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Declaring Institutional Racism a Public Health Crisis

Photo of Senator Martin Quezada

Sen. Martín Quezada (AZ), primary sponsor

Sponsored by Sen. Martín Quezada (AZ) and Sen. Linda M. López (NM)

Reported to the Caucus by the NHCSL Healthcare Task Force
Rep. Louis Ruiz (KS), Chair

Unanimously adopted on behalf of the Caucus on September 18, 2020

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WHEREAS, the American Public Health Association launched a National Campaign Against Racism, calling it a public health crisis;[1] and,

WHEREAS, while there is no epidemiologic definition of “crisis,” the health impact of racism clearly rises to a definition proposed by Dr. Sandro Galea, dean of the Boston University School of Public Health: The problem must “affect large numbers of people,” it must “threaten health over the long term” and it must “require the adoption of large scale solutions;”[2] and,

WHEREAS, racism is a social system with multiple dimensions and no biological basis, causing persistent racial discrimination in housing, education, employment and criminal justice; and,

WHEREAS, communities of color are disproportionally impacted by social determinants of health, such as increased exposure to environmental contaminants, poor air quality, lack of safe places to walk, bike or run and inadequate health education. This was one of the reasons we cited to adopt Resolution No. 2019-21, Call for Research Funding to Investigate and Prevent High Air Pollution Days in Cities,[3] and Resolution No. 2019-20, Equitable and Just Policies to Address Climate Change;[4] and,

WHEREAS, an emerging body of research demonstrates that racism is a social determinant of health, and more than 100 studies have linked racism to worse health outcomes;[5] and,

WHEREAS, institutional racism is systemic and structures opportunity and assigns value based on the social interpretation of how one looks which unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society by wasting human resources; and,

WHEREAS, we addressed part of the discriminatory foundations of the racism-related educational achievement gap in our Resolution, No. 2019-13, Integrating Ethnic Studies into K-12 Education,[6] called for further investigations in our Resolution No. 2019-11, Addressing Chronic Absenteeism in Schools,[7] and addressed the race-related disparities of educational costs in our Resolution No. 2019-25 Fair Policies to Address Student Loan Debt and College Pricing;[8] and,

WHEREAS, we addressed part of the effects of racial discrimination in the workplace in our Resolution No. 2012-04, calling for Pay Equity for Women and People of Color,[9] and some indirect effects in our Resolution No. 2019-10, Paid Medical and Family Leave,[10] and called specifically to address discrimination that can prevent completion of apprenticeships in our Resolution No. 2017-13, Expanding Apprenticeship Programs;[11] and,

WHEREAS, we addressed the racially and ethnically disproportionate effects of the school-to-prison pipeline in Resolutions No. 2005-01, Student Disciplinary Alternative Education Programs,[12] and No. 2019-13, Calling for the Creation and Improvement of Restorative Justice Programs to Reduce Contacts Between Youth and the Justice System;[13] and,

WHEREAS, we addressed some of the many issues racism has caused in our criminal justice system in our Resolutions:

WHEREAS, a wealth of medical research suggests that racism plays an important role in the fact that African American women are more likely than any other race to give birth to premature babies, an issue we committed to address in our Resolution, No. 2019-16, on Maternal Health and Morbidity;[19] and,

WHEREAS, according to the CDC, the infant mortality rate among African Americans is significantly higher than the national average;[20] and,

WHEREAS, immigration policies that sanction institutional practices of discrimination, such as ethno-racial profiling and mistreatment, are forms of structural racism and everyday violence, an issue we have repeatedly denounced, particularly in Resolution No. 2012-09, regarding the Supreme Court Ruling on Arizona SB 1070,[21] and No. 2018-16, End the Separation of Migrant Families and Reject the Detention of Children and Families;[22] and,

WHEREAS, studies suggest that immigration laws that militarize communities and lead to everyday violence exacerbate racial health disparities, an issue we addressed in Resolution No. 2017-18, Regarding the Impact of the Deferred Action for Childhood Arrivals Program on Educational Attainment and Community Stability;[23] and,

WHEREAS, “over two decades of research have shown that subjective or perceived exposure to racial or ethnic discrimination has deleterious effects on both physical and mental health for African Americans, and recent studies report similar findings for Asian Americans, Latinos, and other ethnic groups;”[24] and,

WHEREAS, a “growing body of literature highlights the destructive consequences of discrimination perceived at different time points throughout the life course, the linkage between parents and child perceptions, and the accumulative stressor and traumatic effect on mental health,” but “gaps remain in our understanding of the factors and mechanisms associated with perceived discrimination and mental health status;”[25] and,

WHEREAS, more epidemiological research is urgent to “explore both historical trauma and perceived interpersonal discrimination in order to disentangle the true effect of these constructs on mental health,” to study “the impact of discrimination at different critical periods in the life course and the accumulation of stress due to discrimination throughout life,” and to understand intergenerational racism that could “affect health outcomes of future generations as a consequence of accumulated and persistent exposure to stressors and the resulting disruption of physiological systems,” all of this in order to help “buffer… the effects of discrimination on mental health status”[26] as we work in parallel to dismantle institutional racism; and,

WHEREAS, our national responsibility to address racism in our institutions includes reshaping our discourse and agenda so that we all actively engage in racial justice work.

THEREFORE, BE IT RESOLVED, that the National Hispanic Caucus of State Legislators:

  1. Declares institutional racism to be a public health crisis affecting our entire society; and,
  2. Commits to continue working to create equity and justice-oriented governance; and,
  3. Calls on state legislatures to develop work plans that include educational efforts to address and dismantle racism, expand state personnel's understanding of racism and how racism affects individual and population health and provide tools to assist personnel to engage actively and authentically with communities of color; and,
  4. Commits to support policies that improve health in communities of color and local, state and federal initiatives that advance social justice, calling on state legislatures to do the same.


[1] Georges Benjamin, Racism is an ongoing public health crisis that needs our attention now (APHA May 29, 2020). Available at https://www.apha.org/news-and-media/news-releases/apha-news-releases/2020/racism-is-a-public-health-crisis

[2] Sandro Galea, Crying “Crisis” (April 23, 2017). Available at http://www.bu.edu/sph/2017/04/23/crying-crisis/

[3] Available at https://nhcsl.org/resources/resolutions/2019/2019-21/

[4] Available at https://nhcsl.org/resources/resolutions/2019/2019-20/

[5] See in general, Harvard T.H. Chan School of Public Health, Racial discrimination and health. Available at https://www.hsph.harvard.edu/news/hsph-in-the-news/racial-discrimination-and-health-david-williams/

[6] Available at https://nhcsl.org/resources/resolutions/2019/2019-13/

[7] Available at https://nhcsl.org/resources/resolutions/2019/2019-11/

[8] Available at https://nhcsl.org/resources/resolutions/2019/2019-25/

[9] Available at https://nhcsl.org/resources/resolutions/2012/2012-04/

[10] Available at https://nhcsl.org/resources/resolutions/2019/2019-10/

[11] Available at https://nhcsl.org/resources/resolutions/2017/2017-13/

[12] Available at https://nhcsl.org/resources/resolutions/2005/2005-1/

[13] Available at https://nhcsl.org/resources/resolutions/2019/2019-03/

[14] Available at https://nhcsl.org/resources/resolutions/2006/2006-7/

[15] Available at https://nhcsl.org/resources/resolutions/2016/2016-11/

[16] Available at https://nhcsl.org/resources/resolutions/2017/2017-12/

[17] Available at https://nhcsl.org/resources/resolutions/2019/2019-22/

[18] Available at https://nhcsl.org/resources/resolutions/2019/2019-14/

[19] Available at https://nhcsl.org/resources/resolutions/2019/2019-16/


[21] Available at https://nhcsl.org/resources/resolutions/2012/2012-09/20170

[22] Available at https://nhcsl.org/resources/resolutions/2018/2018-16/

[23] Available at https://nhcsl.org/resources/resolutions/2017/2017-18/

[24] Anisa I. Vines, et al, Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology (Curr Epidemiol Rep. 2017 Jun; 4(2): 156–165). Draft available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596659/

[25] Ibid.

[26] Ibid.