“What we’re hoping will happen is that by thinking of this through a public health lens, it will help people recognize that racism actually hurts people — it impacts their health in a negative way,” Georges Benjamin, executive director of the American Public Health Association, told CNN. “Then we’re hoping that once people recognize that and they take the next step, they will begin to do things to unravel that.”

Here’s what it means to treat racism as a public health crisis, and why officials believe it’s necessary.

How racism and health are tied

When health experts talk about racism as a public health issue, they are referring to the ways that racism affects where people live, where they go to school, the quality of the air they breathe, their income and wealth, their access to food and healthcare and more.

At home, crowded housing conditions make it harder for Black and Latino Americans to practice physical distancing, and many of them work in essential jobs that can’t be performed remotely.

“Racism has been killing people for a long time, either through benign neglect, aggressive policing, gentrification, or through a healthcare system that doesn’t know how to take care of people of color,” Sánchez said.

The ongoing protests and national outcry over systemic racism that erupted after the death of George Floyd has put increased pressure on leaders and institutions to address racism in their communities.

Increasingly, more state and local leaders are doing the same.

What the declarations do — and don’t — entail

That states, counties and cities are recognizing the extent to which racism affects people’s lives is an encouraging first step, public health experts said.

“They help us define that there is a problem,” Benjamin said. “The first part of trying to solve a problem is to identify that it exists.

But many of the declarations are just that — statements that name the issue and pledge to do better but stop short of outlining a clear plan of action or allocating funds for the problem.

“Ultimately what does it mean?” asked Sánchez. “Is the state going to figure out how to put more resources into the public health infrastructure that deals with the social determinants of health? Are they going to stratify data on where people are and how they’re doing and how sick they are and target them with public health messages?”

“Just like we cannot look away from police brutality and the killing of Black men and Black women, we cannot look away from the reality that inaction, indifference and institutional racism has harmed generations of Black and brown Wisconsinites,” Evers said in June.

At that same news conference, Evers rattled off statistics highlighting the disparities between the state’s Black and White residents. He also called on the state legislature to pass a bill that would limit police use of force.

Michigan went further.

Whitmer, a first-term governor, also created an advisory council made up of Black leaders to address issues affecting the state’s Black residents.

What these places can learn from Milwaukee

For an example of how to move forward after issuing a declaration, leaders might look to Milwaukee County, Wisconsin.

The ordinance commits Milwaukee County to ensuring that its leaders reflect its population and evaluating what services it offers and how it spends its budget, among other objectives.

Since then, David Crowley, who was recently sworn in as county executive, said that Milwaukee County has been taking a “deep dive” into the disparities it is perpetuating through its policies, procedures and internal hiring processes.

“For at least the past decade, we’ve been at the top of many of the worst lists,” Crowley told CNN. “… If we want to get off that list, we’re going to have to take a hard look at ourselves and take the proper steps to do so.”

Crowley said that since last year’s declaration, thousands of county employees have undergone racial equity trainings that cover microagressions, implicit biases and other issues. The county has also created a “racial budgeting tool” that will allow it to assess the impact that budget cuts and investments have on communities of color.

Though the coronavirus pandemic has stalled the county’s efforts, Crowley said that the declaration and ordinance have put the county on a path to ensuring racial equity.

What needs to happen next

The growing list of states and localities that are recognizing racism as a public health crisis signals that more people are coming to understand the myriad ways that race shapes a person’s outcomes, Benjamin said.

But the true test, he said, will be whether elected officials “walk the talk, not just pass the resolution.” And that entails making sure that governments have the data they need to understand disparities and that they think about the impact that the existing and proposed laws will have on their communities.

“It’s going to require proactive action,” Benjamin said. “… You actually have to ask for change, and that means you have to measure what you’re doing. You have to get the data and look at the impact and understand why you have that impact.”

The hope among public health experts now is that the momentum of the racial justice movement continues.

“Our hope is that it doesn’t stop, and that this current crop of elected officials don’t just let it lay there,” Benjamin said.

Because while recognizing the problem is key, what ultimately will make a difference in the lives of people is what leaders do about it.