage interagency collaboration toward a shared RAPHC vision.
  4. Increase data capacity for transparency and accountability.

Collaboration and reciprocation

All of the recommendations involve collaborating with different agencies and receiving input from the residents of Summit County. For example, to achieve the first recommendation—commit to ongoing, long-term action focused on racial equity— the Summit County government must have clear steps and measurements that align with the findings of the report, the values of the County, and the goals of the RAPHC declaration.

 As the County continues to address RAPHC, community involvement is key to the advancement of racial equity throughout the agencies, cities, villages, and townships.

Next, the County must relay the RAPHC declaration, goals, and implications to businesses, residents, and agencies. To reciprocate, the residents, agencies, and businesses can provide accountability and build buy-in. In addition, the County can accomplish the third goal—leverage interagency collaboration toward a shared RAPHC vision— by working with other governments (e.g. City of Akron), nonprofit organizations, and businesses on similar equity initiatives. From the report, the SRC will focus on employee retention, advancement, and professional development for people of color. As the County continues to address RAPHC, community involvement is key to the advancement of racial equity throughout the agencies, cities, villages, and townships.

Non-profit efforts to deal with Racism as a Public Health Crisis

Besides governmental entities, nonprofit organizations across Northeast Ohio have been combatting RAPHC such as the Hospice of the Western Reserve. Heidi Barham, Manager of Diversity, Equity and has been helping to coordinate the Agency’s response to racism and how it impacts staff, patients, and families and I had the pleasure of interviewing her to discuss their efforts.  

One of her roles is to provide education and resources to staff to help them understand the importance of diversity and inclusion. Thus far, the organization has brought-in outside consultants to provide education to the management team on racial issues, discrimination, and bigotry. In addition, there is a diversity council that is being formed to address staff concerns. The staff has been encouraged to engage more with the community by attending events like the Men’s Minority Health Fair at MetroHealth. Barham is focused as well on educating the community that their services are for all races, genders, ages, (even babies and children with life-limiting illnesses), etc.

 When groups share resources with a marginalized community, everyone wins.

The Hospice of the Western Reserve has experienced some successes and challenges while addressing RAPHC. Barham described that some of their successes have included partnerships with organizations such as the Council On Older Persons (COOP), the Minority Health Alliance, and the Northeast Ohio Black Health Coalition (NEOBHC). Collaborating with other organizations contributes to resolving problems within RAPHC such as menthol cigarette use within the Black community. In contrast, a challenge they are dealing with is the “zero-sum mindset.” This concept stems from the belief that if people share their resources (e.g. food, healthcare, and quality education) with another group, they will lose their resources. Barham explained that everyone does not need to hoard resources because when groups share resources with a marginalized community, everyone wins. Furthermore, she discussed how not dealing with conflict and facing issues such as racism, especially with our younger generation, will make it harder for them, because they will not be prepared when they enter the workforce and find themselves faced with these same challenges.

Managing mistrust in the community

Barham and her colleagues engage in much work to resolve RAPHC, especially to eradicate mistrust from the community concerning healthcare and dispel myths about hospice care. Many people of color mistrust the healthcare community during end-of-life care, believing hospice care is expensive and that people will not care about them because of their limited time. These notions are false according to Barham. Medicaid, Medicare, and private health insurance pay for services and when hospice services start sooner, patients and families can enjoy a greater quality of life, often for a longer period. To learn more about the Hospice of the Western Reserve, and the services they can offer families, please visit their website or contact Heidi Barham at [email protected].  

Organizations like the Summit County government and the Hospice of the Western Reserve are doing good work in resolving RAPHC throughout Northeast Ohio by consciously focusing on programs, services, and approaches that can be more inclusive and culturally aware. Both entities interact with community stakeholders and residents who are impacted the most by racism to inform how that should be done. As others pursue this work, organizations should make policies and programs to achieve racial equity so that the cycle of oppression will not continue.  

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