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OP-ED TO THE OFFICE OF ENGAGEMENT, WHITE HOUSE

“First recognized in December 2019, the Coronavirus Disease 2019 (COVID19) was
declared a global pandemic by the World Health Organization on March 11, 2020. To
date, the most utilized definition of ‘most at risk’ for COVID19 morbidity and mortality has
focused on biological susceptibility to the virus. This paper argues that this dominant
biomedical definition has neglected the ‘fundamental social causes’ of disease,
constraining the effectiveness of prevention and mitigation measures; and exacerbating
COVID19 morbidity and mortality for population groups living in marginalizing
circumstances. It is clear - even at this early stage of the pandemic - those inequitable
social conditions lead to both more infections and worse outcomes.”

‘Most at risk’ for COVID19, Preventive Medicine October 2020

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Authors Information

Jennifer Maria Padron, M.Ed, CPS, MSWc

Valdosta State University School of Social Work Master of Social Work
Valdosta, Lowndes, Georgia US 31602
jmpadron@valdosta.edu
(706) 391-3864

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ABSTRACT
In the United States systemic racism and psychiatric oppression (Brown and Padron, 2021) is
endemic and there requires an imminent Declaration of a Public Health Emergency. BIPOC
individuals with disabilities face basic and inherent challenges in addition to being a person of color.
In the seminal January 28, 2021, letter from the American Consortia of People with Disabilities and
the Consortia for Persons with Disabilities to the United States Department of Health and Human
Services, Secretary Designate Xavier Becerra, they state, “Disability is most prevalent in women and
in Black, Indigenous, and people of color. People with disabilities experience poverty at
disproportionate rates.”

To exemplify how SARS COVID19 is directly impacting BIPOC people, the Disabilities Consortia
further state, “… Two thirds of all coronavirus deaths have been people with disabilities and staff in
congregate settings. As we have seen in coronavirus data more broadly, congregate settings that
primarily house residents of color, no matter their location, size, or government rating, have
experienced deaths due to COVID at two to three times the rate as congregate settings that primarily
housed white residents.”

Surviving Race: Intersection on Injustice, Disability and Human Rights, Dr. Daniel Fisher, M.D.,
PhD., Founder and Chair of the National Empowerment Center and Harvey Rosenthal, CEO, New
York Association of Psychiatric Rehabilitation Services stated in our formal recommendation to the
President Biden Transition Team, “The pandemic has shone a bright light on racial disparities in
health and health care — as Black and Brown Americans have suffered and died from the coronavirus
at rates far higher than white Americans. We are seeing a national reckoning on racial justice and the
tragic human costs of systemic racism in the murders of Black men, women, and children.”

BIPOC health disparities extends into psychiatric oppression (American Monster, 2021) with firm
evidence to the predominance of disparate mistreatment of individuals of color. Psychiatric
oppression is not separating BIPOC from the >25+ year earlier morbidity and mortality in the US
Public Community Mental Health System (Parks, et al., 2008; World Health Organization, 2020)
remains the rule instead of the exception. Surviving Race: Intersection of Injustice, Disabilities and
Human Rights’ basic tenet states that systemic racism is an inherent cause for US BIPOC health
disparities (Black Lives Matter, 2020; Surviving Race, 2021).

During SARS COVID19, BIPOC individuals are less apt to survive barriers in place in the United
States. US systemic racism and psychiatric oppression (Brown and Padron, 2021) is endemic and
borders on it requiring an imminent Public Health Emergency status (Declaration Act of 2021).
BIPOC Americans die four times the national average of non-BIPOC populations. There is a dire
need for an immediate Public Health Emergency statement (Louis-Jean, J., Cenat, K., Njoku, C., et
al., 2020). This gross impact led to the eventual pairing for our work and call for a Resolution urging
the United States Senate to enact the US BIPOC HEALTH DISPARITIES DECLARATION FOR A
PUBLIC HEALTH EMERGENCY ACT OF 2021 (Padron, J.M., 2021) submitted to US Senator
Raphael Warnock (ATL-D).

Disparities is used in health dialogue referencing racial or ethnic differences in achieved health status.
When there is a noticeable, “… greater/lesser outcome between populations,” (US Department of
Health and Human Services, 2020) it is considered a disparity1. This is not a recent phenomenon,
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having been in existence in the US for BIPOC population showing “differential health outcomes” for
400 years at least (Hammonds, E., Reverby, S., 2019). There exist many health disparities in the
United States, but it is clearly discernable within the US Black, Indigenous People of Color (BIPOC)
populations. Healthy People 2020 defines a health disparity as “… health difference closely linked
with social, economic, and/or environmental disadvantage.” 2

US BIPOC people are sustaining centuries of racial oppression3 and historically have experienced
poorer health outcomes because of our experienced racial and/orethnic assignment. Dr. T. M.
Luhrmann states, “We argue that above all, it is the experience of “social defeat” that increases the
risk and burden of schizophrenia, and that opportunities for social defeat are more abundant in the
modern west. And anthropology plays a new role in the science of schizophrenia” and “… where
standard psychiatric science cannot tell us what it is about culture that has that impact.” (Luhrmann,
T.M., 2016).

Where COVID19 has affected the US BIPOC populations greater than non BIPOC populations from
COVID19 (transmission, death) showing the disparities in health care access and treatment, it is

1
1 Healthy People 2020, derived from Disparities | Healthy People 2020, March 20, 2021

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solemnly tantamount to the 1918 Spanish Influenza pandemic, for example, in numbers lost to death.
Subsequently, into today, the SARS COVID19 pandemic refocuses our attention to BIPOC
Americans effected by it. It exemplifies the continued intersection of systemically racist based
inequities compounding access to care. It propagates racial health disparities through a “lens of health
equity,” (Cooper, L., Krishnan,L., Ogunwole, S., 2020). Obstacles to good (or better) health exist
from disparate socioeconomic status, gender, age,mental health, cognitive, sensory, or physical
disability, sexual orientation or gender identity, geographic location is closely linked to
discrimination and exclusion (US Department of Hand Human Services, 2020).

To better explain health disparities and how it has affected the US BIPOC population, Healthy People
2020 references the context of the health disparities in this population.4 The Department of Health
and Human Services Action Plan to Reduce Racial and Ethnic Health Disparities (2011) prepared the
ground for Healthy People 2020 and did outline anaction plan to reduce health disparities among
BIPOC, “promoting integrated approaches, EBT programs and best practices.” 5

Since the Health People 2008 study, Healthy People 2020 brings health equity into focus taking it to
the next step beyond health disparities in Healthy People 2008. Health equity brings health for all
people. Achieving health equity requires valuing everyone equally with focused and concentrated
effort towards study of equalizing a playing field for achieved health status for US BIPOC people.
Healthy People 2020 defines health equity as, “… attainment of the highest level ofongoing societal
efforts to address avoidable inequalities, historical and contemporary injustices,and the elimination of
health and health care disparities.”12

Dr. Ruqaiijah Yearby, J.D., M.P.H., Co-Founder and Executive Director of the Institute for Healing
Justice and Equity at Saint Louis University wrote in the September 2020 issue of Journal of Law,
Medicine & Ethics “… social factors cause racial inequalities in access toresources and opportunities
(resulting) in racial health disparities,” (Yearby, R., 2020) relational tothe US BIPOC population
poorer health status; however, Dr. Yearby continues, “this recognition fails to acknowledge the root
cause of these social inequalities: structural racism” resulting in health disparities. The current and
historically relevant US national division is entrenched in systemic racism towards BIPOC people,
“… in economic and social lines(that) have long been and continues to be defining features of
American life with health disparitiesacross racial groups considered consequences of these economic
and social division.” (Moore, K., 2019).

The US BIPOC population are individuals which includes those living with disabilities facing basic
and inherent challenges in addition to being a person of color13. In the seminal January28, 2021,
letter from the American Consortia of People with Disabilities and the Consortia for Persons with
Disabilities to the United States Department of Health and Human Services, SecretaryDesignate
Xavier Becerra, they state, “Disability is most prevalent in women and in Black, Indigenous, and
People of Color. People with disabilities experience poverty at disproportionaterates.” 14

The Disabilities Consortia further state, “… Two thirds of all coronavirus deaths have been BIPOC
people with disabilities and staff in congregate settings. As we have seen in coronavirus data more
broadly, congregate settings that primarily house residents of color, no matter their location, size, or
government rating, have experienced deaths due to COVID19 at two to three times the rate as
congregate settings that primarily housed white residents.”16 The US BIPOC populations are no
stranger to existing racial crisis. With COVID19, US BIPOC populations face further challenges
(Forman, H., Nunez-Smith, M., Tiako, M., 2021). Globally, “… 4 percent of the world’s population
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in the US accounts for 25 percent of the global number of confirmed COVID19cases,” (BeLue, R.,
Chaney, C., Davis, D., 2020). BIPOC Americans have a disproportionate morbidity and mortality due
to COVID1917.

To date, the numbers of BIPOC deaths to COVID19 is 63 million and 1.5 deaths globally18. BIPOC
individuals have a greater susceptibility to contracting COVID19 out of age, a propensity for living
with diabetes, hypertension and underlying respiratory and cardiovascular comorbidity associated
with an increased risk to the virus (and developing COVID19 mutations) resulting in greater
mortality19 forthe US BIPOC citizenry. For immediate access to COVID-19 United States Cases by
Country, States and Territories, please visit the Johns Hopkins University & Medicine Coronavirus
Resource Center located at https://coronavirus.jhu.edu/us-map20.

Within the national context of health disparity, referring to differential health outcomes between
BIPOC and Non BIPOC populations, limited access to medical care, resources and supportive
services plays a vital role in the interplay between BIPOC higher numbers to morbidity and mortality
(e.g., COVID19). COVID19 shows a terrible healthcare crisis in the US for people ofcolor. With
Black or African Americans dying nearly four times higher22 than the national average of Non BIPOC
populations requires an immediate Health Emergency statement (Louis-Jean, J., Cenat, K., Njoku, C.,
et al., 2020).

Surviving Race: Intersection on Injustice, Disability and Human Rights stated in their formal
recommendations to the President Biden Transition Team 2020-2021 how “The pandemic has shone a
bright light on racial disparities in health and health care — as Black and Brown Americans have
suffered and died from the coronavirus at rates far higher than white Americans. We are seeing a
national reckoning on racial justice and the tragic human costs of systemic racismin the murders of
Black men, women, and children.”23 BIPOC individuals’ health disparities extend into psychiatric
oppression (Mental American Monster: The Sprawl of American Psychiatry, 2021) with firm
evidence to the predominance of disparate mistreatment of individuals of color. Psychiatric
oppression, for example, is not separating BIPOC from the >25+ year earlier morbidity and mortality
in the US Public Community Mental Health System (Parks, et al., 2006;World Health Organization,
2020) remains the rule instead of the exception.

In the US, Black Americans make up 13.4% (US Census Bureau, 2019); However, mortality numbers
for Blacks is 2.2 times greater than the rate for Latino/Hispanic Americans and 2.4 timesgreater than
the rate for Asians, which is 2.6 higher than the rate for White Americans (Belue, R., Chaney, C.,
Davis, D. 2020). BIPOC racial health disparities propagate hate and ignoble systemic racism and
discrimination towards people of color in the US. In what I consider a critical seminal text 24,
“Eliminating Race-Based Mental Health Disparities: Promoting Equity and Culturally Responsive
Care Across Settings,” (Kanter, J., Rosen, D., Williams, M., 2019) the authors craft EBT practice and
recommendations for clinicians and educators alike on how to best combat BIPOC health disparities
in the behavioral health field utilizing multicultural competency and non-acculturalization of the US
BIPOC community for nonbiased Recovery (clinical, medical model included) in general. Effects of
the influence of racism and bias on BIPOC cultural behavior reveals a disproportionate number of
BIPOC individuals receiving Serious Persistent Mental Illness diagnosis (e.g., Schizophrenia
Spectrum Disorders and Psychosis, Bipolar Disorders).

Race-based stress and experienced trauma occur frequently in BIPOC populations and communities.
Contextually and historically,BIPOC individuals comprise the majority of incarceration and inpatient
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psychiatric hospitalization (Voluntarily/Involuntarily). It is derivative of archaic systemic racist

practice and effected practice for learned assessment, diagnosis and treatment. 25 Teachings on race,
racism and cultural competence now addresses “… biases, resistance, egocentrism,” of non BIPOC
practitioners and providers (O Kanter, J., Rosen, D., Williams, M., 2019). With COVID19 (SARS-
C0V-2) especially, the global pandemic has shown how “racialized” health inequality existing in the
US compares to Non BIPOC populations(Louis-Jean, J., Cenat, K., Njoku, C., et al. (2020). BIPOC
populations are at greater risk due to the burden of living with a Mental Health diagnosis, holding a
mental health history and now affected by COVID19. People living in high/at-risk geolocations are
more apt to not be able to easily access desperately needed medical attention, care,support and
services. BIPOC health disparities did not begin with COVID19 but the virus shows and highlights
the pre-existence of racial health inequities experienced by the US BIPOC populations today.

US DECLARATION FOR AN ADULT MENTAL HEALTH BIPOC

PUBLIC HEALTH EMERGENCY ACT OF 2021

(SUBMITTED 2021)

Resolution No.
City ATLANTA, State GEORGIA

Resolution urging the United States Senate to enact the US BIPOC HEALTH DISPARITIES
DECLARATION FOR A PUBLIC HEALTH EMERGENCY ACT OF 2022

WHEREAS, There is a dire public health need for BIPOC individuals requiring emergency attention
and action;

WHEREAS, BIPOC individuals experience deep historical systemic racism. Health disparities (e.g.,
COVID19) in the numbers being effected and numbers lost to death show significant public health
needs requiring remediative action;

WHEREAS, Needs of BIPOC individuals as an emergent community/population imminently requires

immediate action for relief from COVID19 bias, vaccination disregard, systemic racism and effects of
bystanding psychiatric oppression;

WHEREAS, BIPOC individuals are routed into to the criminal justice intersection at greater numbers
than non-BIPOC populations; and,

WHEREAS, The Surviving Race: Intersection on Injustice, Disability and Human Rights, National
Coalition for Mental Health Recovery and the New York Association of Psychiatric Rehabilitation
with BAZELON National Legal Advocacy presented BIPOC Mental Health Disparities to the Biden
Transition Team DHS and SAMHSA/CMHS in 2021;

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WHEREAS, To exemplify how COVID19 is impacting the US BIPOC populations, the Disabilities
Consortia in a January 2021 Letter to US Secretary Xavier Becerra, stated, “Two thirds of all
coronavirus deaths have been BIPOC people with disabilities and staff in congregate settings. As we
have seen in coronavirus data more broadly, congregate settings that primarily house residents of
color, no matter their location, size, or government rating, have experienced deaths due to COVID19
at two to three times the rate as congregate settings that primarily housed white residents.”; and,

WHEREAS, differential QoL and PHQoL depicts health care national health disparity requiring the
immediate federal executive mandate by the Biden Administration and the Department of Health and
Human Services US Secretary Xavier Becerra with President Biden must declare a US Public Health
Emergency of BIPOC Populations exacerbated by the global Covid19 pandemic and Death by Cop on
the streets across the US; and,

WHEREAS, There exist many health disparities in the United States, and is most clearly discernable
within the US BIPOC populations. Healthy People 2020 defines a health disparity as “… health
difference closely linked with social, economic, and/or environmental disadvantage.”; and,

WHEREAS, US BIPOC people have sustained centuries of racial oppression3 and who have
historically experienced and are exposed to poorer health outcomes, with subsequent lowered QoL
and PHQoL due to intergenerational and oft multigenerational American BIPOC experienced racial
and/or ethnic assignment; and,

WHEREAS, COVID19 shows a terrible healthcare crisis effecting the US BIPOC populations dying
at four times the national average to COVID19 (2021); and,

WHEREAS, The Department of Health and Human Services Action Plan to Reduce Racial and
Ethnic Health Disparities (2011) prepared the ground for Healthy People 2020 outlining an action
plan to reduce health disparities among BIPOC, “promoting integrated approaches, EBT programs
and best practices.”; and,

WHEREAS, Surviving Race: Intersection on Injustice, Disability and Human Rights stated in their
formal recommendations to the President Biden Transition Team 2020-2021, “The pandemic has
shone a bright light on racial disparities in health and health care — as Black and Brown Americans
have suffered and died from the coronavirus at rates far higher than white Americans. We are seeing a
national reckoning on racial justice and the tragic human costs of systemic racism the murders of
BIPOC men, women, and children”;

NOW, THEREFORE, BE IT RESOLVED: US Senator Raphael Warnock urges the United States
Senate AND President Joseph Biden to enact without delay the US BIPOC HEALTH DISPARITIES
DECLARATION OF PUBLIC HEALTH EMERGENCY Act of 2022; and,

BE IT FURTHER RESOLVED, that US Senator Raphael Warnock encourages passage adoption of

the US BIPOC HEALTH DISPARITIES DECLARATION OF PUBLIC HEALTH EMERGENCY
ACT OF 2022

SUBMITTED: April 28, 2021 to US SENATOR RAPHAEL WARNOCK FOR IMMEDIATE

CONSIDERATION AND ACTION

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Citations

1 Healthy People 2020, derived from Disparities | Healthy People 2020, March 20, 2021
2 Ibid.
3 Journal of Comparative Family Studies, retrieved March 20, 2020., Vol. 51 Issue 3/4/2020, p. 418.
4 Ibid.
5 “HHS action plan to reduce racial and ethnic health disparities: a nation free of disparities in health and health care,” US Department
of Health and Human Services (2011)
6 U.S. Census Bureau, American FactFinder. American Community Survey. 2008 American Community Survey 1-year estimates
[Internet]. ACS demographic and housing estimates: 2008 [cited 2010 November 7]. Available from: http://factfinder.census.gov.
[Internet]. ACS demographic and housing estimates: 2008 [cited 2010 November 7]. Available from: http://factfinder.census.gov.
7 Ibid.
8
U.S. Census Bureau, American FactFinder. American Community Survey. 2008 American Community Survey 1-year estimates
[Internet]. Selected social characteristics in the United States: 2008 [cited 2010 November 7]. Available
from: http://factfinder.census.gov.
9
U.S. Census Bureau, American FactFinder. American Community Survey. 2008 American Community Survey 1-year estimates
[Internet]. B01003.Total population – universe: Total population [cited 2010 November 8]. Available
from: http://factfinder.census.gov.
10
U.S. Census Bureau, American FactFinder. American Community Survey. 2008 American Community Survey 1-year estimates
[Internet]. B01003.Total population – universe: Total population [cited 2010 November 8]. Available
from: http://factfinder.census.gov.
11
Mayer KH, Bradford JB, Makadon HJ, et al. Sexual and gender minority health: What we know and what needs to be done. Am J
Public Health. 2008;98:989–95. doi:10.2105/AJPH.2007.127811.
12
U.S. Department of Health and Human Services, Office of Minority Health. National Partnership for Action to End Health
from: http://www.minorityhealth.hhs.gov/npa/templates/browse.aspx?&lvl=2&lvlid=34.
13 Retrieved February 13, 2021 https://diverseeducation.com/article/203762/

14 AAPD, CCPD Letter to US Secretary Designate Xavier Becerra, January 28, 2021.
15 Retrieved February 13, 2021 The Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine (MSM)
16 “The Striking Racial Divide in How Covid-19 Has Hit Nursing Homes.” New York Times. (September 2020). Available at

Covid-19 and Nursing Homes: A Striking Racial Divide - The New York Times (nytimes.com).
17
Journal of Comparative Family Studies, retrieved March 20, 2020., Vol. 51 Issue 3/4/2020, pp. 417-428.
18
John Hopkins Coronavirus Resource Center, Retrieved March 20, 2021 link.springer.com/article/10.1007/s40615-020-00938w .
19
Du, R., Liang, L., Yang, C., Wang, W., Cao, T., Li, M., et al., (2020). European Respiratory Journal; 55(5):2000524.
20
Johns Hopkins University & Medicine | Coronavirus Resource Center, retrieved March 20, 2021.
21
Johns Hopkins University & Medicine | Coronavirus Resource Center, Retrieved March 20, 2021
https://coronavirus.jhu.edu/region/us/georgia.
22
Louis-Jean, J., Cenat, K., Njoku, C., et al., “Coronavirus and Racial Disparities: A Perspective Analysis. Journal of Racial and
Ethnic Health Disparities 7, 1039-1045 (2020).
23 Surviving Race: Intersection on Injustice, Disability and Human Rights, National Coalition on Mental Health Recovery, New

York Association of Psychiatric Rehabilitation President Biden Transition Team BIPOC Recommendations, 2021 (Padron, J.M.,
Brown, C., Fisher, D., Rosenthal, H., 2021).
24
Kanter, J., Rosen, D., Williams, M. (2019). Eliminating Race-Based Mental Health Disparities: Promoting Equity and Culturally
Responsive Care Across Settings, pp. ix-226.
25
Ibid., pp. x-226.

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Declarations

• Funding – Not Applicable

• Conflicts of interest/Competing interests - Not Applicable
• Availability of data and material - Not Applicable
• Code availability - Not Applicable
• Authors' contributions - Not Applicable
• Ethics approval - Not Applicable
• Consent to participate - Not Applicable
• Consent for publication - Not Applicable

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