To say that we live in a hyper-racialized society is certainly an understatement. While race is without question a social construct with very little biological validity, it does not follow that that any effort to classify information by race is inherently pernicious.

Nevertheless, Proposition 54 makes that sweeping assumption and proposes a clumsy and overly broad remedy that would force California into a new Dark Age where willful ignorance would likely mask renewed discrimination against this state's racial and ethnic minorities. In many ways, Prop 54 is similar to religious book-burning efforts and heresy trials wherein knowledge itself is the enemy and blissful ignorance is the desired goal.

The adverse consequences of Prop 54's passage are substantial, particularly in public health, where a renewed effort to confront the root causes of disease would be dealt a stunning blow should this ballot initiative pass.

It is well known that California is plagued by persistent health disparities that exact a continued and disproportionate burden on various racial groups, particularly African Americans, Latinos, and native Hawaiians and Pacific Islanders. In order to design public health programs to address the underlying injustices that cause these disparities, it is critical that public health collect and analyze racial impact data from a variety of sources, including health, housing, employment and education.

Prop. 54 would kill these efforts and effectively render us blind to the root causes of health disparities. As the Alameda County Registrar of Births and Deaths, I am particularly concerned about the impact that Prop. 54 would have on numerous public health programs. In public health, we frequently measure the burden of a disease by calculating an incidence or prevalence rate. A rate requires two basic things, a numerator and a denominator. The numerator is the number of people with the particular affliction, and the denominator is the total number of people at risk. If Prop 54 is successful, and California birth and death certificates were stripped of race information, these simple calculations would become impossible. We would not be able to answer simple questions like: What is the infant mortality rate for African Americans in Alameda County, or what is the incidence of cystic fibrosis among whites in the Bay Area? Other more sophisticated public health screening programs such as genetic counseling and newborn screening would be in jeopardy as well.

These programs exist in every state in the country, and prevent and detect thousands of cases of genetic disease every year. Diseases such as Tay-Sachs, cystic fibrosis and sickle cell anemia are conditions that affect different racial groups to differing degrees. Early treatment in some of these genetic conditions can prevent serious mental retardation, profound disability, and death.

While Prop. 54 does permit racial data tracking for "medical research" purposes, it does not exempt critical public health programs that rely heavily on racial data to target screening and perform data analysis. While this is a presumably unintended consequence, Prop. 54 nevertheless would push California's health care system backwards to a time when this potentially life-saving information was not available to Californians and their doctors. This would be another costly and embarrassing national distinction that California can ill afford.

In 1990, struck by the vastly disproportionate infant death rate among African Americans in Alameda County, the Public Health Department initiated the Black Infant Health Program. This program is designed to reduce Black infant deaths by performing home visits, offering parenting workshops, and providing other medical and social support during pregnancy. In the last three years of this program, there have been no infant deaths in this high-risk population. The passage of Prop. 54 would destroy this program and threaten the success that this and other targeted public health programs have recently achieved in reducing health disparities.

The Alameda County Board of Supervisors and virtually every public health and medical association in California is opposed to Prop. 54. Rather than propelling California backwards, we must be honest and work constructively to achieve racial equity and social justice in California. This can only be done by acknowledging and confronting racial disparities in health, education, housing and employment, and conducting rigorous analysis of the racial impact data that Prop. 54 is targeted at eliminating. In public health, as in many other critical disciplines, ignorance is not bliss.

Tony Iton is the health officer with the Alameda County Public Health Department.