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Suarez-Balcazar Y, Buckingham S, Rusch DB, Charvonia A, Young RI, Lewis RK, Ford-Paz RE, Mehta TG, Perez CM. Reproductive justice for Black, Indigenous, Women of Color: Uprooting race and colonialism. Am J Community Psychol 2024; 73:159-169. [PMID: 36912117 DOI: 10.1002/ajcp.12650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 07/01/2022] [Accepted: 11/25/2022] [Indexed: 06/18/2023]
Abstract
Historically, atrocities against Black, Indigenous, and Women of Color's (BIWoC) reproductive rights have been committed and continue to take place in contemporary society. The atrocities against BIWoC have been fueled by White supremacy ideology of the "desirable race" and colonial views toward controlling poverty and population growth, particularly that of "undesirable" races and ethnicities. Grounded in Critical Race Theory, this paper aims to provide a critical analysis of historical and contemporary violations of BIWoC reproductive rights; discuss interventions based on empowerment and advocacy principles designed to promote women's reproductive justice; and discuss implications for future research, action, and policy from the lenses of Critical Race Theory and Community Psychology. This paper contributes to the special issue by critically analyzing historical and contemporary racism and colonialism against BIWoC, discussing implications for future research and practice, and making policy recommendations.
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Affiliation(s)
| | - Sara Buckingham
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Dana B Rusch
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Alissa Charvonia
- Department of Psychology, Howard University, Washington, District of Columbia, USA
| | | | - Rhonda K Lewis
- Department of Psychology, Wichita State University, Wichita, Kansas, USA
| | - Rebecca E Ford-Paz
- Pritzker Department of Psychiatry and Behavioral Health; Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tara G Mehta
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, Illinois, USA
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2
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Chen E, Wallace D, Leos C, Merino Y. Examining the White Supremacist Practices of Funding Organizations for Public Health Research and Practice: A Composite Narrative From Female, BIPOC Junior Researchers in Public Health. Health Promot Pract 2023; 24:45-58. [PMID: 36310429 PMCID: PMC9806480 DOI: 10.1177/15248399221129864] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background. It is challenging for junior public health investigators who identify as Black, Indigenous, or People of Color (BIPOC) to secure funding for projects and research. We used a narrative inquiry approach to understand and present the funding cascade from the perspectives of female, junior BIPOC researchers and provide funders with actionable recommendations to advance their antiracist goals. Approach. We applied a Critical Race Theory (CRT) framework to guide our narrative inquiry approach. The participants were the four co-authors and we each drafted individual narratives around our experience with the funding cascade and subsequently the five stages of narrative analysis. Results. We created a visual representation of key activities for funders and applicants organized by our perceived magnitude of inequities in a journey map, an interpreter table that describes common phrases and barriers encountered, and a composite counternarrative presented as a group text message conversation, elevating common themes including feeling pressured to have our research agendas conform to funders' interests and receiving limited key information and support in the funding process. Discussion. We discussed how our findings represented manifestations of White supremacy characteristics like power hoarding and paternalism. Implications for practice. We offered specific antidotes for funding organizations to make their processes more antiracist and invited leaders of public health funding organizations to join us to further identify antidotes and share lessons learned in Fall 2023.
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Affiliation(s)
- Elizabeth Chen
- The University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA,Elizabeth Chen, Department of Health
Behavior, Gillings School of Global Public Health, The University of North
Carolina at Chapel Hill, Chapel Hill, NC 27599-7400, USA; e-mail:
| | - Deshira Wallace
- The University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
| | | | - Yesenia Merino
- The University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
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3
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Ezell JM, Chase EC. Forming a Critical Race Theory of Environmental Disaster: Understanding social meanings and health threat perception in the Flint Water Crisis. J Environ Manage 2022; 320:115886. [PMID: 36056493 DOI: 10.1016/j.jenvman.2022.115886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
A Critical Race Theory of Environmental Disaster can aid researchers in better contextualizing racially disproportionate environmental disasters and their intricate social meanings to survivors. Such a theory, as proposed and operationalized here, incorporates interpretations of the causes and consequences of environmental disaster. In so doing, this theory weighs the racial and economic stratification often preceding environmental disaster and that which reflexively becomes more embedded in the aftermath. Focusing on the water crisis in the racially diverse, socioeconomically diminished city of Flint, Michigan, this article examines survey data from research conducted with city residents. The analysis considers residents' attitudes and beliefs around the crisis' scope and its intentionality and residents' health outcomes. Results suggest that various institutional and community-level mechanisms contribute to processes of meaning-making during crisis, or "crisis-making," finding consistent variation in residents' understanding of the nature and scope of the water crisis that is associated with specific cultural and health-related experiences. This construction substantiates that a Critical Race Theory of Environmental Disaster must consider not only race, but class in the context of race, as instrumental in developing social understandings of, and experiences with, environmental disaster.
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Affiliation(s)
- Jerel M Ezell
- General Internal Medicine, Weill Cornell Medicine, New York, NY, USA; Center for Cultural Humility, Cornell University, Ithaca, NY, USA.
| | - Elizabeth C Chase
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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4
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Amani B, Cabral A, Sharif MZ, Huỳnh J, Skrine Jeffers K, Baptista SA, McAndrew B, Bradford NJ, de la Rocha P, Ford CL. Integrated Methods for Applying Critical Race Theory to Qualitative COVID-19 Equity Research. Ethn Dis 2022; 32:243-256. [PMID: 35909643 PMCID: PMC9311305 DOI: 10.18865/ed.32.3.243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Racism persists, underscoring the need to rapidly document the perspectives and experiences of Black, Indigenous and People of Color (BIPOC) groups as well as marginalized populations (eg, formerly incarcerated people) during pandemics. Objective This methods paper offers a model for using Public Health Critical Race Praxis (PHCRP) and related critical methodologies (ie, feminist and decolonizing methods) to inform the conceptualization, methods, and dissemination of qualitative research undertaken in response to the evolving COVID-19 pandemic. Sample Using purposive snowball sampling, we identified organizations involved with health equity and social justice advocacy among BIPOC and socially marginalized populations. Focus group participants (N=63) included community members, organizers, activists, and health workers. Design We conducted topic-specific (eg, reproductive justice) and population-specific (eg, Asian and Pacific Islander) focus groups (N=16 focus groups) in rapid succession using Zoom software. Methods A self-reflexive, iterative praxis guided theorization, data collection and analysis. We obtained community input on study design, the semi-structured discussion guide, ethical considerations and dissemination. Applying PHCRP, we assessed our assumptions iteratively. We transcribed each interview verbatim, de-identified the data, then used two distinct qualitative techniques to code and analyze them: thematic analysis to identify unifying concepts that recur across focus groups and narrative analysis to keep each participant's story intact. Results The praxis facilitated relationship-building with partners and supported the iterative assessment of assumptions. Logistical constraints included difficulty ensuring the confidentiality of virtual discussions. Conclusions These novel approaches provide an effective model for community-engaged qualitative research during a pandemic.
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Affiliation(s)
- Bita Amani
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA,COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA, Address correspondence to Bita Amani, PhD, MHS; Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA;
| | - Alejandra Cabral
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Mienah Z. Sharif
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Epidemiology, University of Washington, School of Public Health, Seattle, WA
| | - James Huỳnh
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Kia Skrine Jeffers
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,School of Nursing, UCLA, Los Angeles, CA
| | - Shelby A. Baptista
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Breann McAndrew
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Natalie J. Bradford
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Patanjali de la Rocha
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Global Health, School of Public Health, University of Washington, Seattle, WA
| | - Chandra L. Ford
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA,Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
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5
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Levin L. Perspective: Decolonizing postmodernist approaches to mental health discourse toward promoting epistemic justice. Front Psychiatry 2022; 13:980148. [PMID: 36276325 PMCID: PMC9582654 DOI: 10.3389/fpsyt.2022.980148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Currently, it is possible to observe a slowly (but surely) growing volume of claims seeking to disprove Foucauldian ideas about knowledge and power as overlapping basic theories of epistemic justice. Prompted by these claims, alongside adopting tenets of Critical Race Theory to address injustices inflicted upon people facing mental health challenges, I propose applying decolonizing deconstruction to Foucault's terminology, toward identifying opportunities to enhance epistemic justice, primarily in direct interventions in mental health services.
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Affiliation(s)
- Lia Levin
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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6
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Cannon Y, Tuchinda N. Critical Perspectives to Advance Educational Equity and Health Justice. J Law Med Ethics 2022; 50:776-790. [PMID: 36883402 DOI: 10.1017/jme.2023.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
A robust body of research supports the centrality of K-12 education to health and well-being. Critical perspectives, particularly Critical Race Theory (CRT) and Dis/ability Critical Race Studies (DisCrit), can deepen and widen health justice's exploration of how and why a range of educational inequities drive health disparities. The CRT approaches of counternarrative storytelling, race consciousness, intersectionality, and praxis can help scholars, researchers, policymakers, and advocates understand the disparate negative health impacts of education law and policy on students of color, students with disabilities, and those with intersecting identities. Critical perspectives focus upon and strengthen the necessary exploration of how structural racism, ableism, and other systemic barriers manifest in education and drive health disparities so that these barriers can be removed.
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Affiliation(s)
- Yael Cannon
- GEORGETWON UNIVERSITY LAW CENTER, WASHINGTON, DC, USA
| | - Nicole Tuchinda
- LOYOLA UNIVERSITY NEW ORLEANS COLLEGE OF LAW, NEW ORLEANS, LA, USA
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7
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Pierson-Brown T. It's Not Irony, it's Interest Convergence: A CRT Perspective on Racism as Public Health Crisis Statements. J Law Med Ethics 2022; 50:693-702. [PMID: 36883398 PMCID: PMC10009367 DOI: 10.1017/jme.2023.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Racism as a Public Health Crisis Statements (RPHCs) acknowledge the reality that racism must be eradicated to ensure health justice: a fair and just opportunity for all individuals to be healthy. Scholars of critical race theory (CRT) have expressed doubt when it comes to the capacity of law-related institutions to catalyze or sustain anti-racist efforts. These strains of skepticism underscore the question of whether so many RPHCS were adopted precisely because, in many instances, they were merely symbolic acts. This commentary argues that the trend in adopting RPHCs carries signs of interest convergence, and asserts that the alliance between government and the movement for health justice reflected in this phenomenon falls short of the substantive anti-racist action needed to realize health justice. The spate of RPHC adoption, in lieu of passing anti-racist policy or meaningfully empowering people of color, signifies that the movement for health justice must be strategic in determining whether to leverage, or be wary of, the power dynamics which shape political change. The health justice framework must expand its toolkit to include CRT.
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8
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Freeman A. Food Oppression in a Pandemic. J Law Med Ethics 2022; 50:711-718. [PMID: 36883390 DOI: 10.1017/jme.2023.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
COVID-related racial disparities represent a spectrum of injustices and inequalities. Focusing on food oppression, this essay argues that racism infuses food law and policy in ways that contribute to racially disparate COVID deaths and severe illnesses. USDA nutrition program participants were at a nutritional disadvantage when COVID hit. Yet, government responses focused on food insecurity, not nutritional quality. Racism against a predominantly Black and brown labor force of essential food workers - from fields to meat plants to grocery stores - created tolerance for the administration's failure to protect or compensate some of the country's most vulnerable workers. When COVID-driven supply issues threatened to narrow white people's activities and choices, the favored response was to keep their options open by sacrificing Black and brown workers. A food oppression lens - understanding how corporate interests drive food policy - is necessary to achieve food equality in this pandemic and beyond.
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9
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Duerme R, Dorsinville A, McIntosh-Beckles N, Wright-Woolcock S. Rationale for the Design and Implementation of Interventions Addressing Institutional Racism at a Local Public Health Department. Ethn Dis 2021; 31:365-374. [PMID: 34045838 DOI: 10.18865/ed.31.s1.365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose The Bureau of Communicable Disease (BCD) at the New York City Department of Health and Mental Hygiene developed and implemented a multi-level intervention to: 1) establish bureau-wide race consciousness; 2) provide opportunities to examine the contemporary manifestations of racism impacting institutions and communities; 3) develop praxis applying a racial equity and social justice lens to communicable disease surveillance; and 4) center the experiences of Black, Indigenous, People of Color (BIPOC) staff. Methods A staff committee designed and implemented a multipronged initiative grounded in Public Health Critical Race (PHCR) praxis. The findings from a qualitative report focused on the experiences of POC staff formed the basis of the initiative. Results Three major themes were identified in the report (Microaggressions Report) as factors that resulted in institutional inequities within the workplace: race-based biases in promotion of staff; lack of opportunity sharing for professional growth; and dominant power relations silencing the voices of POC staff. Based on findings from the Microaggressions Report, BCD designed and implemented seven interventions including: 1) Racial Identity Caucusing; 2) Multimedia Learning; 3) All-staff Workshops; 4) Social Breakout Committee; 5) Surveillance and Data Equity; 6) Core Values Development; and 7) Committee for Hiring, Retention and Promotion. Conclusion We describe the rationale, design, and implementation of a multipronged intervention at a local health department as a strategy to address institutional racism. The creation of a Microaggressions Report and the PHCR methodology framed our ongoing effort to improve workplace culture and promote equitable opportunities for POC staff.
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Affiliation(s)
- Ryan Duerme
- New York City Department of Health and Mental Hygiene, Division of Disease Control, Long Island City, NY
| | - Alan Dorsinville
- New York City Department of Health and Mental Hygiene, Division of Disease Control, Long Island City, NY
| | - Natasha McIntosh-Beckles
- New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Long Island City, NY
| | - Stacey Wright-Woolcock
- New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Long Island City, NY
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10
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Nguyen-Truong CKY, Rakha S, Eti DU, Angelesco L. Deconstructing Racialized Experiences in Healthcare: What a Missed Opportunity for Healing Looks Like and Healthcare Resources for Children and Their Families. Asian Pac Isl Nurs J 2021; 5:227-235. [PMID: 33791410 PMCID: PMC7993890 DOI: 10.31372/20200504.1109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Some patients and families of color, including Asian Americans, face significant adverse stressors due to living within a White-dominant society. Xenophobia and racism can impact health. Research evidence points to early exposure to adverse childhood experiences such as racial discrimination as being detrimental and having significant short-term and long-term impact on physical and mental health. The purpose of this commentary article is to illuminate the need of patients and their families who may seek health care providers (HCPs) to express their concerns and fears when issues of xenophobia and racism arise. Patients and families need space in a healthcare setting to feel heard and understood. Anti-Asian xenophobia and racism among medically underserved Asian Americans persists and has been heightened during the COVID-19 pandemic. We describe tenets of Critical Race Theory and AsianCrit, and use this lens to understand an example actual scenario, a counter-story, of a Vietnamese mother, and her Vietnamese-Chinese American family’s experience with xenophobia and racism at a community recreation center and the subsequent communication of this experience with a HCP. We describe the impacts of these experiences of seeking healing including discontinuity of a HCP-patient-family relationship. It takes bravery for patients and families to tell their story of xenophobia and racism to a HCP. There are Asian Americans who are afraid to seek healthcare because of anti-Asian xenophobia and concerns about White fragility. Following, we highlight research evidence on implicit bias, also known as unconscious bias, as context about its persistent and widespread existence among healthcare professionals in general and the need to address this in healthcare. Implicit bias can influence care provided to a patient-family and the interactions between a HCP-patient-family. We include additional resources such as those from the National Association of Pediatric Nurse Practitioners, American Psychological Association Office on Children Youth and Families, the Office of Ethnic Minority Affairs, the Office on Socioeconomic Status, and American Academy of Pediatrics to consider in support of equity in healthcare practice of children and their families.
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Affiliation(s)
| | - Shameem Rakha
- Washington State University College of Education in Vancouver, Washington, United States
| | - Deborah U Eti
- Washington State University College of Nursing in Spokane, Washington, United States
| | - Lisa Angelesco
- Washington State University College of Nursing in Vancouver, Washington, United States
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11
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Abstract
Events in 2020 have sparked a reimagination of how both individuals and institutions should consider race, power, health, and marginalization in society. In a response to these developments, we examine the current and past limitations of the ways in which bioethicists have considered race and, more generally, discourses of marginalization. We argue that the foundational principle of justice necessitates that bioethics, as an institution, maintain an active voice against systemic injustice. To carry out this charge, bioethics as a field should promote alternative narratives-"counter storytelling"-to the mainstream voices that have traditionally been heard and accepted, largely without opposition. Additionally, we engage with both Post-Colonial and Critical Race Theory, which we believe are important tools for bioethics in pursuit of equity. Ultimately, we advocate for a proactive form of bioethics that actively resists and denounces injustice and which considers a much wider variety of voices about justice than bioethics has historically considered.
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12
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Tsai J. Building Structural Empathy to Marshal Critical Education into Compassionate Practice: Evaluation of a Medical School Critical Race Theory Course. J Law Med Ethics 2021; 49:211-221. [PMID: 34924057 DOI: 10.1017/jme.2021.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Ideas of racial genetic determinism, though unsupported by scientific evidence and atavistic, are common and readily apparent in American medical education. These theories of biologic essentialism have documented negative effects in learners, including increased measures of racial prejudice.
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13
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Villasenor V, Bui A, Guan SSA, Jain D, Saetermoe C, Chavira G, Khachikian C. Mentors Make a Difference: Community College Students' Development in a Biomedical Research Training Program Informed by Critical Race Theory. J Appl Res Community Coll 2021; 28:155-170. [PMID: 35199107 PMCID: PMC8863108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study examined the impact of participation in an undergraduate biomedical research training program (BUILD PODER) on community college students' academic, career, and psychosocial development. The program leveraged Critical Race Theory (CRT) as a guiding theoretical framework to empower students as learners and social justice advocates as well as to build a bridge to science through respectful, supportive research mentoring relationships (Saetermoe et al., 2017). In this quasi-experimental design, community college students (Mage = 21.29, SD = 5.02, 78.6% female) who had been in the program for a year (BUILD treatment group, N = 8) reported significantly greater understanding of research, course materials, and satisfactory mentorship compared to community college students in the pre-treatment, comparison group (Pre-BUILD group; N = 18). Qualitative analysis provided further insight into the academic and psychosocial impact of research training and mentoring for community college students interested in health and health equity.
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Affiliation(s)
| | - Amber Bui
- California State University, Northridge
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14
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Senreich E. The Persistent High Rates of Heroin Use Among the Puerto Rican Population in the United States: A Qualitative Study. Soc Work Public Health 2018; 33:419-438. [PMID: 30477409 DOI: 10.1080/19371918.2018.1543626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
For a half- century, the Puerto Rican population in the United States has experienced very high rates of heroin usage with significant health ramifications. At substance misuse programs in the Bronx, New York, two focus groups consisting of a total of 13 Puerto Rican counselors, and four focus groups consisting of a total of 35 Puerto Rican clients, discussed the impact of heroin usage on Puerto Rican communities as part of a qualitative study using a phenomenological perspective. Societal marginalization and social dislocation were identified as major contributors to heroin usage in Puerto Rican communities. The findings indicate that full access to economic, vocational, and educational opportunities, along with a decrease in institutional racial discrimination, would appear to be the most effective way to decrease heroin usage among this population.
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Affiliation(s)
- Evan Senreich
- a Social Work, Lehman College , City University of New York , Bronx , New York , USA
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15
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Butler J, Fryer CS, Garza MA, Quinn SC, Thomas SB. Commentary: Critical Race Theory Training to Eliminate Racial and Ethnic Health Disparities: The Public Health Critical Race Praxis Institute. Ethn Dis 2018; 28:279-284. [PMID: 30116099 DOI: 10.18865/ed.28.s1.279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Racism is a fundamental cause of racial and ethnic disparities in health outcomes. Researchers have a critical role to play in confronting racism by understanding it and intervening on its impact on the health and well-being of minority populations. This requires new paradigms and theoretical frameworks that are responsive to structural racism's present-day influence on health, health disparities, and research. To address the complexity with which racism influences both health and the production of knowledge about minority populations, the field must accelerate the professional development of researchers who are committed to eliminating racial and ethnic health disparities and achieving health equity. In this commentary, we describe a unique and vital training experience, the Public Health Critical Race Praxis Institute at the University of Maryland's Center for Health Equity. Through this training institute, we have focused on the experiential knowledge of diverse researchers committed to examining racism and trained them on putting racism at the forefront of their research agendas. The Institute brought together investigators from across the United States, including junior and senior faculty as well as postdoctoral fellows. The public health critical race methodology was purposefully used to structure the Institute's curriculum, which instructed the scholars on Critical Race Theory as a framework in research. During a 2.5-day training in February 2014, scholars participated in activities, attended presentations, joined in reflections, and interacted with Institute faculty. The scholars indicated a strong desire to focus on race and racism and adopt a Public Health Critical Race Praxis framework by utilizing Critical Race Theory in their research.
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Affiliation(s)
- James Butler
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD.,Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD
| | - Craig S Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD.,Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD
| | - Mary A Garza
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD.,Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD
| | - Sandra C Quinn
- Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD.,Department of Family Science, School of Public Health, University of Maryland, College Park, MD
| | - Stephen B Thomas
- Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD.,Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD
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16
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Abstract
Objective Race consciousness serves as the foundation for Critical Race Theory (CRT) methodology. Colorblindness minimizes racism as a determinant of outcomes. To achieve the emancipatory intent of CRT and to reduce health care disparities, we must understand: 1) how colorblindness "shows up" when health care professionals aim to promote equity; 2) how their colorblindness informs (and is informed by) clinical practice; and 3) ways to overcome colorblindness through strategies grounded in CRT. Design/Setting/Participants We conducted 21 semi-structured interviews with key informants and seven focus groups with personnel employed by a large Minnesota health care system. We coded transcripts inductively and deductively for themes using the constant comparative method. We used a race-conscious approach to examine how respondents' accounts align or diverge from colorblindness. Results Evading race, respondents considered socioeconomic status, cultural differences, and patients' choices to be the main contributors to health disparities. Few criticized the behavior of coworkers or that of the organization or acknowledged structural racism. Respondents strongly believed that all patients were treated equally by providers and staff, in part due to race-neutral care processes and guidelines. Respondents also used several semantic moves common to colorblindness to refute suggestions of racial inequality. Conclusions Colorblindness upholds the racial status quo and inhibits efforts to promote health equity. Drawing on CRT to guide them, health care leaders will need to develop strategies to counter personnel's tendency to focus on axes of inequality other than race, to decontextualize patients' health behaviors and choices, and to depend heavily on race-neutral care processes to produce equitable outcomes.
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Affiliation(s)
- Brooke A Cunningham
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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17
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Abstract
Gloria Ladson-Billings cautiously promotes the use of Critical Race Theory (CRT) to address racism's contribution to educational disparities. Nearly a decade ago, we issued a similar call to the multidisciplinary field of public health. Public health touts its progressive roots and focus on equity, but do those efforts draw on CRT? To answer this question, we define CRT, describe its origin in the field of law, and review the ways its use has grown in the field of public health. Public health interventions and policies rely heavily on evidence; therefore, we re-introduce the semi-structured research method we developed to facilitate empirical application of CRT, ie, the Public Health Critical Race Praxis (PHCRP).
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Affiliation(s)
- Chandra L. Ford
- Center for the Study of Racism, Social Justice & Health, UCLA Fielding School of Public Health, Los Angeles, CA
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18
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Abstract
Ethn Dis. 2018;28(Suppl 1):215-218; doi:10.18865/ed.28.S1.215.
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Affiliation(s)
- Luisa N. Borrell
- Department of Epidemiology & Biostatistics; Graduate School of Public Health & Health Policy; City University of New York; New York, NY
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19
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Abstract
Critical race theory (CRT) is a body of work that seeks to understand and change the relationship between race, racism, and power. While relatively new to the health sciences, CRT is increasingly used as a conceptual framework to examine the role of racism in health inequalities. In this commentary, I outline ways in which CRT can also be used to enhance public health education, methodology, and practice.
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20
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Abstract
Objective Driven by intersectionality, a central tenet of Critical Race Theory, this study examines the combined associations of racial and gender discrimination, which are interlocking, macro-level social forces, and teen dating violence (TDV). Design Self-report surveys were administered via Audio Computer Assisted Self Interview (ACASI) equipment. Logistic regression models were used to estimate associations between racial and gender discrimination and TDV. Setting Study participants were recruited during August 2003 to June 2004 from high school health classes and an after-school program located in South Bronx neighborhoods of New York City. Participants Non-probability sample of 142 Black and Latino teens aged 13-19 years who reported experiences dating someone of a different sex. Main Measures Experienced discrimination based on race and gender adapted from the Experiences of Discrimination (EOD) instrument, dating violence items from the Youth Dating Violence Survey. Results Of the participants, 40.1% reported experiencing both racial and gender discrimination, and nearly all (93%) experienced dating violence. Participants reporting both racial and gender discrimination were 2.5 times more likely to report experiencing the highest frequency of dating violence, adjusted for age and sex (95% CI: 1.0-6.7). A dose-response of EOD observed in unadjusted models (P for trend =.024) was no longer statistically significant after adjustment for age and sex (P for trend =.073). Conclusions Strategies to prevent TDV in this population should not ignore the compounding negative effects of racial and gender discrimination.
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Affiliation(s)
- Lynn Roberts
- Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY
| | - Mahader Tamene
- Department of Psychiatry, Boston Medical Center, Boston, MA
| | - Olivia R. Orta
- Epidemiology Department, Harvard T.H. Chan School of Public Health, Boston, MA
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21
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Ford CL, Takahashi LM, Chandanabhumma PP, Ruiz ME, Cunningham WE. Anti-Racism Methods for Big Data Research: Lessons Learned from the HIV Testing, Linkage, & Retention in Care (HIV TLR) Study. Ethn Dis 2018; 28:261-266. [PMID: 30116096 DOI: 10.18865/ed.28.s1.261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Public Health Critical Race Praxis (PHCRP) contributes three functional elements to health equity studies: a race conscious orientation; an antiracism lexicon based on Critical Race Theory (CRT); and an integrated, reflexive approach. Few big data studies employ all three functional elements. Therefore, this article describes the application of PHCRP to the Human Immunodeficiency Virus Testing, Linkage and Retention in care (HIV TLR) study (N=3,476,741), which connects multiple large datasets to electronic medical records to examine contextual determinants of racial/ethnic disparities in HIV care continuum outcomes in southern California. As HIV TLR demonstrates, PHCRP's innovative tools and strategies help big data research maintain fidelity to CRT.
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Affiliation(s)
- Chandra L Ford
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health at UCLA, Los Angeles, CA.,Department of Community Health Sciences, Fielding School of Public Health at UCLA, Los Angeles, CA
| | - Lois M Takahashi
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health at UCLA, Los Angeles, CA.,Price School of Public Policy, University of Southern California, Los Angeles, CA
| | - P Paul Chandanabhumma
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health at UCLA, Los Angeles, CA.,Department of Community Health Sciences, Fielding School of Public Health at UCLA, Los Angeles, CA
| | - Maria Elena Ruiz
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health at UCLA, Los Angeles, CA.,School of Nursing, University of California at Los Angeles (UCLA), Los Angeles, CA
| | - William E Cunningham
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health at UCLA, Los Angeles, CA.,Department of Health Services Research & General Internal Medicine, Geffen School of Medicine at UCLA, Los Angeles, CA
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