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Health & Science
Ideastream Public Media investigates how racism contributes to poor health outcomes in the Cleveland area and uncovers what local institutions are doing to tear down the structural barriers to good health.

Cuyahoga County is trying to address decades of disinvestment in communities of color. Is it working?

Cuyahoga County building
Michael Indriolo
/
The Land
In the past two years, the Cuyahoga County government has launched initiatives to address racism as a public health crisis. But some say change hasn't come quickly enough.

Nearly two years ago, Cuyahoga County declared racism a public health crisis as the Black Lives Matter movement was sweeping the country. Since then, county officials have taken some initial steps to address racial and health inequities that have plagued the area for centuries.

The county made the declaration because officials are dedicated to addressing the issue, said County Executive Armond Budish.

“It's something that we need to focus on, and do everything we can to address,” he said. “And we've been doing a whole lot. In fact, we, even before we took the formal position of adopting a resolution that racism is a public health crisis, we have multiple, multiple programs that address equity and address racism and address making sure that everybody is included in our various programs.”

Cuyahoga County Executive Armond Budish
Castele, Nick
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Cuyahoga County
Cuyahoga County Executive Armond Budish said the county made the declaration that racism is a public health crisis because officials are dedicated to addressing the issue.

But change has not come quickly enough for some in the community who charge that the county’s bureaucracy has tripped up efforts to provide relief to underserved communities. There is also some frustration and pessimism about the county’s approach, which some say has not addressed obvious differences between historically white and Black neighborhoods.

“Look at the East Side, the disparity, and look at the West Side, how they build it up,” said Norman Edwards, president of The Black Contractors Group, which advocates for work for Black contractors, tradespeople and professionals in Northeast Ohio.

“The East Side looks like a hellhole and the West Side is built up pretty nice,” said Edwards, who was born and raised in Cleveland.

Norman Edwards of the Black Contractors Group
WEWS
Norman Edwards of the Black Contractor’s Group

But Cuyahoga County officials are playing a long game and it will take time to unravel a complex problem, Budish said.

“We are trying to plant as many seeds as we can now that will blossom over the years,” said Budish, who has been in office since 2015 and is not running for reelection this year. “That's one of the better ways we can make sure that the success we're experiencing will continue into the future, regardless of the executive.”

In the past two years the county government has taken some steps, including making Juneteenth an official county holiday and reorganizing several departments to create a Department of Equity and Inclusion (DEI), according to the Cuyahoga County 2022 Equity Commission report. Additionally, the Department of Health and Human Service department staff attended bi-monthly discussions on race-related issues and other county officials have also prioritized development projects in historically disinvested neighborhoods and doled out more loans and contracts to minority- and women-run businesses.

The report shows much of the county’s efforts focus on economic development. That’s because the county government charter calls for the government to “significantly improve” economic competitiveness and due to a growing awareness that factors such as access to transportation affect people’s health, said William Tarter, Jr. a Cleveland branch of the NAACP executive committee member.

“We think about the impacts of historical decisions, such as redlining. One of the things that's really important is how those decisions impact health outcomes, but they also have an economic impact as well,” said Tarter. “That's where I think that there's been a recognition at the county level of the importance of prioritizing health and human services and economic development.”

But Edwards, with The Black Contractors Group, questions whether the programs that county officials are working on are having an impact in his community, and he said he is skeptical whether they were even designed to make life better.

“I don't see the programs that they have. I don't know if they're designed for Black people to stay in the hole and the minorities to stay in the hole forever,” he said. “But the disparities and the wage gaps have gotten large. I mean, they've not they've not gotten smaller.”

Nationwide, the wage gap between Black and white workers grew between 2000 and 2019, according to research by the Economic Policy Institute, a liberal-leaning think tank.

It’s only been two years since the county’s resolution was adopted and there is still “an opportunity to see how the decisions that are being made are going to play out,” Tarter said.

The current racial health disparities, such as lack of access to transportation and neighborhoods that are food deserts, were not established overnight and won’t necessarily change overnight, he said.

“It’s really good to see how there is agreement that the disparities are not acceptable,” he said. “And that there's a commitment to try to change those things.”

What does declaring racism a public health crisis mean and what is the county government doing about it?

2020 was a watershed year for declarations of racism as a public health crisis. As of February of this year, at least 27 cities and counties in Ohio - including Cleveland and Cuyahoga County – have made similar declarations, according to the American Public Health Association (APHA). Ohio has the second-highest number of municipalities that have passed declarations.

Since 2020, some declarations at Ohio agencies have been repealed because of pushback, others were changed and then reinstated. But Cuyahoga County’s nine-page resolution, with four pages of racial disparities on everything from life expectancy to suicide to educational outcomes, spurred “systemic change across Cuyahoga County starting with the county government,” the Cuyahoga County 2022 Equity Commission report says.

The county identified five agencies and one board to begin assessing policies and programs through a lens of racial equity, according to the report.

They were the departments of health and human services, development, public works, equity and inclusion and human resources, and the Cleveland-Cuyahoga County Workforce Development Board & OhioMeansJobs/Cleveland-Cuyahoga County.

Racism creates a disparity between Black and white people in nearly all aspects of people’s lives but most importantly in healthcare, the criminal justice system, healthy food, safe and affordable housing, well-paying jobs and business ownership opportunities, quality transportation, educational opportunities and safe places to be active, resulting in adverse health outcomes and shorter life expectancies among people of color, thus creating a public health crisis.
Cuyahoga County's 2020 resolution declaring racism a public health crisis

Among those agencies was the newly created Department of Equity and Inclusion. It is responsible for monitoring contracts to make sure they meet diversity requirements and increasing participation in the bids and requests for proposals process by minority and women-owned businesses.

“Our goal would be to be an example of diversity, equity inclusion within our own operations,” said Lenora Lockett, who was appointed to lead the department shortly after it was formed. “We can learn from the community and benefit the community.”

Increasing participation by minority-owned firms in the county’s bids and request for proposals process could improve health disparities, said Edwards.

“If you enrich the families, and they're able to provide for their families… They're going to hire within their races. They're going to hire the people, brothers, sisters, nieces, nephews, cousins, neighbors, friends so you've built up a wealth in the community. And then they're able… to have medical care,” he said. “The guys that are out here making $12 and $13 an hour at the restaurants, they don't have medical care so it is a health crisis.”

But Edwards said he’s skeptical that the county will make necessary changes to improve the number of minorities who receive county contracts. Past efforts by county officials to address discrimination in this area failed, according to a recent county study.

Between 2014 and 2018, Cuyahoga County spent more than $1.1 billion dollars on construction, architecture and engineering, goods and supplies and other services, a 2020 Cuyahoga County disparity study shows. Less than 1% of that spending went to firms owned by racial or ethnic minorities.

The study concluded that the county’s efforts to eliminate long-standing discrimination in awarding contracts to minority-owned businesses “had not worked” and that despite a good effort by the county to address race and gender bias “discrimination still exists.”

Less than a year after the report was published, the county dissolved the Office of Procurement and Diversity and created the Department of Purchasing to manage their procurement process and the Department of Equity and Inclusion to oversee diversity requirements.

But so far, Edwards said he hasn’t seen any improvement.

“Our public officials have let us down,” he said. “We're not growing, and we're not gaining the wealth… We’re still ranked, one or two in poverty for major cities... And we've been stagnant there for quite some time. I don't see the daylight.”

What happens next?

With an administration change coming next year, officials noted that the county’s equity platform could face a test in adapting to new leadership without losing momentum.

“We certainly need to leave anyone who might succeed us with an understanding of the work done, the ambitions that were created, and the hope for what might be possible,” said Eddie Taylor, who chairs the Cuyahoga County Citizens' Advisory Council of Equity (CACE), an advisory board organized to collect citizen input after it declared racism a public health crisis. “That is a duty that we are going to take seriously as we go through this process because transition sometimes can lead to that stumbling, that inaction.”

Eddie Taylor, chair of Cuyahoga County Citizens’ Advisory Council of Equity (CACE)
Michael Indriolo
/
The Land
Eddie Taylor currently chairs Cuyahoga County Citizens’ Advisory Council of Equity (CACE).

Chris Ronayne, the former president of University Circle Inc., and Tariq K. Shabazz, a Navy veteran, will face off in the Democratic Party primary election on May 3, with Ronayne favored to win. The winner will face Republican Lee Weingart in the Nov. 8 general election for the

County Executive position.

All three candidates, for the job currently held by Budish, have expressed a commitment to equity, highlighting socioeconomic and racial disparities prevalent in the county’s housing market and economy.

Despite the administrative changes coming, County Council will remain committed to racial equity in the future, said District 7 council member Yvonne Conwell, who chairs the Health, Human Services and Aging Committee.

District 7 council member Yvonne Conwell chairs the Health, Human Services and Aging Committee
Michael Indriolo
/
The Land
District 7 council member Yvonne Conwell chairs the Health, Human Services and Aging Committee.

While the immediacy of the COVID-19 pandemic has pushed her passion for equity “to the backburner,” Conwell said she has faith in her colleagues like District 9 council member Meredith Turner. Turner was recently appointed to fill U.S. Rep. Shontel Brown’s former seat and wants to focus her work on health equity.

Even still, Conwell said confronting the county’s disparities will require participation from outside entities, too, like MetroHealth and the Cuyahoga County Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board, both of which receive taxpayer dollars.

“This is not something that we can overturn in a night,” Conwell said. “This is everybody being dedicated to it.”