Why It’s Important to Address Racism As A Public Health Crisis

A Q&A with Dr. Cynthia Langtiw, Clinical Psychologist and Professor, The Chicago School of Professional Psychology

This year, as a part of our Stand Against Racism campaign, YWCA focused our efforts around the theme, From Declarations to Change: Addressing Racism as a Public Health. Public health is, and always has been, central to racial justice work. This theme was especially pertinent as our nation continues to face the intersecting public health crises of COVID-19 and racism. This work led us to connect with Dr. Cynthia Langtiw—a community-based mental health professional, professor, and educator with over 15 years of experience working with immigrants and people of color in the Chicago area—to provide her informative opinion on why it’s important to address racism as a public health crisis.

Please introduce yourself and describe your background, experience, and understanding of racism remediation and public health work.

CL: I am Dr. Cynthia Lubin Langtiw. A Haitian American clinical/community psychologist and professor at The Chicago School of Professional Psychology. As the daughter of Haitian immigrants growing up in New York and Miami during the 1980’s, anti-Haitian immigrant and anti-Black sentiment was ever present. Currently, much of my work is helping immigrants, refugees, and asylum seekers understand the emotional and psychological implications of being an immigrant here in the United States through the lens of race and ethnicity. In my understanding, racism can cause psychological trauma that occurs due to discrimination against targeted communities of color, much like those I serve every day. Whether we are aware of it or not, all of us bear the psychological burden of racism and to remediate the public health crisis it has created, our entire country needs to heal together.

When you hear the statement, “Racism is a Public Health Crisis,” what does that mean to you and how do you define it?

CL: Public health is the wellness of communities, public systems, and the public at large. Unfortunately, racism is embedded and causes structural racism in all our public systems, including our health, education, legal, carceral, and religious systems. The fact that one’s race or ethnicity can predict higher rates of transmission and deaths from COVID-19, higher rates of suicide completion, lower life expectancy, or success in the educational system, are examples of structural racism at work. Racism is a public health crisis because public systems are not designed to take care of folks equally or equitably. In every public system, especially in mental health care, the needs of minorities are underserved.

As a clinical and community psychologist, I am interested in the wellness of communities, as well as individual mental health. If you look at any public health issue, such as those outlined above, you will find a significant mental health component. Due to what I have witnessed and experienced, I have come to a firm conviction that mental health is THE public health issue of our time.

What are the most critical ways that you believe racism affects public health outcomes specifically in the field of mental health?

CL: Within the field of mental health, the public health outcomes of racism are illuminated in three critical ways. The first is access. We know that targeted communities of color are overrepresented in not having adequate access to mental health care, often due to affordability. The second is the inability to treat race based trauma by the system. When people of color cannot find clinicians equipped to address race-based trauma, they do not receive services that fully meet their needs. The last outcome is healthy paranoia. The research also tells us that there is a health paranoia, or skepticism, that some African American people have with respect to health care systems. For some Black people, there is a sense of mistrust in a health system that historically, intentionally, and systematically harmed Black bodies.

How do you think racism as a public health crisis affects the most vulnerable communities and how can we address these discrepancies?

CL: Racism in our public system of care means that the unique needs of minoritized communities are not seen, centered, or met. This also means that often the public systems tasked with caring for these vulnerable communities harms them. Due to these experiences, the psychological implications of structural or systemic racism can leave targeted communities of color feeling helpless and untrusting of public systems.

Every member of this society should have excellent and equitable care in every public system. Regardless of the intentions of the creators of our public systems, if public health data show that marginalized folks are not getting the same level of care, then that system has structural racism woven into it. To address these discrepancies, we need to name and recognize the disproportionate impact of racism, take systemic responsibility, and then act. We must make sure that public health officials and policymakers are forming, recreating, and reimagining health systems, centering the experiences of vulnerable communities such as immigrants, people of color, and trans folks. When we elevate our health care and mental health systems by centering these vulnerable communities, we strengthen the entire system for everyone.

When you understand racism as a public health crisis, how does that change how you think folks should approach addressing it?

CL: When we start talking about race and racism, folks can take it personally, which causes a defensiveness since no one wants to be seen as racist. What I appreciate about Ibram X Kendi’s definition of racism, is that it’s about policy and action. If a policy, or action, disproportionately harms Black, Latinx, Indigenous, or Asian folks, it is racist.

If we look at racism as a public health issue, we look at public systems, what they were intended to do, for whom, and whether they are equitably achieving their goals. By understanding racism as a public health crisis, the issues AND solutions become systemic. This perspective puts the responsibility on all of us to take part of the health system, find our voice in the conversation, and participate in the resolution of these inequities regardless of if we personally participated in the creation of these racist systems.

How would you encourage the common person to stand against racism and address racism as a public health crisis?

CL: I would encourage the common person to take the following actions:

Listen to accounts of racism with deep curiosity and empathy.

Understand that our individual health and liberation is inextricably tied to our collective health and liberation.

Look for racism and inequities in the systems in which you love and live.

Take action to dismantle racism in your sphere of influence.

Build bridges of solidarity to combat racism.

Conspire together about what you can do to change your block, community(ies), city, state, and federal government.

It is important for all of us to address racism as a public health issue and it is essential to our collective well-being to act in dismantling racism.