“Racism is a threat to public health,” says medical professional (Physician Assistant, Preventative Cardiology) Leslie Gregory.

Huh?

How can racism be a threat to the public health of an all-white small town?

What about the Dallas suburb of Allen, Texas, where only 11 percent of the population of that town are Hispanic?

Public health, of course, is physical health and mental health and that of the community. Imagine how the Hispanic folks in Allen feel when a white man from their town shot and killed 22 people in El Paso, and his online rant that he posted noted that he was targeting “Mexicans.” Such shooters who target based on race are obviously a direct threat to the physical and mental health of an entire identity of Americans. This is clearly domestic terrorism, the definition of which is targeting civilians for great harm for ideological or political gain.

And imagine how racism affected the mental health of white residents of Allen, Texas, one of whom shot and killed all those folks in El Paso. Certainly the mental health of the Allen, Texas shooter was clearly affected. Now, of course, there must be some from Allen who are waiting for the other shoe to drop, the revenge upon their town. Racism thus introduces fear in everyone, and fear elicits the pathology of stress, activating undue clinically observable activity by the adrenal glands, pumping out the high levels of cortisol that frequently is associated with many health problems.

So this is the tip of the public health threat from racism, of course, when we think about it. The evidence goes to many causal and correlative factors apart from being shot by a racially motivated white nationalist.

Heart disease: Racism certainly affects poverty historically and those residual effects are still in play today. “Your ZIP code is more important than your genetic code,” says Dr. Eldrin Lewis, a cardiologist at Harvard-affiliated Brigham and Women’s Hospital. We are also in millions of cases of the aforementioned adrenal gland overproduction of the stress hormone cortisol and its association with heart disease. Racism is bad for the heart in every sense.

Longevity: In a Department of Population Health at NYU Langone Health System study that looks at race and life span, “Chicago had the biggest gap in life expectancy between neighborhoods at 30.1 years. That was followed by Washington, D.C., at 27.5 years; New York City, 27.4; and New Orleans and Buffalo, N.Y., both at 25.8 years.” This is tied to both income and race; when studies show employment discrimination based on race, both factors obtain in our potential for premature death.

Infant mortality: Centers for Disease Control and Prevention finds that African American, Native American/Hawaiian, and Hispanic infant mortality is all greater than white American, with African Americans suffering more than double that rate. Does racism produce this? When all the variables are input, that is virtually certain, since racism affects employment, police profiling/incarceration, public health clinic availability, and other elements of the infant mortality rates. Specifically in the case of African Americans, race is overwhelmingly important; UCLA obstetrician and gynecologist Michael Lu, M.D. and other researchers and clinicians point to disparate prenatal care and to racism as a constant hyper-stressor that, again, compromises health of mother and fetus.

Cancer: Even when income and wealth/poverty levels are controlled for, African Americans, Native Americans/Pacific Islanders have lower five-year survival rates for the aggregate of cancers suffered in the U.S., according to a study conducted examining American Cancer Society data. The Susan G. Komen Institute notes that African American women have a 42 percent higher rate of breast cancer than the aggregate American population of women and attribute this in part to poor early diagnosis and that is in turn often due to preventive care inequities. Another factor is diet and obesity, a problem related to racism in several ways.

Suicide: The Suicide Prevention Resource Center finds the worst rates of suicide are in the Native American population. Is this due to racism? Certainly Native peoples are especially poor on many reservations and they have a history of being murdered en masse in the greatest forcible land theft of the hemisphere, so that collective memory of grief is not effaced to this day and these and other factors may apply in that sense.

Death by police: In a new finding, the National Academy of Sciences finds that, “Police violence is a leading cause of death for young men in the United States. Over the life course, about 1 in every 1,000 black men can expect to be killed by police. Risk of being killed by police peaks between the ages of 20 and 35 for men and women and for all racial and ethnic groups. Black women and men and American Indian and Alaska Native women and men are significantly more likely than white women and men to be killed by police. Latino men are also more likely to be killed by police than are white men.”

The list of public health correlates to race and thus in many cases racism is quite long, but these factors should at least indicate that our public health as Americans is made worse by racism.

Gregory is advocating for that to be noted by all public health university departments, county agencies, state agencies, and the Centers for Disease Control and Prevention. She notes that the American Public Health Association already makes that case but that the current administration informed the CDC that they should not even use words like transgender or science-based or fetus or evidence-based, a clear contamination of the imperative of science and medicine and clinical research in formation of public health policy. Gregory hopes that, as in the case of tobacco lobbyists delaying the determination of smoking as a threat to public health for decades, CDC can overcome this undermining interference by politics and meet its mandate. She authored an online petition to bring this more cogently to the attention of CDC.

“When CDC and other important public health bodies make this logical determination and assertion,” says Gregory, “we will be taking serious steps to remediate both racism and this threat to our collective American health. There is a reason that public health threats require four criteria; they remove emotional, sociopolitical and bias influences and racism clearly meets those criteria.”

Dr. Tom H. Hastings is PeaceVoice Director and on occasion an expert witness for the defense in court.