A Systematic Response to Racism in Public Health:Melody Goodman, Danielle Joyner
Introduction to the NYU Center for Anti-racism, Social Justice, and Public Health
Many professional organizations (e.g., American Public Health Association), health departments (e.g., NYC Department of Mental Health and Hygiene), and government agencies (e.g., Centers for Disease Control and Prevention) have declared racism a public health emergency. The COVID-19 pandemic and continued fatal police interactions for Blacks—with heightened attention and protest in 2020—shed light on how systemic racism persists in America and highlight the need for population health researchers to become more involved in solutions. In 2020, similar to several other schools of public health, the New York University (NYU) School of Global Public Health released an Anti-Racist Statement. In addition, we took this one step further by subsequently establishing the Center for Anti-racism, Social Justice, and Public Health (CASJPH).
The CASJPH takes as its guiding definition of racism the following quote by Dr. Camara Jones, former president of the American Public Health Association:
“Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call “race”), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources.”
Today, CASJPH is undertaking a sweeping, multifaceted, transdisciplinary effort to build a science base that examines racism as a social and structural determinant of health and analyzes policies and social structures, such as residential segregation, that have created racial inequities in education, healthcare, criminal justice, social services, and other areas that can negatively impact health. The CASJPH is committed to using science to tackle systemic racism. Research has shown that of racism has had impactful and negative outcomes in communities of color. This impact is so deeply imbedded in our society that it affects where we live, what we eat, where our children can be educated, where we work, where we worship, and our level of access to care. BIPOC (Black, Indigenous, and people of color) communities experience higher rates of morbidity and mortality from highly preventable diseases. The only way to ensure a more equitable society is to tear down the driving force of health disparities and inequity.
Framework for Anti-racism Research
Kilbourne and colleagues developed a framework for health disparities research that we have adapted to our anti-racism research.
- First phase (detect): Answer the question “Is racism operating here?”
- Second phase (understand): Answer the question “How is racism operating here?”
- Third phase (solutions): Answer the question “Do anti-racism interventions work?”
We are intentionally pushing our work from the first to the third phase of anti-racism research to focus on solutions.
CASJPH Three-Pronged Mission
- Scholarship in the Service of Impactful Change – To translate research into policy, practice, and action and to increase diversity among researchers, policymakers, and public health practitioners. The center is solutions focused, using stakeholder-engaged, community-driven research approaches with an emphasis on translational and intervention science.
- Forging transdisciplinary research collaborations – To bring together the best minds from multiple disciplines to examine how persistent racism manifests in the social and political determinants of health that contribute to the poor health of Blacks and other people of color.
- Stakeholder engagement and partnership development for a community-driven translational research agenda – To harness community expertise and generate evidence-based public health strategies for successfully reducing the levels of racism-related illness and premature death among BIPOC communities.
- Enhancing the infrastructure for community-academic partnerships that will train community health stakeholders and academic researchers on community-engaged, community-based, and community-driven research approaches and to foster collaborations and forge community-academic research partnerships.
Aligned with our three-pronged mission will be the provision of tools for improving the scientific rigor with which researchers examine racism as a social and structural determinant of health.
The efforts of our mission will
- expand public awareness of racial inequities in health,
- increase the political will to address racial inequities in health, and
- develop concrete, practical strategies and policies that can bring about significant long-term change.
Our efforts will also use research findings to build a groundswell of public opinion that recognizes the depth and breadth of racism across American society—and demands serious, lasting solutions.
Diversity of the Public Health Workforce
With our scientific, practice, and policy work, CASJPH is also committed to increasing the diversity of the public health workforce. Public health as a career has become increasingly attractive to underrepresented students due to the social justice focus of the field. With this, there is also an increased need for underrepresented public health workers. In 1996, among all institutions that are members of the Association of Schools and Programs of Public Health, racial/ethnic minority groups comprised 29.4% of students enrolled in graduate degree programs (Asian [11.3%]; Black [8.3%], Hispanic [9.0%], and Native American [0.8%]). By 2016, enrollment of racial/ethnic minority students pursuing master’s or doctoral degrees at schools of public health had increased 10.9 percentage points to 39.8% (Asian [15.7%], Black [11.1%], Hispanic [12.6%], and Native American [0.4%]), with Native Americans being the only racial/ethnic minority group with a decrease (Goodman et al., 2020).
CASJPH does not subscribe to the leaky pipeline narrative, which suggests that BIPOC simply do not pursue advancement in scientific fields. We are aware that Blacks and other racial/ethnic minorities are intentionally pushed out of STEM disciplines starting in elementary school and continuing through secondary education (Riegle-Crumb et al., 2019). We are rolling out the red carpet to welcome these students into public health through the development of pathway programs starting at middle school that provide
- Windows – A look through the window to get a glimpse at a career. What do people working in the field do?
- Mirrors – Diversity of the field reflected back at them. They can see someone in this career who looks like them.
- Sliding glass doors – An open door allows them to walk through. They can spend some time working in the area.
Other Anti-racism Centers
As a new center, we are delighted to be in a community with other anti-racism centers at schools of public health, including
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity at the Dornsife School of Public Health at Drexel University
- The Center for Anti-Racism and Community Health at the University of Washington
- The Center for the Study of Racism, Social Justice & Health at the Fielding School of Public Health at the University of California at Los Angeles
- The Center for Antiracism Research for Health Equity at the University of Minnesota School of Public Health
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