In thousands of conversations with community members, businesses, grassroots organizations, and elected leaders across Baltimore, I have seen how our City continues to wrestle with deeply-rooted issues of poverty, racial inequality, and structural racism.
Dr. Leana Wen
Here in Baltimore, there are neighborhoods just blocks apart where the life expectancy differs by 20 years. We have made significant strides in reducing infant mortality, and yet Black babies continue to die at twice the rate of White babies. Homicide continues to be the leading cause of death among 15-24 year olds in the city – more than 90 percent of homicide victims in 2016 have been Black.
These disparities tie intimately into the fabric of the work we do at the Baltimore City Health Department (BCHD). Since our founding over two centuries ago, our responsibility has always been to ensure the health of all of our citizens.
But there is a higher standard to which we should hold ourselves accountable.
We cannot expect to markedly improve health and wellbeing in our city without simultaneously fighting the social inequities that our communities continue to experience. It has been said that it is the role of public health to diagnose the problem—to call it as it is. Well, count us in.
First we must acknowledge that racism, poverty, and historical exclusion are unequivocally public health issues, and therefore require public health solutions. Improving health for our most vulnerable is the only way that we can ensure health for our entire city. When we prevent an overdose or a shooting, the emotional and financial benefits are to us all. When we keep our children healthy and in school, we even the playing field for their futures and ensure the right of all communities to thrive.
Secondly, we must go beyond applying “the lens of health equity” to conversations on these issues. We need a magnifying glass…and a bullhorn.
In Baltimore, we have never taken a back seat to public health, and have never been afraid to be bold. That is why in Healthy Baltimore 2020, our newly released blueprint for health in the city, we are going to go even further. Our community members have spoken, and we have listened. We cannot be content with simply aiming to improve health. We must call it as it is and specifically address the issue of health disparities.
Together, we commit to cutting health disparities across Baltimore City in half over the next decade.
As we tackle the opioid addiction epidemic facing our city, we will be laser focused on reducing the disparity between Black and White overdose deaths. We will ensure that there is no difference between access to vision care for students in our lowest-performing schools and those in our highestperforming schools. We will not only reduce the rate of new HIV incidences across our population, but also among those who have been marginalized including our elderly and transgender residents. And as we continue our multi-pronged fight against chronic disease, we will reduce the disparities for our citizens who live in a food desert, test positive for lead, or are at risk for obesity and heart disease.
While this aspiration may seem ambitious, it is in fact grounded in the work that the health department tackles each day, from comprehensive wellness services for our most vulnerable children to ensuring that seniors are able to age with dignity and respect.
That is why we have chosen to focus on four key priority areas for cutting disparities where we have a proven track record, but also where much work remains: behavioral health, violence prevention, chronic disease prevention, and life course core services (including youth health and wellness and care for older adults).
We commit to pouring everything we have into achieving this vision. But we at the department cannot do so alone. That is why we invite all of you, our community partners, to access the plan and share your feedback with us and to work with us. On Aug. 30, we are also scheduled to hold our first Healthy Baltimore Community Conversation at the Druid YMCA to launch this work.
Tackling health disparities will require embracing difficult conversations together as a city. It is through these conversations, however, that we will instigate change.
Healthy Baltimore 2020 is the North Star, our guiding principle and our shared vision. We must all work together to achieve it—to improve health for all of our residents, and to cut disparities in half over the next decade.
Dr. Leana Wen is the Baltimore City health commissioner. She can be reached at health.commissioner@baltimorecity. gov. Twitter: @DrLeanaWen and @BMore_Healthy