(WASHINGTON) — Milwaukee’s outgoing health commissioner said she faced racism and received threats during her tenure — events she said contributed to her decision to resign last week.

Dr. Jeanette Kowalik said she received anti-Black and anti-immigration threats from white supremacists and was faced with a racist and toxic environment as head of the Milwaukee Health Department.

“It’s one thing to get into a position, it’s another thing to be supported in the position and it’s another thing to be able to bring in other people so that you’re not the one and only,” Kowalik said in a county call on Tuesday, according to ABC affiliate WISN. “I was receiving some anti-immigration, white supremacist types of threats and things before COVID.”

“So of course, with Milwaukee city and county declaring racism as a public health crisis, there’s many people that rallied behind us for doing that, but there are still many people angry by that who feel they are under attack and their way of life is being threatened,” she added.

Kowalik did not say if she had or planned to file any formal complaints about the alleged racism and discrimination.

Kowalik said she started receiving the threats before the COVID-19 crisis took shape in spring, but it got worse after the pandemic. She said she started to notice them more in June after she sent out a statement denouncing anti-Black racism in June, and last year when the city passed a resolution to declare racism a public health crisis.

“Like some other health officials across the country, I received threats of harm mailed to my office prior to COVID-19 and of course after — among them many emails authored by far-right white supremacists,” Kowalik wrote in an opinion piece for the Daily Beast published Monday. “As the only Black woman health officer in the state, the luster of being in the role wore off rather quickly. Mostly, I found myself praying that things wouldn’t get any worse.”

“The job was also a personally grating one. It was a constant power struggle from day one. I was micro-aggressed, man — and ‘Karen’-splained beyond belief and subject to major passive-aggressive outbursts and plenty of double standards,” she added.

Kowalik announced her resignation last week, revealing plans to take on a new role with a Washington, D.C.,-based health and policy think tank. She agreed to stay on as health commissioner until Sept. 22.

“Racism kills. … It’s evil. It’s a sin, and we’ve got to change it,” she said.

Kowalik highlighted obstacles related to testing, mask mandates and other public health matters when explaining her overall reasoning for her departure.

Milwaukee Mayor Tom Barrett thanked her for her “hard” work in a statement after the announcement last week.

“This is another example of how the Federal government has politicized this pandemic and the important work of public health professionals bringing out the worst in some people,” he said. “I appreciate she worked so hard to address these issues particularly during such a difficult time.”

She said she opened up about her experience because she wanted to share what it was like to serve as the state’s only Black female health officer.

“Anything, the rationale for me being open about my experience is to bring about change, and that’s certainly my intention here,” she said. “I’m moving into a national space, so you will continue to hear more from me at that level of what it’s like to be a commissioner — a Black, woman commissioner.”

Kowalik is one of several high-profile public health officials who have resigned amid intense criticism in light of the deadly COVID-19 pandemic. Several women in top state positions have been fired or asked to resign during the pandemic, including in Connecticut, Wisconsin and West Virginia, where Dr. Cathy Slemp was ousted as the state health officer earlier this summer.

The pushback has been especially notable for women in high-profile positions, according to an ABC News analysis.

According to a 2019 report by the National Association of County and City Health Officials, 66% of top executives in local health departments were women, up from 62% in 2016.

They also may be more vocal about what has been happening to them during the pandemic, NACCHO CEO Lori Tremmel Freeman told ABC News. Dr. Fauci, the nation’s leading infectious disease expert, has also been forthcoming about harassment, saying in April that he had received threats.

ABC News’ Meredith Deliso contributed to this report.

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