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After the killing last year of George Floyd, a Black man, by a white Minneapolis police officer, Wisconsin Gov. Tony Evers declared racism a public health crisis. The governors of Michigan and Nevada quickly followed, as have legislative bodies in Minnesota, ibuprofen acetaminophen together dosage Virginia and Washington, D.C.

Yet California Gov. Gavin Newsom, who governs one of the most racially and ethnically diverse populations in the U.S., has not.

State Democratic lawmakers are not waiting for Newsom to make a declaration and are pressuring the first-term Democrat to dedicate $100 million per year from the state budget, beginning July 1, to fund new health equity programs and social justice experiments that might help break down systemic racism. Possibilities for the funding include transforming parking lots in low-income neighborhoods into green spaces and giving community clinics money to distribute fresh fruit and vegetables to their patients.

Lawmakers say covid's disproportionate impact on California's Black and Latino residents, who experienced higher rates of sickness and death, makes their request even more pressing.

"Covid uncovered the disparities of the segregated California of the past that still has an effect today, and that we can correct if we focus on equity,” said Assembly member Mike Gipson (D-Carson), who is spearheading the funding push. "We need to build a healthier society that works for everyone.”

Lawmakers are lobbying for the money in their negotiations with the governor over the 2021-22 state budget. The legislature must pass a budget bill by June 15 for the fiscal year beginning July 1. Once Newsom receives the bill, he has 12 days to sign it into law.

The $100 million proposal to address the health effects of racism is part of the Democratic-controlled legislature's broader public health agenda that includes a request for $235 million annually to help rebuild gutted local public health departments, $15 million per year for transgender health care and $10 million to establish an independent "Office of Racial Equity," which would attempt to identify and address racism in state spending and policies.

Health care advocacy groups say the investments are critical to address inequality in society and the health care system that has contributed not only to higher rates of covid within disadvantaged communities, but also chronic diseases like diabetes and heart disease.

"Those who got sick and lost jobs were mostly communities of color, so seeing no new investment from the governor to really tackle racial equity is unconscionable," said Ronald Coleman, managing director of policy for the California Pan-Ethnic Health Network, which sent Newsom a letter last July asking him to declare racism a public health crisis.

Newsom hasn't committed to supporting the funding but said he'd be "very mindful" in negotiations with lawmakers. One proposal Newsom and state lawmakers agree on is funding for a chief equity officer to address racial disparities within state government.

Newsom pointed to other budget proposals he has made, including $600 economic stimulus payments to households earning less than $75,000, rent and utility bill assistance, and an expansion of the state's Medicaid program for low-income residents, called Medi-Cal, to unauthorized immigrants age 60 and older.

Dr. Georges Benjamin, executive director of the American Public Health Association, said George Floyd's killing in May 2020 motivated state and local lawmakers tolook at racism through the lens of public health — which could have helped save lives during the covid pandemic. "We're at a tipping point," Benjamin said. "It's important to first acknowledge that racism is real, but then it requires you to do something about it. We're now seeing other states beginning to put money and resources behind the words."

Some cities and counties in California have declared racism a public health crisis, including Los Angeles and San Bernardino County. But those declarations would be more meaningful backed by an infusion of state resources, health care advocates say.

"We need to be willing to put dollars into innovative approaches to addressing racism in the same way we invest in stem cells, and we need to be willing to accept that some of the things we try will work and some won't," said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network.

Should Newsom sign off on the funding, grants would be available to health clinics, Native American tribes and community-based organizations to develop programs aimed at combating racism and health disparities.

The Community Coalition in South Los Angeles, a nonprofit that originally set out decades ago to address the crack epidemic, expressed interest in applying.

"There are so many vacant lots in South Los Angeles that could be turned into mini-parks. That helps not only with physical health but mental health," said Marsha Mitchell, the organization's communications director. "We have very few grocery stores, and if you live in Compton or South Los Angeles, your life expectancy is almost seven years lower than if you lived in Santa Monica, Beverly Hills or Malibu."

Directing more resources to address racism could backfire, in part because voters, including some Democrats, have displayed skepticism over some of the liberal and expensive policies sought by Democrats who control Sacramento, said Mike Madrid, a Sacramento-based Republican political consultant who has also worked for Democrats.

He pointed to Proposition 16, the November 2020 ballot initiative that would have repealed California's 1996 law banning affirmative action, which was defeated 57% to 43%.

"Racism is very much a public health problem — just look at the chronic diseases and lower life expectancies of Black and brown people, and most people believe that racism is systemic in our governance," Madrid said. "But voters are becoming more discerning about how racism is being used by politicians to advance an agenda."

Focusing too heavily on racism could prompt a backlash, he said, "whereas if you focused on poverty and inequality, that would solve many of the racial problems."

But state Sen. Richard Pan (D-Sacramento), who is leading the drive to establish an Office of Racial Equity, said funding and state leadership focused intensely on structural racism are essential to ending it. Should the office not be funded in the budget, Pan said he'd press forward with a bill.

The office would work with the state's new chief equity officer to examine the California government, including state hiring practices, proposed legislation and budget spending decisions, for evidence of racism or inequality.

It's a priority for the legislature's Asian & Pacific Islander Legislative Caucus, given the rise in hate crimes perpetrated against people of Asian descent, Pan said.

"We need to invest more in prevention," Pan said. "The state needs to step up and support communities of color."

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.