In a unanimous but largely symbolic resolution, the Virginia Health Council called recent remarks about racism by U.S. Health Commissioner Dr. Colin Green a “shame” for the body and its members.
A strong statement was adopted by 12 board members who were present (three absent) at a board meeting on Thursday, a week after reported the Washington Post that Green – appointed by Republican Gov. Glenn Youngkin – has repeatedly downplayed the role of racism in health differences during his five months as head of the state Department of Health.
In an interview with the newspaper, Green said he had not yet seen “convincing evidence” that racism played a role in the well-documented differences in the health of mothers and babies of black mothers and their babies. He also described racism as a “politically charged” word, telling the Post that “if you say ‘racism, you’re blaming white people.’
While Green has since backed away from some of his comments, the board’s resolution described his interview as “contradictory” to members’ positions and well-documented scientific evidence of the role of racism in public health inequalities. Members instructed both the Commissioner and the staff of the department to “recognize” these differences and to allocate resources to the departments within the agency, focused on “improving practices and providing care that will reduce these differences over time.”
The resolution also prohibits the commissioner and other spokesmen for the agency from making public statements “contrary to the policy or intentions of the board” regarding health differences or comments “which carry a message of denial of basic scientific facts”.
“You are the voice and face of the Department of Health,” said Dr. Holly Puritz, a Norfolk-based member of the OBGYN board affiliated with the Virginia Medical Society. “And whatever you think personally, when you spoke on our behalf, your words were very hurtful, your words were very harmful and very harmful to the very hard-working people of this organization.
The State Health Council has no oversight powers over either Green or the VDH, and the resolution can only serve as a guide for the commissioner and staff of the department, according to a representative from the Attorney General’s Office who attended Thursday’s meeting. But this was the first time the board, which currently consists of members appointed by former Democratic governors. Terry McAuliff and Ralph Northam publicly rebuked a commissioner or issued a public directive related to their leadership.
And while four members, including President Faye Pritchard, will end their terms on June 30, Youngkin will not be able to appoint a majority on the board by 2024. This could put Green in a lengthy dispute with the body that lists reducing health disparities as a priority public health problem and has the task of assisting in both the planning and policy development of the department.
In more than an hour of question-and-answer session added to Thursday’s agenda, Green said many of his comments in the Post article were taken out of context, while maintaining that structural racism is not the only factor contributing to clearly documented differences in pregnancy. -related deaths and infant mortality between white and black mothers and babies.
“We can’t talk about racial differences without talking about the consequences of racism,” he said, describing his comments to the Post as part of a broader discussion of the department’s communications and efforts to avoid division. “But I would prefer to emphasize specific effects, such as differences between mothers, differences in mortality, differences in infant mortality.
“One of the problems with structural racism is that it is not an objectively quantifiable variable,” Green added later during the meeting. “That’s why I’d like to look at the department’s measures so I can understand it.”
Many board members disagree with Green’s assessment that structural racism is not a measurable factor, especially given years of research into how discrimination affects health beyond socioeconomic status and other social determinants. He quotes the Washington Post. study by David R. WilliamsProfessor of Public Health and African and African American Studies at Harvard University, along with research on how racial inequalities are physically reflected for the health of black patients.
Patricia Ann Kinzer, assistant dean for research in the Department of Family and Community Health at the VCU School of Nursing, pointed out that the differences remain regardless of the level of education. Pregnancy-related deaths are among black women with higher education almost twice as high as they are for white women without high school diplomas, and the infant mortality rate for their babies is more than three times higher.
“I’m worried about not conveying the message and losing the audience”
While Green described the interview as a “learning experience”, promising to improve his public communication, he backed other comments in sometimes tense exchanges with board members. Among them were his objections to the term “gun violence,” which he described to the Post as a “democratic point of conversation.”
“I’m worried about carrying the message and losing the audience,” he told Pritchard, who asked if his fears of offending people with the term outweighed his importance in describing events such as the recent shooting at a school in Uwalde, Texas.
“Gun violence is a term that actually combines – and again unites – four different problems,” Green said. He told the board that firearm-related deaths as a category included suicides, homicides and a relatively small number of incidents and mass shootings, all of which had different sources and motives.
“Combining them with the fact that there were firearms ignores the fact that there are very different origins to these four different problems,” he said. “And I’m worried that we will miss the opportunity to really deal with the root causes of why people choose to take their own lives, why people choose to take other people’s lives, how they carelessly handle dangerous objects like firearms to allow children to be hurt and what it is in our society that makes people want to be mass murderers. ”
“These are the things I think we need to look at,” Green continued. “It’s not the actual method people use.”
His views contradict the policy recommendations of more than a dozen research groups and health organizations, including American Public Health Association,, John Hopkins Center for Solutions to Gun Violence,, American Psychological Association and John J. College of Criminal Justice. All use the term gun violence and list measures to control and restrict access to firearms as crucial steps to reduce deaths in the United States.
“It was a political act.”
The Commissioner did not respond directly to the resolution, nor did he answer questions from reporters after the meeting. And while he said on board that he really believes there is compelling evidence that racism plays a role in the differences in the health of mothers and babies, going back to his previous statements, it is unclear whether the directive will change his plans for the department.
Earlier this month, the Post reported that Green had removed an online presentation that listed one of the department’s priorities as exploring and eliminating “drivers of structural and institutional racism” within the Family Health Services. The document was not restored on the agency’s website, although Green said on board that he had ordered staff to investigate factors contributing to health disparities, including high infant and maternal mortality rates in the state among black families.
At Thursday’s meeting, he also said he had removed a VDH website with links to “inappropriate” sexual health resources at the request of an MP, although it was not clear what exact information had been removed from the agency’s website or who made the request. .
Board member James Edmundson said these actions, combined with Green’s answers to many of the questions raised during the meeting, left him with long-standing concerns about the agency’s future direction.
“Despite his denials, it was a political act,” Edmanson said. “It reflects the wishes of the current administration.”
Green himself shuddered at the idea that he could no longer question the root causes of health differences and other lengthy work in the health department.
“This meeting is the beginning, but I also argue that we need to make better use of data and objective measures,” he told Vice-Chair Dr. Wendy Klein, when asked how he plans to restore morale and confidence in department.
“You’re talking about ‘established science,’ and that’s a bit of a chilling word for me,” he continued. “That tells me I’m not allowed to disagree.”