The "saddest repudiation" redux: Structural racism and the unlearned lesson of 1918

The COVID-19 pandemic reveals how the systems and structures of racism devastate the health and well-being of people of color. The debate is an old one and the lesson we have yet to learn was tragically apparent a century ago during the 1918-1919 influenza pandemic. Any history of structural racism in America must begin with the chronicles of African Americans, Native Alaskans, and Indigenous North Americans as they were the originally enslaved and displaced people, subjected to overt and covert policies of oppression ever since. The experiences of Native Alaskans of Bristol Bay Alaska in 1918-1919 present a parallel, illuminating a wrenching example of structural racism that cost lives and impoverished society, then as now. Proven policy solutions exist to remove the structures that produce inequitable health outcomes, but implementing them will require public health officials and policymakers to take multidisciplinary policy actions, to find policy opportunities for change to be made, and, likely, a change in the political environment. The first exists now, the second is afforded because of the current pandemic and the urgent need for policy solutions, and the third is likely coming soon.