 Good morning and welcome to the Vermont House Human Services Committee. Today is Thursday, April 8th. And this morning, we are beginning our testimony on JRH 6, a joint resolution relating to racism as a public health emergency. Clearly an important and very current issue. We're going to start with a legislative council, Katie McLean, doing a walkthrough of the resolution for us. The resolution was sent to the committee to be treated as a bill. So if you have questions about that process, please direct it to legislative council as well. Katie. Good morning. Katie McLean, Office of Legislative Council. I will pull the document up on my screen. There we go. Are we all seeing the document? Yes. I'm seeing some nods. Okay. Great. So this is joint house resolution number six, relating to racism as a public health emergency. And I'll go through each of the whereas clauses with the committee to start with. Whereas stark and persistent health inequities exist in the United States based on race and that are caused by systemic racism. And whereas systemic racism is a principle social determinant of individual and public health impacting economic employment, education, housing, justice and health opportunities and outcomes, all of which further adversely impact the health of people of color. And whereas the COVID-19 pandemic is now exasperating these inequities and black and Latino people in the United States have been nearly three times as likely to die. And whereas the same inequities exist in Vermont and during the pandemic, though black residents comprised just over one percent of Vermont's population, they account for approximately 4.8 percent of the total confirmed COVID-19 cases as of December 16, 2020. And whereas research and experience demonstrate that Vermont residents experience barriers to the equal enjoyment of good health based on race and ethnicity. And whereas the incidence rate of COVID-19 for non white Vermonters is 74.2 versus 26.2 for white Vermonters. And specifically the incidence rate for black Vermonters is 225.7. And the incidence rate for Asian Vermonters is 61 and the incidence rate for Hispanic Vermonters is 41.7. And the incidence rate for other races is 20.5. And whereas while there is not statistically significant differences in the rates of preexisting conditions such as diabetes, lung disease and cardiovascular disease among white and non white Vermonters, there are disparities in the rates of preexisting conditions among Vermonters testing positive for COVID-19, which suggests that non white Vermonters are at higher risk of exposure to COVID-19 due to their type of employment and living arrangements. And whereas 36 percent of non white Vermonters had household contact with a confirmed case of COVID-19 as compared to only 20 percent of white Vermonters. And whereas according to the Department of Health's 2018 behavioral risk factor surveillance system report, non white Vermonters are statistically less likely to have a personal doctor, statistically more likely to report poor mental health, more than twice as likely to report rarely or never getting the necessary emotional and social support, significantly more likely to have depression, significantly more likely to have been worried about having enough food in the past year, and significantly more likely to report no physical activity during leisure time. And whereas non white Vermonters are disproportionately represented in the total number of patients in the highest level of involuntary hospital beds in the state, comprising 15 percent of the patients admitted to the Vermont psychiatric care hospital between May 1st of 2019 and April 30th of 2020. And whereas social determinants of health are underlying contributing factors of the foregoing health inequities. And whereas 21 percent of black Vermonters own their own homes, while 72 percent of white Vermonters own their own homes, and nationally 41 percent of black Americans own their own homes. And whereas the median household income of black Vermonters is $41,533, while the medium household income of white Vermonters is $58,244. And whereas in 2018, 23.8 percent of black Vermonters were living in poverty, while 10.7 percent of white Vermonters lived in poverty, and 57 percent of black Vermonters earned less than 80 percent of Vermont's medium income, while 43 percent of white Vermonters earned less than 80 percent of Vermont's medium income. And whereas about one in two non white Vermonters experience housing problems, which is defined as having homes that lack complete kitchen facilities or plumbing, having overcrowded homes are paying more than 30 percent household income towards rent mortgage payments and utilities. And whereas Vermont Vermonters, well, excuse me, black Vermonters are overrepresented among Vermonters experiencing homelessness, and that they make up 6 percent of Vermonters experiencing homelessness while making up approximately 1 percent of Vermont's population. Now, therefore, be resolved by the Senate and House of Representatives that racism constitutes a public health emergency in Vermont. Be it further resolved that this legislative body commits to the sustained and deep work of eradicating systemic racism throughout the state, actively fighting racist practices, and participating in the creation of more just and equitable systems. And be it further resolved that this legislative body commits to coordinating work and participating in ongoing action grounded in the science and data to eliminate race based health disparities and eradicate systemic racism. And be it further resolved that the Secretary of State be directed to send a copy of this resolution to the Governor Chief Justice of the Vermont Supreme Court, League of Cities and Towns, all regional planning commissions and the Vermont Racial Justice Alliance. So that's it. Thank you. Thank you very much, Katie. Perhaps if you could just briefly explain how, if at all, a committee working on a resolution that is the same or different from working on a bill? Sure. So far, this process has been fairly similar to a bill request. I was assigned the resolution, much like I'm assigned a bill request. And I worked with the sponsors to come up with the where as clauses and to provide citation for each of the classes. So we have each of the statistics backed up with documentation. And then from there, the process has been fairly similar to committee members having an opportunity to sign on to sponsor the resolution and have it introduced. And as you know, it's been referred to your committee much like a bill and the committee at this point has responsibility over reviewing the bill and making any changes that it feels necessary before bringing this resolution back to the floor. Okay. Thank you. Thank you. I think that's helpful to understand the process. Before we go on to our first witness, Representative Wood. This is a process question, Madam Chair. So I perhaps should know the answer to this, but I don't. So when does the speaker assign a resolution to a committee? I don't understand under what circumstances that resolution is assigned to a committee versus just passed by the house or whatever. So you're making me want to check house rules to see if there's any language that creates a distinction. In my experience, then that policy resolutions are more likely to be referred to a committee, whereas resolutions that are congratulating a sports team, for example, are not likely to be referred to a committee and just go straight to the floor. But because this particular resolution has particular policy implications, I believe that's the distinction. Thank you. Representative Rosenquist. Thank you, Madam Chair. Just if a resolution like bill is referred to committee, is it required by the committee to take up the resolution? It seems to me, if a bill comes to the committee, many of them stay on the wall. So is what determines whether this gets taken up by our committee, given the many things we're dealing with during this period of time? I was frozen. I'm not sure if that question was directed at. I didn't hear the whole question, but I think the question was what determines whether this is taken up. And I would say it's the same as anything that's referred to the committee that things, bills, resolutions are added to the wall and that anything that comes off the wall is at the discretion of the chair. Thank you, Katie. The speaker has identified that equity and racial justice is an important and integral part of our collective work this session. And so the expectation was before that we take it up. And I think and I personally think that it is important. We're going to work on this as we work on three, if not four other issues, just as we were working on this along with the other bills that are in front of us. Representative Redmond. Thank you, Madam Chair. I just want to kind of offer another comment. And that is just that I'm actually really glad we're taking this up. I feel like the time we're in is perfect. It's a perfect time to really look into these things. And I know we have other priorities and we'll get to as much as we can. But I really am grateful that we are looking at this today. Thank you. Thank you. Other comments right now? Okay, our first, Representative McFawn. Thank you, Madam Chair. We're going to treat this just as we treat any other bill, correct? We're going to listen to some testimony and ask questions about it, et cetera, just as any other bill. Exactly, exactly. Will, if there's wording that we disagree with that we think should be different if we have questions about the data or about what this means. Yes, absolutely. Representative McFawn. Today is just the introduction. Today we have Mark Hughes, who is from the Racial Justice Organization. If you noted, they will be getting a copy of this. We have the Commissioner of Health, the Vermont Commissioner of Health, and we have a nationally renowned educator and trainer and provider, Dr. Avila. I'm sorry. I know Mercedes, I'm not going to use that name, but am I pronouncing your name correctly? Yeah, that's fine. But I hope in your introduction that you will introduce more specifically how she has, how you have testified nationally, as well as taught courses and trained people across the country, and done research on this. So this is day one is sort of the introduction, and as you all know me well, I'd like to have us start with sort of some education. So in some respects, that's what this is. Dr. Avila, please. So thank you so much, committee chair Anpu, for having me and all the members in the committee. For those of you who haven't seen my other testimony in the House Health Care Committee related to health disparities legislation, that was a two hours testimony. I encourage everybody to watch, it's a two part, we have to take a break, and I encourage everybody to watch that testimony as well, because it connects to this issue of racism as a public health emergency in Vermont. So what I'm going to do in this short time I have with you is to share some definitions related to this work. I'm also going to share racial disparities at the intersection of health disparities at the national level in Vermont. And then some of the work I've been involved in advocating for, for example, removing eligibility criteria for BIPOC communities in Vermont. That was one of the professionals in Vermont who advocated for that eligibility to be removed that happened last week. And then some data related to vaccine allocation, equity, and some of the disparities that we are currently seeing related to COVID-19 vaccines here in Vermont. So as Representative Anne Pugh mentioned, I'm an associate professor of pediatrics at the University of Vermont in the Learner College of Medicine. I'm also the director of a program called Vermont Lent Leadership Education in Neurodevelopmental Disabilities. And most of my career for the last 20 years in Vermont nationally has focused on addressing and eliminating health disparities and advancing knowledge related to health equity and racial equity at the intersection of health equity. And I've done work in more than 27 states and I've trained more than 10,000 providers in this work of intersection of racial disparities with health disparities. Yet today, and this is the disclaimer I'm speaking today as a health disparities and health equity scholar, but my views are not necessarily those of the University of Vermont. I'm also a member of the governor's, Phil Scott's governor, racial equity task force. I was appointed last summer specifically to look at health disparities in COVID-19. And that was an initiative that is happening across the nation with racial equity to address COVID-19 health disparities that are happening across the nation and also in Vermont. So let's look briefly at some definitions that they generally share related to this work. This is one of the most important definitions by the World Health Organization related to health disparities. Health disparities are unnecessary and they are avoidable and they are unfair and unjust. So if we say that health disparities are unnecessary and avoidable, what we are saying is that health disparities are preventable. There are things that we can do in our society, in our communities, in our country to ensure that disparities don't exist to begin with. And once they take place, there are many best practice models and approaches to addressing and eliminating health disparities and inequities. One of them is declaring racism as a public health emergency, crisis or epidemic. There are different terminologies that is happening across the nation. Other best practice models is to have health disparities legislation that regulates the way we do this work and then having mandates related to training, professional development, workforce diversity, and related topics to address and eliminate these disparities. Why are they considered unfair and unjust? Because they disproportionately affect groups that have been historically disadvantaged in our society to this date and they continue to be disproportionately disadvantaged. This is the definition of health equity by the Robert Wood Johnson Foundation, a very short, simple definition that everyone, every member of our community, regardless of their identification of race, ethnicity, socioeconomic status, religious beliefs, sexual orientation, gender identity, they should have a fair and just opportunity to be as healthy as possible. That's our goal in this work of addressing health disparities and understanding racism as a public health issue that our goal is for every member of our community to have a fair and just opportunity to be as healthy as possible. This is also the definition and I know you're going to have Health Commissioner Mark Levine joining later on about this topic. This is the definition he gave in 2018 related to health equity. He defined it as health equity exists when all people have a fair and just opportunity to be healthy, especially those who have experienced socioeconomic disadvantage, historical injustice, another systemic inequality that are associated with social categories of race, gender, ethnicity, social position, sexual orientation. So again, keeping in mind that our goal is to ensure that all community members in our communities in our society have a just and fair opportunity to be as healthy as possible. So what is happening with COVID-19 across the nation that has led to more than 190 declarations of racism as a public health emergency across the United States? For many of you, you might know that COVID-19 is called by many of us in this health equity field the racism pandemic because COVID-19 has resurfaced many racial inequities that had existed for a long time in the United States and now they have become more salient as a result of a public health emergency and a pandemic like COVID-19 is happening across the globe and in the United States. These are some racial disparities and this is a chart by the CDCs. What you see on these are hospitalizations of a patient with COVID-19 on the top, you see race, gender, and then underlying conditions and I'm going to focus on underlying conditions and this definition as you saw on the declaration, this is addressed in the declaration that was just read to the committee. Underlying condition is defined as having diabetes, hypertension, asthma, cardiovascular disease. Interestingly, the definition of underlying conditions or chronic health problems for accessing vaccines has been defined differently across states in the United States which speaks to how these are socially constructed definitions that vary, can be expanded, can be adapted based on issues that are happening in our society. What is important to understand, excuse me, about underlying conditions is that underlying conditions are also the direct result of exposure to poverty, redlining, gentrification, food deserts, health care disparities, and most importantly, environmental, structural, systemic, and institutionalized racism. What I urge everybody who attends my presentations is to focus on critical thinking and emotional intelligence. We need to be addressing systemic, structural, and institutionalized issues in our country and in our communities as issues that we critically think about why are specific groups disproportionately affected by COVID-19? Why are specific communities exposed to higher chronic health problems compared to other communities? What is happening at the environmental, structural levels that are causing these disparities to take place instead of blaming victims for their position in society? I have heard so many times being a professor and teaching in this field. I have had so many students, I have said, why don't African Americans try harder? Why don't Hispanic Latinos do this? Why don't Native American communities do that? What happens when we make comments like that is that we apply our system of privilege and position in society into another person without critically thinking about what are the issues that are preventing communities from thriving and leading flourishing lives in our society? That's the responsibility we all have, whether it's legislators, whether it's providers, whether it's health equity scholars, anybody in this field to ensure that we critically think about these issues and we lead the work in a way that we are forming just humane providers in the future to be able to address these disparities and inequities that take place on an ongoing basis. The American Public Health Association a few months ago released this statement that is on their website that says across the country local and state leaders are declaring racism a public health crisis or emergency and these declarations are an important first step to advancing racial equity and justice and must be followed by allocation of resources and strategic action. And again this is one of the most important aspects of this work and I highlighted here that we need to have a declaration of racism as a public health crisis emergency but we also need to have allocation of resources and strategic action that goes go hand in hand with these types of declarations because sometimes we have declarations or legislation bills that are enacted but there's no funding then to address the the health disparities and inequities or effectively address the disparities and inequities in our communities. The American Public Health Association also created this website that has a map of declarations across the United States so this is the map and there are as you can see on the top here there are more than 190 declarations across the United States and these highlights the states that have declared racism as a public health crisis and then the cities and the counties and towns and county boards that are focusing on this work across the United States. And let's look at one example this is one of my favorite example from the declarations is the definition of racism as a public health crisis by one of the cities in Ohio from 2020. They define racism as a social system that has multiple dimensions including individual racism that is internalized or interpersonal covert racism which is subtle and often socially acceptable and this is something that I generally compare to states like Vermont that happen to be liberal and progressive racism doesn't generally happen in an overt manner but it happens more in a covert manner or more subtle manner compared to other states where it might be more overt so that's something to also keep in mind. Overt racism which is blatant and often and repentant systemic racism which is institutional or structural and systemic racism is a system of structural opportunity and assigning value based on social interpretation of value which unfairly disadvantages specific groups and unfairly gives advantages to other groups and communities what most importantly it saps the strengths of the whole society through the waste of human resources and this is the biggest takeaway message of this definition that we waste human resources talent and opportunity when black and Latino children end up incarcerated instead of in post-secondary education when black and Latino men end up incarcerated like we have currently higher rates of incarceration instead of being part of our workforce this is a waste of talent resources and human resources that at the end affects every one of us and communities and society as a whole. For those of you who are following the city of Burlington this is the declaration of racism as a public health epidemic that happened last year in the city of Burlington and this is one of the quotes from that city one of the reasons for this community declaration is that the coronavirus has laid bare a terrible and non-standing truth the result of deeply embedded structural racism that black and brown Americans experience far worse health outcomes compared to their white neighbors and let's look at how far worse those outcomes look like in Vermont which is the second white state in the country so keeping in mind that we live in the in the second white state in the country and we are seeing disparities similarly to other states across the nation. In Vermont black Vermonters are overrepresented among COVID-19 cases they make up 1.4 percent of the state population and more than 14 percent of confirmed positive cases and if somebody asked earlier the citation so this is this data from the Department of Health from July 2020 and they have a current data now that has come out related to these issues as well one in five cases are people of color in Vermont black or african-american Vermonters have the highest rate and I want also the group to keep in mind that black and african-americans are the smallest racially diverse group in our state the largest racially diverse group is hispanican latinos and then a two or more racists so this is even more alarming that african-americans and black or african-americans have the highest rates of COVID-19 followed by asian and hispanic latino again in the second white state in the country. Let's look at children because I work in pediatrics and in child development and I'm always shocked by this statistic that came out last summer in our state and this is the age breakdown of COVID-19 positive cases across age groups and if you look at these cases these are positive cases and for children under 19 of positive cases in Vermont for children 56 percent were children of color and if you look at under nine 68 percent were children of color so this is one sad example in a way of the impact of systemic racism the impact of not having information reaching communities in a timely manner in many limited english proficient communities didn't have accurate and timely information about COVID-19 until May or June of 2020 and that delay in a few months of getting information led to several of the outbreaks that we had in the winooski area and as many of you know winooski is the the most diverse city that we have right now more than 25 percent of winooski's population is racially diverse which is showing also the demographic changes that are taking place in Chittenden and across the state of Vermont. These are more statistics that came out in one of the statements that governor that commissioner Mark Levine gave in the Vermont Association of Hospitals and Health Systems in the 2020 conference he explained that BIPOC are more likely to be part of an outbreak more likely to have been in contact with someone else who had COVID more likely to have household contact with a case as we saw the largest outbreak in winooski important also to note that many BIPOC community members have a higher rate of living in multi-generational households so when COVID-19 affected disproportionately these communities it was very impractical to try to isolate or quarantine a family when you have a couple of family members that tested positive compared to some family members that tested negative in the same household it was almost impossible to isolate or quarantine that led to more positive cases in in those communities. Commissioner Levine also mentioned in this keynote opening that he did for the for the conference that I followed the presentation that BIPOC Vermonters are also more likely to have underlying conditions that can make COVID more serious and Commissioner Levine attributed these underlying conditions to the conditions and circumstances that people are living in in other words the social determinants of health which these are defined as education, economic stability, health and healthcare, neighborhood and built environment and social and community context so keeping in mind in the declaration that was just presented to this committee that it was explained that racism is a social determinant of health we know that exposure to racism, discrimination, incarceration fall under the social and community context of the social determinants of health is one of the five main areas affecting a person's life in the United States and those five areas represent 65 to 70 percent of a person's life in our society. So I also included here I mentioned this earlier these were the two testimonies I gave about the health disparities legislation and the articles that led that discussion that they encourage everybody to to watch and read then these are some of the articles I've done if interviews for the news related to racial disparities and the impact of COVID-19 there are many more that are coming up next week that are going to be there's going to be an article and an interview in the national news specifically about removing eligibility criteria for BIPOC community members. So let's look briefly at vaccine access and outreach. We learned last fall that many community members from refugee and immigrant communities had concerns about the vaccine and questions so we immediately put together a group of three of us and we organized 16 educational sessions that took place in the at the end of the fall and spring of 2021 and we reached more than 500 community members to this date and this is a statement from governor Phil Scott about the racist responses that have taken place related to vaccination of BIPOC populations and he explained that Vermont's data shows that BIPOC population is at increased rate of hospitalization for COVID-19 and these populations are already experiencing historical inequities and disparities and when we look at vaccination rates right now BIPOC community members are accessing vaccines at a rate of 20 compared to 33% to white non-Hispanic whites. So most of the efforts that we are leading with BIPOC vaccination clinics that are happening every Saturday and I'm there every Saturday helping with those initiatives and the limited English proficient clinics that are happening twice a week in Wellington and Winooski that I was there also for for a couple of months before we started the BIPOC clinics are efforts that are data driven and they're specifically created to ensure that we provide a culturally and linguistically responsive space for community members to access vaccines in an informed manner with a culturally and linguistically responsive approach. So we conducted five sessions in the fall related to COVID vaccines concerns led by Dr. Kristen Pierce with an infection disease doctor for new BMMC and we reached 200 community members and then we did 11 sessions this spring we had two more coming up next week and one this evening in more than 18 languages the Spanish version is available online so if you are interested in watching the sessions that we do and the concerns the questions that come up from the community members about vaccines I encourage also everybody to watch that video. So the advocacy that we've done has led to having LEP vaccination clinics and BIPOC community clinics this is the video for the vaccine education session in Spanish that we recently did in our community. So we know that the clinics that we are doing right now in the communities are not only addressing systemic racism as a public health problem but are able to reach to our community members in a way that is much more effective less intimidating and in a culturally and linguistically effective way. The last point I have here in the slide is to encourage all leaders to continue to advocate for systemic change and speaking up against systemic racism we know that there has been a lot of racist comments about vaccine vaccination clinics in the last a few days and last week so we encourage everybody to speak up against systemic racism and declare systemic racism as a public health crisis in one of the most effective ways to do this work. So I'm going to leave you with this quote which is actually from our governor Phil Scott in response to these racist comments and he explained that unfortunately the legacy of racism in America and in Vermont still drives a lot of anger and fear. It is evidence that many Americans and many Vermonters still have a lot to learn about the impacts of racism in our country and how it has influenced public policy over the years and I could not agree more with governor Phil Scott and this declaration of racism as a public health crisis is a perfect example of the response that we have to give to show that we understand the impact of systemic racism in public health and that all communities are valued respected and included in our in our communities and in everything that we do. So thank you again I'm going to stop sharing and answer any questions that you might have related to this topic and thank you again for having me. Thank you so much Dr. Avila it's really very helpful and informative and I'm sure we have some questions though. Representative Redmond. Thank you Madam Chair and thank you Dr. Avila really appreciate all of this great information. I am going to get my shot the other day I noticed a lot of families of color coming in and getting their shots which was wonderful to see and I'm curious if you have any information or data on what the response has been with the latest order that people of color may bring family members when they come and get their vaccines are people taking advantage of that from your understanding. Thank you for that question and there are there are currently two initiatives going on at the same time one is the limited English proficient clinics some people call them ELL or LEP clinics that are happening twice a week in Burlington and Winooski and those are reaching currently 300 community members every week and then we have the BIPOC clinics on Saturdays which are reaching 264 community members and this Saturday we start first and second dose we're going to be 468 community members every Saturday for the next few weeks so those initiatives currently have a couple of weeks of wait lists of community members eager to be able to access vaccine which speaks to how outreach education and addressing concerns increases that likelihood of being interested in accessing a vaccine after we did the first vaccine education session we saw a dramatic increase in interest in accessing vaccines and once the eligibility was completely removed last week we saw an increase also in registrations going on in LEP clinics in BIPOC clinics and in the general public clinic which speaks to the interest that communities have in accessing vaccines unfortunately we are still seeing that BIPOC communities are behind in rates of vaccination especially the lowest right now is for native indigenous community members which is understandable due to the history of eugenics the medical experimentation that happened in Vermont and across the country so now we are being strategic in figuring out how to reach out to a native and indigenous communities in an effective manner that can help build and in many times rebuild that trust so again I think the efforts are showing that are effective unsuccessful but we still have a lot of work to do to increase the rates of vaccination for BIPOC communities in a specific communities thank you for that question thank you we have one from Representative Wood and then Representative Bromsted. Good morning thank you so much for being here I have a question regarding one of the charts that you showed which surprised me a little bit when you were it was showing the the the rate especially around children when you were highlighting the rate around children what I was also surprised to see in that chart is on the other end of the scale on older Vermonters BIPOC Vermonters it seemed much less so and I'm just that surprised me and I was just wondering if you could say a little bit more about that since you know we knew early on that that was a more vulnerable part of the population people who are older I was expecting to see similar rates of BIPOC infections there as we saw in the younger ones but it seemed much dramatically less and that's a thank you for that question that's a an important question because I think it's driven by the demographics of our communities and much of the racial diversity of our state more than 50 percent of the racial diversity of Vermont state is driven by refugee resettlement and immigrant migration and we know that the majority of that population is within the 30 to 50 year old age group when you go older the numbers are pretty small so when we started for example the LEP clinics we started with 50 vaccines in every clinic 100 vaccines and that was enough to reach many of the communities that we needed to reach once we started reaching the 50 year old 40 year old with there were thousands of community members so I think it has to do with the numbers in elderly populations that are directly impacted by how many cases we're going to see because the populations are much smaller in that age group. Thank you, thank you very much. Representative Bromstead and then Representative Small. Thank you Madam Chair and thank you very much Dr Avila. I was curious just your everything that you said was interesting and helpful and something to really sit and think about a bit as we take on this resolution and do it as well as we can and and realize the incredible importance of doing it. I just wondered as our first person to come and talk with us whether or not you have any suggestions for us with regard specifically to the resolution does it you know I'll just leave it at that what are your thoughts specifically is does it meet the the need the wording and so forth how how does it look to you? So your question is specifically about the the resolution itself or whether the resolution should be past or is effective in addressing? Yeah no just more specifically the first is whether or not when you look at this resolution does it is there anything missing? Is there any what would be your thoughts as we move forward on this work? So that's a another great question. I always say this is similar to when I gave testimony to the health disparities legislation. Somebody asked me a similar question and I said if I had written the health disparities legislation it would have been probably 40 pages long however because there's so much we need to do to address health disparities. Similarly to this resolution if you look at them there are 190 examples across the nation and there some of them are very similar some of them are very different but many of them are short and very concise. I think this is a great example of the different disparities that exist by income housing. I would even add when I do presentations there are disparities in education suspension rates of children of color incarceration of communities of color those are all aspects of systemic racism as well. You have homelessness explained there and the BIPOC COVID-19 health disparities are all explained there. I think the the resolution is clear at least for those of us who who work in the racial equity field is clear what the disparities are. You can continue to add this many disparities and inequities that exist in many intersecting social determinants of health but I don't know how much that will add or take away from already a resolution that has had so much work taken into putting it together and this is something I always share as well related to the health disparities legislation that legislation related to health disparities started at the federal level in 2014. We are in 2021 for the first time in our history in Vermont talking about something that started seven years ago at the federal level and it was led by a BIPOC organization in the state of Vermont so also being respectful that it took communities of color to advocate for this change to take place and when they asked me if I if I would modify it of course I would add probably 25 pages of literature around health disparities that we have had for decades in the United States. However the legislation is effective it's clear similar to the racism as a health as a health a public health crisis the information is clear concise and to the point we could expand and add many more other areas but if that will delay the process of declaring racism as a public health crisis I would advocate for moving forward and then eventually continue to add there is an urgency to declare racism as a public health crisis we see it across the nation that's why so many states and cities declared it last year in 2020 so that would be my response is that there is a sense of urgency and there is a lot of work that was put together in this declaration it can always be better it can always be longer because I work in this field we can always find more data but at the end of the day the importance is to ensure that we are actively dismantling systemic racism so all communities can thrive but thank you for that thank you very much representative small and then just represent would you have another comment representative small then representative Whitman thank you madam chair and thank you doctor Avila for your presentation today I think what is resounding for me is that the action on this resolution is a response to a long long history of racism within our institutions and and our organizations and my first question is really in regards to education as the protective factor and wanting to know what does the education look like currently around health disparities specifically when we look at people of color for physicians or even medical students I mean beyond your very in-depth presentations which I think is tackling a piece of this issue and thank you so much for that question because that's my my field and what I love talking about I'm an educator so I strongly believe that education is key in addressing many of the systemic issues that we have in our society but not just education but ongoing education and training around this topic around health disparities health inequities and racial disparities at the intersection of health disparities I mentioned every time I do presentation that I was not born in the United States so I was born in another country however I spent I have spent my career teaching U.S. born people about the history of the United States which speaks to the gaps in knowledge that exists related to systemic racism in the U.S. and how this country was founded how racial disparity the root causes of racial disparities and how those connect to health disparities my research of having trained more than 10,000 providers across 27 states shows that providers don't know the history of racial disparities and systemic racism which directly links to not understanding health disparities in today's 2021 U.S. and and this is one of the key aspects of the world that we need to do I strongly believe that education and training should be mandatory for providers where there are examples happening across the nation California passed legislation mandating bias training for all health care providers to be able to practice in the state of California I think it's a change I want to continue to see there are bills in the Senate right now at the national level looking at mandatory training anti-racism and bias training for all health care providers we know that there is a direct correlation between provider bias poor provider patient communication and health literacy issues with poor health outcomes in our community so the more education we provide around health disparities health inequities the history of racial discrimination and racism in the United States the more we're going to be able to narrow these health disparities and eventually eliminate them if we are able to effectively dismantle systemic racism but I think it's a great question I've been an advocate for 20 years in Vermont to mandate this type of training and education for all providers all health and not just health providers but health and allied health providers any provider that works with patients should be receiving ongoing education and training around these topics because we know that the harm that is caused in communities and the distrust that happens when there is a poor interaction leads to poor health outcomes and distrust in the system and then we see what we're seeing now with vaccines that communities don't want to access a vaccine that is one of the the only thing that we have right now to stop this pandemic from from growing so that's a great question I've been a strong advocate of mandating ongoing education and training for all providers and start as early as possible in preschool if possible no to teach about the social construction of race systemic racism somebody asked me in the news the other day when I thought it was the time for children to learn about anti-racism and my response to that is if children of color can experience racism since they're born every child can learn anti-racism from the moment they're born so that's my response I'm having a six-year-old is my my approach to ensure that children understand and can learn about social construction of race systemic racism and they can become you know active members and change ancients in in addressing the systemic issue but thank you so much I can talk about this all day but I will leave it there and and go to the next question thank you I also thank you for that I also think about a presentation that we had as a legislative body early on this year from Susanna Davis the director of racial equity and there's one slide that's coming up in up for me in regards to a medical textbook that talks about pain and pain scales for various ethnicities and races would you be able to touch on that especially since our committee just worked so hard on an opiate bill and preventing slash saving lives thank you for that question and that's also directly connected to the work that we need to do in health and allied health education especially in higher education my the courses I used to teach were called racism and health disparities and I would start my courses at the university saying race is a social construct invented created to justify inequalities in the United States it's not based on genetics it's not based on biology but it was socially created to justify inequalities and I will have students that will come with a book several books not one book and they will show me but Dr. Avila this is what we've been learning in our school that says race is genetic in origin it defines hair type no shape eye shape and when I look at the book it had been revised in 2013-15 so it wasn't that long ago and I brought this up in academia so this is an ongoing issue that the way we continue to teach about health disparities can lead students to believe that there is nothing we can do which is so dangerous no there's nothing we can do if we say that these issues are based on biological genes which is not correct these issues are based on social environmental and structural conditions which are created by our policies especially public policies so we need to see critically think about these issues and this is why when I open the presentation I talk about critical thinking and emotional intelligence we focus on intellectual teaching most often but we don't actually focus on forming just humane providers and that has been one of the root causes of many of the health disparities that we have when we have providers that say for example I treat all patients equally and I respond to them and I say we need to be treating patients equitably which is a very different concept it has to be fair it has to be just it has to meet the specific needs of the communities given everybody the same doesn't work because we do not live in a level playing field so aspects of the world that we need to be doing and how we need to rethink a professional development training for health and allied health providers and all this can be regulated through through legislation again I'm a strong advocate of mandating changes that should happen we are in 2021 so I think it's time with everything happening in our country it's time to critically think about the work that we do and how we can change this work and thank you for that those are two of my favorite questions and thank you so much for those questions well I'm glad I hit the top two and I just have one more if I may madame chair the last question is really as we're talking about COVID and talking about vaccines and understanding and hearing hesitancy from black Americans around taking a vaccine where there's plenty of research out about its efficacy and supports in promoting herd immunity and wondering from that historical perspective why there would be that hesitancy in receiving a vaccine from our medical systems thank you and that is my third favorite question so the reason we're seeing hesitancy in in access to vaccines is there are two issues one there is a global aspect of an ethical medical experimentation that happened in Africa in South America across the nation so some of us come from countries where when you hear a brand or a or the name of a pharmaceutical we immediately associate that with something that happened badly back home or there was a negative impact in a specific community so that is we're never going to forget that aspect the other issue is that if somebody has a negative experience with the medical system or the healthcare system in the US it's going to create this trust to be able to access a vaccine in a time of a pandemic there's we have had questions in the vaccine education sessions especially from African communities they wanted to know if the vaccine vile will be mixed right in front of them and that speaks to that this trust that exceeds that if somebody brings a syringe from a few feet away and you don't know where that's coming from there is that type of this trust so we have questions in the educational sessions specifically asking who is bringing the vaccines how are they being mixed are why people receiving the same vaccine that we are why so all these questions speak to the distrust I mentioned earlier the eugenics movement and other horrific events that connected to medical and ethical research in BIPOC community that continues has passed through generation and continues to negatively affect our communities and build that distrust with the healthcare system and the medical system I am at every I've been in at every BIPOC clinic for the last three Saturdays I always say there's no happier place right now in medicine than to be in a COVID vaccine clinic and we've heard from community members that are coming to the clinic that they would not have gone to a larger clinic they would have not gone to a clinic run by a health center or a state health department that they came to these BIPOC clinics because they see trusted leaders they see trusted BIPOC organizations on site and they see some of us getting the vaccine so many people ask me did your mom get the vaccine did you get the vaccine so we take pictures we put them on social media so many people ask me if you get the vaccine I will get the vaccine which speaks to that trust that some people have with community members in being able to reveal that trust we still have a lot of work to do we still see concerns and hesitancy in some communities to access vaccines we now have a new vaccine coming into the market like Johnson and Johnson and so many people are saying you know we don't want that specific vaccine so now we started educational sessions to talk about the efficacy of the J&J vaccine and that speaks to the issue that the vaccine hasn't been in them in the population long enough to be able to build that trust with a specific brand and a specific vaccine so we have to it takes time to build trust with in the medical field and in medical practice so everything takes time and rushing it sometimes can be more problematic than effective and thank you again for all those questions of course thank you Dr Avila thank you for having me we have one last question that we're able to or one last person is able to ask questions representative Whitman thank you madam chair and thank you so much Dr Avila for being here today for your testimony and all of your work in the field really appreciated mine's a little bit more of looking at the resolution question there is one paragraph that raised questions for me and with you here I figured I you are a perfect person to ask being a doctor and some to experience in this field it's the last paragraph of page one and you mentioned underlying conditions in your presentation the language here I'll just read it aloud is whereas while there are not statistically significant differences in the rates of pre-existing conditions such as diabetes lung disease and cardiovascular disease among white and non-white Vermonters there are disparities in the rates of pre-existing conditions among Vermonters testing positive for COVID-19 which suggests that non-white Vermonters are at a higher risk of exposure to COVID-19 due to their type of employment and living arrangements so what I kind of hear from this is that it's like a line of reasoning saying that while we can't necessarily say that there's a statistically significant difference in pre-existing conditions we do see that there are more pre-existing conditions among people that have been infected with COVID-19 and that's disproportionately more so people of color are you reading that the same way and do you think that that's would you agree with that statement correct and I think what the statement is also leading to is to the other social determinants of health like employment housing and living conditions are directly leading to many of the disparities that we're seeing with COVID-19 we know that many BIPOC community members are working in in jobs that are defined during the pandemic as essential jobs so they're more at risk to be able to test positive for COVID-19 and many of them also as I mentioned earlier they live in multi-generational households also exposing the family members in at higher rates of COVID-19 when we started the LEP clinics in Winooski and Wellington the goal was to vaccinate not only eligible BIPOC community members but all household members and the strategy and the advocacy I was one of the community members who advocated for that the rationale behind that was not only the high rates of COVID in children that the way to protect children was to vaccinate everybody in the household but also because we were seeing that due to the employment exposure that some community members have they were making other household members positive as well and testing positive so then the more we were able to vaccinate all household members regardless of age anybody who was older than 16 we were able to protect everybody in the household so I think is looking at exposure to COVID-19 but also all other social determinants of health like housing conditions employment conditions education so all other social determinants of health are also leading to higher COVID cases and hospitalizations in BIPOC communities thank you so much for that question and I know I'm way over time but that's what generally happens when we talk about health disparities thank you I appreciate it um thank you doctor and um you're not over time I actually figured um that this would happen you have a lot of information to share you're a fabulous presenter and we like to ask questions and so uh the next person was scheduled for 10 o'clock and he actually has come um so we are just on time thank you very very much um it's good to see you here thank you so much for having me okay we have uh Mark Hughes who um from the racial um Vermont Racial Justice Center uh good afternoon good morning good morning how are you thank you for joining us um I am well thank you for having me madam chair um for record I am Mark Hughes the executive director of racial justice alliance and I'm also the director of justice for all I am the sole proprietor of an LLC called the Racial Equity Association which is also a diversity equity inclusion consulting firm my retired army officer I've resided in the um Burlington area for the last two years and then Washington County for about 10 years prior to that so I've been in the state for since 2009 um I came here accepted a position at the um the folks over at the insurance company what's the big insurance company down there I forgot the name of it it's um I started and in um you know what is now being called diversity but we call racial justice it started in 2009 and it was a result of not George Floyd but Michael Brown uh and I walked away from the cyber security space uh since then so we started to come uh a um nonprofit as the um our DAP or we call it the racial disparities in the criminal and juvenile justice system the coalition evolved to the racial justice alliance and there is a nonprofit called the foundation that is the C3 um and is doing business as the racial justice alliance today the racial justice alliance here in in this session um and and uh well I should say last by any image you should note that the um we identified as the the cornerstone of system was the um amending the constitution uh to make it clear uh that um slavery and indentured servitude across uh from the senate on friday uh that is this is uh let's call it the third quarter because uh it's already been through the house and the senate once um it will arrive in the house next week knowledge create and transform and that is the way we framed our legislative agenda uh in this session and there are a um a litany of policies that are within that framework pr2 is uh is one of those the uh the declaration the declaration uh I should say the reparations uh reparations task force bill uh ability a problem to attend because you all voted on it last week or a week before which is the also you'll see um policy on economic uh clearing obstacles for economic opportunity also housing and land access and ownership um cannabis market um equity um that was abali slavery vermont which just really speaks to the other activities that are happening including cultural empowerment where we do we're doing affinity groups where we are uh teaching our people uh black and brown folks about their history their culture their power their resilience um and also teaching a true history about uh the nation uh the united states of 1865 and specifically the 1619 story so the list goes on uh with the um other activities that we're doing in the communities and I thought it was really important for for me to frame the work of the resolution the joint resolution was quite deliberate um that we came forward with this at the same time we're doing the work here uh our initiatives and our platforms and initiatives uh the work that we're doing um are in full swing in the city of burlington and in fact uh across chitenden county you know uh some of the work that we've done in chitenden county and specifically in the city of burlington has led to uh the creation of the racial equity inclusion and belonging office here in the city as well as a standing committee of racial equity inclusion and belonging various reforms in in policing uh here in the city of burlington um there is a standing uh a standing task force that has been assigned the responsibility of reparations the only in the nation there's not another one like this one in the nation is a result of the work that we've implemented here in burlington uh there is um there's in full swing and initiative called operation phoenix rise where we're um taking a look across public safety also cultural empowerment economic development economic development and equal opportunity and racial equity inclusion and belonging across all this the city government here and we're in partnership with the city and all of this work and in addition to that there is a standing a standing declaration here that not just from city council but from the mayor or the racial justice alliance has partnered with the city here uh in their um their public health their public health emergency resolution which which uh i'm holding in my hand so we've partnered with the city and this work here and to be clear the reason why this work is being done is um in as a part of the combined efforts in addressing systemic racism so pause there for a minute and what i'd like to do is get into um telling you a little bit about um you know more of the work of the alliance and as well as how we've been um facilitating and working in conjunction with some of these folks in chitening county i want to tell you who some of these folks are and what some of these folks are saying uh surrounding um the work that they've committed to organizationally i want to take some questions on the uh the actual resolution itself um as i i did listen to part of the last segment and i heard that there were some thoughts and questions and any we you know we authored this this resolution we wrote it uh we um you know clearly fully support it you know we were prepared to bring uh some of our um some of some of our other folks uh you know who are actually on the wellness working group of the alliance uh as well as one steering committee of the alliance um mayumi cornell will submit a written testimony also the the chair of the foundation and also the who's also the the pastor of new alpha missionary baptist church the only black church here in vermont was prepared to bring testimony uh he will offer written testimony and and also offer perspectives of some of many of our our congregants as well again i think um and if i could be allowed to also maybe share a couple slides i get i can there are a couple things i wanted to drive home in terms of how we're framing um this um this declaration on um declaring uh racism a public health emergency thank you and and so yeah i just want to pause there for a minute madam chair and see if if there are early questions thus far in that way i can kind of head some off and maybe um we could um go to the next portion any questions madam chair um thank you thank you um mr hughes and i right now i am not seeing um any questions from the committee they're particularly interested in hearing um from you as you were the person identified um as uh being instrumental and the vermont racial justice alliance and being instrumental in writing the resolution this is our first day of taking testimony and um as is our um usual and customary process we then hear from people who were not necessarily involved but um in the writing or the crafting of the legislation but who in fact would have interest in it um because of who they are or um who they represent so we'll be trying to get testimony from um a diverse group of stakeholders um uh and we are um treating this resolution as a bill so um uh as as you came in you said you heard um some of it is then looking at the language you know probably better than than than i do the words matter and the importance of how we say things matter as well as the accuracy um or whether we've um uh there are things that um upon a second reading you would go oh yes that makes sense um you know um we would continue to support this if you added that so um do you please go um forward sure absolutely um if you have slides i um Julie could you make uh him i have it oh you already are i do so i um would would just say that you know at this stage in the game uh what i have in front of me is a um a small segment for uh in terms of impetus i think a lot of folks are sitting there wondering saying why are we doing this you know what is this what does this really mean and when i first heard the term when i first heard people talking about public health emergency the first thing i thought about was as well health i thought about you know this this is this is about health and it's an emergency and and i was trying to put this racism and emergency thing together um honestly you know even with the work that we're doing i was actually thinking about it going how's that line up how does that come together and and what is that you know how you know what is the connection we're and um the first thing i went to is is yeah of course they're killing us you know and then i said well that's probably not gonna you know that's probably not exactly what what we're we're really talking about and i begin to start thinking about this whole you know how you know the things that we how covert and overt and and and how systemic racism institutional racism on aggregate how it affects people how and how it affects the um just not just demographics but all of us so there's a there's a whole lot that goes into it but i have something here that i read read to you just for me this is um and this is the impetus for community declaration and this is just from the work that's happening in burlington and i know sometimes talking about burlington in Montpelier is like suicide but i'm going to do it anyway okay so it says um the community declaration of racism as a public health emergency comes at a pivotal moment first the globe is uh continuing with the impact of COVID-19 pandemic second across the nation and across brahmant black indigenous and other people of color have raised their voices to speak out against systemic racism and police violence in response to the death of george floyd and then it goes on to say um on june 29th the city of burlington in partnership with the vermont racial justice alliance joined a small group in growing number of municipalities that declared racism a public health emergency in response to the enormous health disparities between blacks and whites in many areas including COVID-19 infection and mortality rates infant mortality morbidity and more mortality rates of of many chronic diseases and police involve killings so that was that's what came out of burlington um last year and i'm just what i want to do is i'm i just want to share a couple of comments because probably maybe three three uh dozen or so uh organization signed on to this and uh here's here's um uh king street center vicki at king street center she said we've been examined in our own practices programs environment and integrating this learning into our ongoing strategic plan while we're not experts and recognize that this is an ongoing listening and learning process we commit to being loud and proud members of an anti-racist community in which hatred and intolerance have no place here's um here's one over at chimpanzee college and i'm just randomly so i haven't pre-selected any of these i'm just randomly reading uh one and this is this is uh uh benjamin um ola akande and i'm sorry about that benjamin um benjamin is the new uh ceo there um it says we're proud to support the uh the city's efforts to create a whole systems approach to addressing the crisis of systemic racism that is threatening the lives and well-being and members of community in our nation chimpanzee college is committed to work and in partnership with the city and those advocating for racial justice to advance this work in our community and contribute our our institutional strengths and expertise to create a stronger more inclusive burlington for all who live work and study here here's charlie baker um from regional county planning commission he said um we believe deeply that resources and opportunities employment afford affordable and plentiful housing accessible transportation quality education healthcare environmental justice and overall quality of life must be allocated fairly so that all people can thrive we must actively eliminate barriers to full meaningful participation in community life and work tirelessly to correct past injustices we're committed to working through these issues together with our members municipalities partners organizations employers and so forth and finally the last one i'll give you is jeffrey mckay over at the community health centers of burlington um and jeffrey said um identifying and reducing health disparities has always been central to ch cb's mission of care as such we are uniquely prepared to act as a part of a local population health alliance in addressing racism as a public health issue we are eager and ready to work together with our organizational partners and to build future to build future built on anti-racism and equity for all members of the community so just wanted to share with you what some of the many many many many many many folks and what happened here is is that um each one of these organizations provided a list of a number of initiatives that they wanted to um sign off on like for example burton said that they hired somebody as a full-time consultant for their jedi committee i know it sounds really you know tactical jedi i think that's justice equity diversity and inclusion um there's a lot of those going on a lot of those have started what i'm trying to get you a sense of is is you know the you know what what this actually began to put in motion here in our county and just as a result of folks coming together and acknowledging something and building a community around it how it has ignited uh so much work that's happening uh here in the prospect of that occurring across the state uh burton donated a thousand dollars to the 100 thousand dollars to the n double acp lvf they joined in a solidarity project project as a partner to play a role in bringing the outdoor industry together for a more inclusive future and more boys and girls club has a list of things developing relationships with for my employers to create and support professional opportunities for our bi-pot club members this list goes on and on and on there's 30 some organizations on this list community health centers chitney county state's attorneys champlain college champlain housing trust local motion let's grow kids housing vermont the family room here king street center lake champlain chamber in the list goes on and on and on of um just initiatives that are currently in play right now that are actionable that are producing outcomes that would not have existed had we not initiated this work here in the county so um i guess i got a couple slides um and i just look because where we started this work within the working group is really important to understand because what we begin to understand more and more about the challenges that we're struggling with here is is that as as the doctor said prior to me there are social determinants that are bearing down on black and brown folks uh coming from every area so i just wanted to talk a little bit more about that and it's the impact that is creating you know it is taxing and it is um it's it's not good for your health uh and it's it's not good for any of our health so let me just show you something real quick here and i think uh i'm not quite sure i don't know if my um if my um full presentation was was um actually is actually working right but i'm going to try it and if if you could talk to me madam chair and let me know whether you're getting a full presentation uh screen um i'm going to try it right now okay um if you uh right now we see um some of if you can go up and do uh i'm looking at your um presentation mode if you can do a presentation mode because we see both the outline as well as your slide here's what i'm going to do is we're going to madam chair we're just going to go with this because i i had the same issue last night and we never resolved it because i even when i went to presentation mode we were getting the same thing so i'm just going to stay here um i think well maybe i i'll just have to do this because it for effect what i wanted to do is i just wanted to show you the um just get a sense of how we're you know feeling the impact so the how we define because there are many ways to kind of dissect this but when you start to think about the determinants as far as um how we're being impacted it is our culture it is our access to health services or the lack thereof the you know access to income or wealth we know that the median wealth of black folks in america is one thirteenth that of the median wealth of white folks and growing and we expected to to um to you know to be exacerbated even more we know the disparities in education in terms of um you know the um the outcomes in our education system expulsions um suspensions access to higher education and so for housing and land access the numbers are dismal here even child development safety and security you know and and we want to kind of fold that into the whole uh criminal justice system and we understand that those disparities are being created uh by systemic racism i used this this quote from a um and there are many but joe fagan and kimberley duce and ducey in the book uh racist america defined systemic racism um as uh including the complex array of anti black practices the unjustly gained political economic power of whites the continuing economic and other resource inequalities along racial lines and the white racist ideologies and attitudes created to maintain and rationalize white privilege and power so here systemic racism means essentially if it exists anywhere it exists everywhere and that is what we have right now and that and what is laying this all bare um is is obviously you know covid 19 um what's happening now is is that all of this is being exacerbated so and this is really a slide that speaks more to find out or what now more effectively and so i just wanted that's i think that was the main slide i wanted to share with you um but i i did want to talk just a little bit about uh something that is you know related to some of the activities that we are doing as an organization and how it feeds into some of the things that we're talking about uh when there is a group that meets here on a regular basis uh the health outcomes group and there are there are dozens of folks who who have aligned around this and this group is going to be expanding and it is as a direct result uh you will hear from from dr levine later this morning probably in about 30 minutes or so he's one of those members steve lefler's one of those members jeff bridges is one of those members from united way i've talked about charlie baker uh there are many gene helms that gene helms that are um the list goes on and on and on and what we are what we're meaning on is is having conversations around racism being a public health emergency in those actionable things that are that we're trying to align to be able to make progress namely surrounding the collection of racially disaggregated data and being able to move forward in a way where we are looking at various systems because here there are three things that need to happen that we need to do here if we're really talking about addressing racism uh as being the cause for this public health emergency one is is our personal work obviously and all of us are doing that then is there's the organizational work and then how do we work collectively to to work on some of these systems and what we mean by working collectively to work on some of these systems is you'll hear a lot about data data data data data because data is going to be central to uh eradicating systemic racism because we'll want to be able to measure our progress we'll want to be able to look back and see where we're going we don't want to be talking about collecting data 10 years from now um and we don't want to be having a an antidotal conversation about what we know to be empirical data existing so so that's why the data thing is is there so i'll just um kind of go through some of this i think one of the things that we're doing as a as a working group in turn inside of the alliance now this is an alliance conversation is yes we are informing that process and we're collaborating with partner organizations but we're also working on our own disruptive initiatives what do i mean by disruptive because we know that the health system has never served black and brown people equity equitably in this country hard stop that is the issue but as dr avilia said it's not our problem it's the systems problem it's your problem it is a white problem as the kerner report stated in 1968 it is not a black problem because the systems were not created to accommodate us in a way that's sufficient so there are things that are not clinical in terms of awareness and training creating affinity spaces peer-to-peer support uh wellness and cultural empowerment initiatives these are the things that we are working on within the alliance um to to be able to move the needle if you will some of the other things and here you see leveraging data we also have a data team if you go out to our website you'll see just volumes of data on policing race traffic stop use of force COVID-19 so we we are we have become a repository too as well so but this data is informing the work that we're doing here we we've we've used some of this work to contribute to the ACT the statewide policy which is why you saw age 210 come forward because the what we know is is that equity in health care is very important um but it's also why you saw other policies come forward um quite frankly when you start thinking about um those policies that relate to economic development cultural empowerment those policies um that relate to even you know cannabis equity and you know as far as taxation and regulation in the market it's also um that's also why i want to go on to um talk just a little bit about some other activities that we're we are undertaking um is currently we're we're leading into the creation of a strategic plan we're we're developing that consensus and creating a framework for for a proposal of a strategic plan because we what we understand is there's a lot of work that needs to be done here and we want to be partners we want to be a part of the we want to be a part of the solution and and not just keep calling out the problem so we've got just a whole network of partners that we're working with because we are an active member of this alliance of organizations that are here in this community here in the Burlington and the greater uh Chittenden County area and you know what we thought it just made sense it just makes sense that if if the state because you know what we what we know is is the state is not Burlington and Burlington is not the state it makes sense that if we had a similar effort if we had similar commitment if we had half the commitment across the state in doing this kind of work um you know i believe that you know we would see just just a tremendous level of progress uh in the work that we i know that we're all committed uh to getting done so that's that's how we came full circle uh on um determining that yes you know a resolution um a joint resolution in the legislature is is probably the way to go because what we can do with this is is we can really motivate a lot of other folks to kind of dial in because sometimes it's just hard you know to just say what's the most important thing we can be doing right now and you know what's determining that but when you when you make that commitment when we made this commitment here what we said was uh we said you know yes we're going to stand behind this and and yeah folks have you know we've called each other out you know talking on the phone or something and it's like well i thought it was an emergency ah i see what you did there so there's that as well as to be able to make that commitment to acknowledge as i said with ac and t um to make a public acknowledgement that what we're doing is just that important and it's just that urgent so i'm gonna you know again stop here and hopefully what we can do is is you know get some other questions if you have them if not if nothing else um in our in our conclusion you know take you to a place where you can maybe get a break before your next um your next witness is even sitting in place for a while too well thank you thank you very much um we do have a we have a question from representative uh rosenquist thank you very much mr hughes i'm a very uh animated and strong presentation i appreciate many of the things you said i'm just and i know you've made a case against what i'm just about ready to say anyway already but i just think uh the if if this resolution said that it was racial disparities are a public health emergency i think you'd get 100 agreement when when you bring in racism because of the connotation of the word and the and the fact that it causes in our society today still for whatever reason a certain amount of separation and uh between groups i i just think it uh it does harm to the overall resolution i think most of us could agree on all the things that are brought up on all the warehouses and all that that those those are uh public health emergency and we need to deal with them and i just think by using the term racism and the connotation that goes along with it it divides us instead of bringing us together which i think is the aim that we all wanted to is to come together thank you yeah i appreciate that and and that's um it's it's it's an interesting observation in it but it's not a surprising one um i think that um you know what where we've come to is is we've come to a place to where um here's a scenario here's how it plays out is is um quite often it's been my experience where i've heard a i've just basically been gasoline quite frankly and um and i've i've you know i've heard a you know some kind of dog whistle or something you know say well those people you know were if if they if they weren't coming in our country then there'd be more you know space in our schools wait a minute wait a minute so i i might say well you know what that's really a racist statement that's that's not a it's it's not a you know that that policy is racist um and then usually i get the response of what and and and then after that um i try to push it and they say well they say well i'm i'm not a racist so it becomes about them personally and then finally if i push it any further they'll ultimately just spend the whole thing around and call me a racist but that's a whole other conversation but that's usually how it plays out i've seen it a thousand times and i think that the reason why i play that scenario out is is because we spend far too much time as a nation nation being worried about being accused of being a racist in fact nothing that i've said has anything to do with anybody being a racist it has everything to do with the question of systemic racism which has nothing to do with individuals it has everything to do with systems and as dr Avila and this is really representative rosenquist respectfully is it's a it's a really great teachable moment and it's a really great opportunity for us not just here and now but the process the whole process that we're talking about right now because i can guarantee you sir there's other folks who feel like you in fact even on this call right now and folks who are watching it's i just i just really appreciate the honesty that candor the transparency and and also maybe i'm giving myself too much credit but creating a space or being involved in a space where you felt it was appropriate or safe to have this conversation thank you for that but i think that you know this conversation is a really important one because you are right sir there are there are people who will ask that question and who will take that and personalize it and say wait a minute we're not racist here and this is much easier to impalatable for us if you don't say racism is a public health emergency but the flip side of that is the opportunity for us to have these conversations and to delineate racism systemic racism from overt racism to be able to make it clear in our education and our understanding of the issues that we're trying to resolve here that there is a difference that that that you can be you can be in a system of racism but not necessarily be racist you know i quoted to you a book of racist america because what with with tom fagan with um with joe fagan and kimberley ducey is seeing is is basically america is racist uh if if you if you take a nation and you build it on a genocide and slavery i would imagine they're probably not far off in the truth so i think that um i as much as i appreciate what you say i want to push back a little bit on it and also just uh extended as an opportunity for this committee right now and i'm happy to come back to this committee as well and and have more of these conversations um because i think it's important for us to be having these conversations um but i think it's an opportunity for us to learning bro and also to extend that opportunity um to a broader community maybe the full the full legislature um hopefully the state as a whole hopefully that helps thank you thank you and let me um look and see what other uh comments or questions that we have right now looks like you get a break not quite not quite it's the three um it's the three second or three you know three times and then uh representative redmond hi representative redmond hi mark um thank you madam chair and i promise it's it's fairly quick um i just want to um uh kind of ask a question that was asked previously of our witness which is is there anything in the resolution that um you know you feel is problematic or um you know having looked at it i know that you were very involved in the um legislation around uh h210 and really appreciate that but i just wondered if there's anything we should um look at more closely or you know anything we we've missed here to be clear we wrote this um this is uh you know so we're i'm here to support it and i probably should start it is i came to support this uh this uh this resolution this joint resolution i've had i've been in conversations with the president pro tem as well as the speaker um you know we've you know we participate in the as you know the social equity caucus we've had many conversations about this and i think that um what i'd highlight um is a couple things is number one is is that uh collectively or on aggregate when you look at each one of these wearouts as clauses and you you pull them all together and i'm i know um every member of this committee has already read this but it it kind of knocks you back in your seat a little bit um when you when you put all of these these these things together and there's so much more uh when you when you start to read our policy the policy that was put forward um by us on economic development the policies on health services there are portions of some of this language but there's we haven't this is this is like this is and i think um mersi uh dr afilia had indicated it so that's the first thing is is that we realize that you know that this is this is really even in its limited form is a shell shocker uh for somebody who just picks this up especially a legislator um because truthfully you just don't see this in the same you don't you don't see stuff like this every day i just want to say that i mean you don't you don't see stuff like this every day and um i see representative noise kind of laughed a little bit there but i think you degree it's so true because you pick this up and you start reading and and you get through the first clause and you start persistence of health inequities and then you're talking about determinants and then you're getting into you know all these stats and it kind of blows your way and i just want you to know that that's what we want to do that's that was the intention it wasn't it was specifically designed to to in to really imprint upon us the the stark reality of what it is that we're dealing with it is so important that we address this as a stark reality it is so important for us even if it doesn't feel comfortable let's work through it but it's real it's real and i think that again there's three three things that are happening here representative redmond personal growth organizational growth and then there's that collective and societal growth that's happening that's why we're here and it's it's my hope if nothing else happens let's just say you guys say oh that guy's crazy you know just table it put it back on the wall get him out of here or whatever bottom like i doubt that happens but i'm just saying if if nothing else happens on this resolution we've already accomplished something today so i think so that's the first thing um the second the second thing and final thing i'll i'll just share with you is is these resolutions were pretty well thought out you know as far as not just calling out the resolution but you notice that um there is um a commitment i know it's just words but words as somebody said earlier matter words matter and i think that there's here a sustained and deep it commits to a sustained and deep work work in eradicating systemic racism through throughout the state actively fighting racist practice so on and so forth and then that the last part is is who's going to actually get a copy of this you know we thought we thought that out in terms of you know in extending you know as an olive branch to the executive branch to the legislative to the judicial judiciary branch to say hey guys look what we're doing you know maybe you might want to be a part of this so uh that was the long answer the short answer is is you know we feted this thoroughly um this has been through multiple iterations uh and i'm happy to engage in you know discussion on um you know any type of uh i guess recommendations for um modification of language and we'd be happy to come back and and provide additional testimony if necessary thank you super helpful i just wanted to have that be clearly established and you did thank you thank you represent mcphone has a question i represented from how you know pretty good thanks good thanks for coming in today thank you thanks for having you're welcome here's my question what do you think you accomplished today you mentioned you've already accomplished something what have you accomplished today what we what we were able to first of all you you have taken up for the first time in history a joint resolution declaring racism as a public health emergency first time in history of in 244 years of this legislative body this is the first time this has ever happened that's the first thing that we've accomplished today the second thing that we've accomplished today is we've had an open communication about systemic racism racism and systemic racism in your committee specifically for that purpose and i think and hopefully hopefully and this and this this can only come from you is is there may have been some things that committee members have learned regarding if nothing else the difference between systemic racism and overt racism in this conversation so i think those are some of the things that i believe i feel really good about in terms of accomplishments does that help representative absolutely i just wanted to give you a forum i appreciate you it's not often i get a bone thrown in mr hues i want to thank you and i want to hope you'll express to the folks who you worked with in creating the resolution that we we thank them for giving us this opportunity to look at things and this is not the not the only day this is the first day we will be at looking at this we will be managing this along with a couple of other pieces of legislation that we have so rather than doing it all on one day or all on three days together we will be mixing it up with other pieces of legislation madam chair i appreciate having had the opportunity to come i i appreciate all of the brilliant and insightful questions and it's it's so good to see the members of the committee i also want to just give a special shout out madam chair julie tucker who coordinated so hard to get me here and and all the work that she's doing on the back end of the committee and i i think the final thing i would just say to the committee is thank you thank you all for considering this policy and taking it up thanks for treating it like a bill because i think that slows it down and it gives you an opportunity to take a close look at it to think about it to process it i believe that at the end of the day you're going to come to the conclusion that this is the thing that is the best for the state i think the senate's going to agree with you and i'm excited about what's going to happen after that so i wish you all a great weekend i'm getting ready to hop on a plane tomorrow to the west coast but um i wish you all a great weekend and and thank you for having me well thank you and i do offer if you wish um to submit um any of those slides julie will um post them for us so that we can look at them more closely absolutely i appreciate you have a great day thank you um right committee it looks like we have about um five minutes to take a break before uh the commissioner of health is expected to be here