Black Hawk County Public Health

Black Hawk County Board of Health

Position Statement: All forms of bias, including racism, are a public health crisis

Statement adopted: April 26, 2023

The Black Hawk County Board of Health formally declares that bias, including but not limited to racism, transphobia, heterosexism, xenophobia, ableism, oppression, or sexism, is a public health crisis and must be eliminated in order to achieve health equity. Bias, the prejudice in favor or against one thing, person or group compared to another, usually considered in a way to be unfair, is present in the policies, systems, and overall community conditions that have prevented the attainment of optimal health. This shapes where and how people live, and what resources and opportunities they have. It also results in a lack of access and opportunity, and increased sickness, mental illness, and premature death among impacted communities.

The declaration aligns with the Health Equity (the state in which everyone has a fair and just opportunity to attain their highest level of health) Policy adopted by the Black Hawk County Board of Health in February 2020. The policy directed the public health department to seek transformation of public health practice to address health equity using the following strategies:

1. Develop and monitor social health and well-being, including inequities in population health.
2. Recruit and retain a racially/ethnically diverse workforce.
3. Support an on-going, all-staff workforce development program that aligns with core health equity and cultural competencies.
4. Systematically integrate an equity lens to support public health activities.
5. Convene and engage the community to build strategic partnerships with the community, external stakeholders, and other local jurisdictions to develop public policies outside the department’s purview for the purpose of eliminating health inequities. Provide institutional means for community-based organizations and individual community members to participate in decision-making for programs, policies, services, interventions, and materials. Standardize the community’s use of a Health Equity Impact Assessment for decisions under consideration to address systemic, avoidable, unjust, and unfair differences between population groups in factors important to health.
6. Support research that explores the generation of social and economic inequality and explores the power dynamics that enable decisions that increase social and economic inequality.
7. Develop a public narrative that articulates the relationship between health inequities and the underlying social inequalities and reclaims the legacy of social justice.
8. Provide health education, health communications, and other public information about community health status and needs in the context of health equity (e.g., focused on determinants vs. focusing solely on individuals’ health behaviors).

The Board of Health seeks to deepen and broaden the work already underway by the department and in the community to combat bias and support those marginalized by its impact. This includes support of the strategic actions underway as a result of the systems thinking initiative co-led by the department to advance equity and eliminate racism which was initiated following the labeling of Waterloo-Cedar Falls by the 24/7 Wall Street as the worst city for Black Americans to live in the United States in November of 2018.

It also includes the adoption of health equity as a foundational issue for community health assessment and improvement planning.

The Board encourages policymakers at the federal, state, and local level to adopt a “health in all polices approach” to ensure that health issues are addressed broadly, especially with respect to social policies that affect vulnerable populations. This includes policies and practices that impact transgender and gender- nonconforming people resulting in a negative impact on gender minority health by permitting discrimination and reinforcing stigma.

The Board advocates for the adoption and application of inclusive policies and practices that recognize and address the needs of all people, with all identities, and for all communities.