Why did San Antonio declare racism a public health crisis? KSAT Explains

Much of 2020 has been defined by the novel coronavirus. But there’s been another big story, one that some argue is another public health crisis.

In August, after a summer of demonstrations demanding an end to systemic racism and police brutality, the City of San Antonio joined dozens of cities and counties across the country and declared racism a public health crisis.

In this episode of KSAT Explains, we take a look at how racism has shaped health outcomes, how the city plans to address the issue and what it means to treat racism as a public health crisis. (Watch the full episode in the video player above.)

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An honest discussion

Three different people. Three different experiences with racism.

Glo Armmer writes corporate contracts by day and works in event planning and promotion by night. Pharaoh Clark is a personal chef and community activist. Josey Garcia has retired from the U.S. Air Force and is now a mother of eight and a community advocate.

Armmer, Clark and Garcia sat down with KSAT Explains host Myra Arthur to discuss their personal experiences and what they hope comes of the city’s declaration.

Why more cities and counties are declaring racism a public health crisis

On August 20, the San Antonio City Council passed a resolution declaring racism a public health crisis. But what does that mean?

More research is showing that race and health outcomes are related.

“We know that racism has an impact on individual health,” local epidemiologist Dr. Cherise Rohr-Allegrini said. “When you think of that collectively, it’s public health.”

Black women are four times more likely to die of pregnancy complications than white women. Latino children have a 50 percent chance of developing diabetes. The average life expectancy of Black Americans is four years lower than the rest of the U.S. population. These are just a few of the stats that have prompted cities and counties in at least 26 states around the country to declare racism a public health crisis.

But not everyone is on board.

Just take a look at the September Bexar Facts-KSAT-San Antonio Report poll. More than 600 registered Bexar County voters were asked by phone and internet if racism should be considered a public health crisis in Bexar County. 49 percent disagreed. 46 percent agreed.

Demonte Alexander, director of external affairs & special projects for Bexar Facts, said that a big indicator of whether someone agrees with the premise that racism is a public health crisis depends on political party affiliation and where a person lives. Alexander said that in Bexar County Precincts 1, 2 and 4, roughly 50 percent of those asked said they believe racism is a public health crisis. But that number dropped significantly for the North Side Precinct 3, which is the most affluent county precinct and has the largest percentage of white residents.

“In Precinct 3 alone, 60 percent feel like this is not an issue,” Alexander said.

But the City of San Antonio’s 2019 Racial Equity Indicator Report demonstrates that people of color often experience worse outcomes in education, health and housing. Here are some of the report’s findings:

Percent of residents 25 or older with less than a high school education: 25.7 percent of Latinos, 9.6 percent of Blacks, 4.8 percent of whitesPercent of residents who have delayed health care in the past year because of cost: 24.1 percent of Latinos, 17.9 percent of Blacks, 10.6 percent of whitesPercent of low birth weight births by race/ethnicity of mother: 14.6 percent of Blacks, 9.1 percent of Latinos, 7.5 percent of whites

What is leading to these disparate outcomes for people of color? A lot of things.

There are obvious problems, things like lack of access to health care and insurance. But there are also systemic problems that play a big role — a lack of access to healthy foods, safe outdoor spaces for exercise and transportation.

History has created systemic issues

A part of acknowledging that racism has played a role in these disparate health outcomes requires taking a look back to identify the root of some of these structural issues. Watch the video below for an explainer on the federal government’s role in denying resources to some communities.

What steps will the city take next?

Since the city’s declaration in August, a citywide action plan hasn’t been presented. But Dr. Sandra Guerra, the Interim Deputy Director of the Metropolitan Health District, said the city has been trying to create an equitable city even before the declaration.

The city’s Office of Equity is dedicated to advancing social equity and dismantling racism. Each year the office releases a report. According to the 2019 report, 4,000 city employees took equity training in 2019.

“It might be words on paper right now, but it definitely has a passion behind it,” Guerra said.

Guerra called the resolution a first step. It lays out some commitments, including:

The city will update the community twice a year about policies and programs that improve racial equityThe city will commit to engaging historically marginalized communities in the development of equitable health policies

But critics say the resolution doesn’t specify any immediate change or allocate money for this specific movement.

“We gave these resolutions with no teeth,” Alexander said. “And that’s where my criticism comes from.”


The story behind what inspired a local vascular surgeon to open up her practice on the city’s South SideThe impact of historic racial redlining in San AntonioThe reason why even some who agree with the premise of the city’s resolution worry it will reinforce negative stereotypes

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