In May 2019, Milwaukee County, Wisconsin, became the first to pass a resolution declaring racism a public health crisis. The move wasn’t inspired by a big event, but study after study showing economic inequality in the county was among the worst in the country.

Now, more than 60 local and state governments, including Minnesota, are considering or have done the same — most of them in the last few months, according to the American Public Health Association. The designation of racism as threat to health comes as COVID-19 continues to ravage the country and people of color continue to be disproportionately affected in cases and in deaths. Structural inequality and systemic racism have created a never-ending pandemic of their own.

But can a declaration really make a difference? Just pushing it through the process can have an impact, said Paula Tran Inzeo, a director at University of Wisconsin’s Public Health Institute.

“Part of the work is to name and acknowledge that those things are true and that people in power believe that it’s true,” she said.

Inzeo said the institute works with close to 100 local organizations, including hospitals, research groups and schools, to set goals for diversity in hiring and measuring outcomes for things like infant mortality. 

Declaring a crisis also invites accountability.

“And six months from now, the public can say, so County X or City Y, what are you doing, have you done and what are you going to do about this?” said Camara Phyllis Jones, an epidemiologist at Morehouse School of Medicine. And that timing will be just about right given that the vast majority of declarations have been made in the past few months.

But measuring progress is complicated.

“The public health emergency here, racism, is quite amorphous because racism is at the foundation of much of what we do in this society,” said Thomas LaVeist, dean of Tulane University’s School of Public Health and Tropical Medicine.

Racism runs through housing, education, jobs, health care and more. “It’s not like an acute traumatic event like a hurricane or an earthquake that we know has a beginning, middle and end,” he said.

And unlike a national disaster, a racism crisis doesn’t trigger a flood of government funds. So until a national entity creates rules, states and cities will make them up as they go.