Board aims to address racial disparities in health care
In Santa Clara County, residents who identify is Latino are bearing the brunt of the COVID-19 pandemic, accounting for half of all cases. This is far out of proportion with the county’s population, of which Latino residents make up only about 25%.
Across the board, the COVID-19 pandemic has disproportionately affected communities of color. But the virus is not the only health outcome where racial disparities are playing out, and the county is hoping to address some of the underlying causes with a new community board.
The Race and Health Disparities Community Board was conceived of by county supervisors Susan Ellenberg, whose District 4 includes Campbell, West San Jose and San Jose’s Cambrian and Burbank neighborhoods, and Joe Simitian, whose District 5 includes Cupertino, Saratoga, Palo Alto and portions of Sunnyvale and San Jose.
Ellenberg said that last summer, as protests raged nationwide after the police killings of multiple unarmed Black people, she felt “an obligation that we in government needed to take a very hard look at the gaps in our existing systems that were persistently leaving some community members behind.”
The board of supervisors declared racism a public health crisis in August.
In the U.S., racial disparities in health manifest in various ways — for example, white residents are less likely to contract HIV, diabetes and heart disease than people of color, according to the Centers for Disease Control.
The reasons for these disparities are varied. Racial disparities in socioeconomic status and systemic barriers for people of color often lead to higher risk factors for health. For example, the CDC cites a 2010 survey that found higher rates of Hispanic residents living near highways, and poor air quality could thus account for higher rates of health issues.
But the healthcare system itself also plays a part in these health outcomes. Ellenberg points to the fact that people of color are less likely to be taken seriously by medical professionals and often suffer for lack of care.
Simitian, who chairs the county’s health and hospital committee, said although societal forces are harder to change, healthcare systems rely on policies and practices that can be shaped to eliminate harmful practices.
“We think of our healthcare systems as the solution to our healthcare needs. But we really were trying to ask ourselves, to what extent are healthcare systems part of the problem rather than part of the solution?” Simitian said.
This is not the first time county leaders had called out the role of race in determining residents’ health. Over the last decade, the Public Health Department and board of supervisors have undertaken specialized health assessments for different racial and ethnic groups throughout the county. Simitian, who sponsored the Asian and Pacific Islander health assessment, said the surveys proved how stark the differences were between and within the groups.
“The health status of the Vietnamese community, for example, in Santa Clara County, is very different than the health status and health outcomes of South Asian members of the community,”
Simitian said.
The new board will focus its attention on countyadministered health care, which includes three hospitals, clinics and other healthcare services the county provides or contracts out.
“This would be an opportunity to take an honest, unapologetic look at the outcomes of our health system, and then take what may be very difficult steps to make radical changes,” Ellenberg said.
Simitian said the board will look at issues like unconscious bias, institutionalized customs and practices “that may not serve the entire community equally.” He said questions such as how best to communicate with an extremely linguistically and culturally diverse population are critical in the South Bay.
The board will consist of 11 members: five community members who have experience with county healthcare, two members representing community clinics, one member from a mental health organization, two members representing Medical and one member from a racial justice group. Ellenberg said she hopes the group can begin meeting in March.
The group will begin its work by conducting largescale research into the racial health disparities in the county. They will work closely with the existing county health and hospital committee, and ultimately the county board of supervisors will use the recommendations to create policy.
“We know that people of color tend to fare worse in their health outcomes,” Ellenberg said. “And I want to know that our system is not only not contributing to that but undoing that damage.”