Uprooting Institutionalized Racism as Public Health Practice

Bassett, Mary T.; Graves, Jasmine

doi:10.2105/ajph.2018.304314

Cited by 31 publications

(18 citation statements)

References 5 publications

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“…Learning the history helps undo the biased—sometimes unconscious—perspective that present-day inequities are somehow natural or the fault of marginalized communities. It pushes public health professionals to view an issue as caused by policies and social constructed norms (i.e., a structural lens) and makes the notion that individual choices are the root cause of a particular health inequity seem illogical (Bassett & Graves, 2018). This awareness can prompt public health professionals to design programs geared at root causes rather than downstream consequences.…”

Section: Why Is a Historical Perspective On Inequities Important?mentioning

confidence: 99%

The Importance of Teaching History of Inequities in Public Health Programs

Fleming

2020

Pedagogy in Health Promotion

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Learning the history of inequities is typically not a major part of public health degree programs but can be fundamental to truly understanding health inequities and identifying potential solutions. A historical perspective on inequities can help understand present-day inequities as constructed over time, provide needed context for community engagement efforts, and help identify the system of advantages and disadvantages based on race, gender, and class that have been built into U.S. society. There are many ways to integrate a historical perspective on inequities into public health degree programs, and this article provides an example course on historical roots of health inequities. To more effectively reduce health inequities, it is imperative that Schools and Programs of Public Health adopt curriculum content to provide public health professionals and researchers a much-needed historical perspective on inequities.

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Section: Why Is a Historical Perspective On Inequities Important?mentioning

confidence: 99%

The Importance of Teaching History of Inequities in Public Health Programs

Fleming

2020

Pedagogy in Health Promotion

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“…Over centuries, it has been entrenched in numerous countries, influencing the way medicine is taught and practiced as well as the functioning of healthcare institutions [29]. This might help to understand whyalthough genetic predisposition or unhealthy lifestyle, biological inferiority, socio-economic factors, and medical distrust are put forward as some of the reasons contributing to the persistence of healthcare inequalities between ethnic and racial groups [30,31] even when some of such factors are taken into account, these inequalities remain [32]. Furthermore, unhealthy lifestyle and socio-economic factors themselves are in turn partly a product of structural racism and discrimination [30].…”

Section: Introductionmentioning

confidence: 99%

Structural racism in precision medicine: leaving no one behind

et al. 2020

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Background: Precision medicine (PM) is an emerging approach to individualized care. It aims to help physicians better comprehend and predict the needs of their patients while effectively adopting in a timely manner the most suitable treatment by promoting the sharing of health data and the implementation of learning healthcare systems. Alongside its promises, PM also entails the risk of exacerbating healthcare inequalities, in particular between ethnoracial groups. One often-neglected underlying reason why this might happen is the impact of structural racism on PM initiatives. Raising awareness as to how structural racism can influence PM initiatives is paramount to avoid that PM ends up reproducing the pre-existing health inequalities between different ethnoracial groups and contributing to the loss of trust in healthcare by minority groups. Main body: We analyse three nodes of a process flow where structural racism can affect PM's implementation. These are: (i) the collection of biased health data during the initial encounter of minority groups with the healthcare system and researchers, (ii) the integration of biased health data for minority groups in PM initiatives and (iii) the influence of structural racism on the deliverables of PM initiatives for minority groups. We underscore that underappreciation of structural racism by stakeholders involved in the PM ecosystem can be at odds with the ambition of ensuring social and racial justice. Potential specific actions related to the analysed nodes are then formulated to help ensure that PM truly adheres to the goal of leaving no one behind, as endorsed by member states of the United Nations for the 2030 Agenda for Sustainable Development. Conclusion: Structural racism has been entrenched in our societies for centuries and it would be naïve to believe that its impacts will not spill over in the era of PM. PM initiatives need to pay special attention to the discriminatory and harmful impacts that structural racism could have on minority groups involved in their respective projects. It is only by acknowledging and discussing the existence of implicit racial biases and trust issues in healthcare and research domains that proper interventions to remedy them can be implemented.

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“…By problematizing the non-participation of "missing minorities" while taking the adequacy of the blood procurement system at face value, the hitherto dominant, instrumental approach risks overlooking "the macrolevel systems, social forces, institutions, ideologies, and processes that interact with one another to generate and reinforce inequities among racial/ethnic groups" (Hardeman et al, 2018: 241). In contrast, we explicitly consider how the under-representation of minorities can be understood as a specific manifestation of institutionalized (or systemic) racism (in healthcare settings) (Bassett and Graves, 2018;Feagin and Bennefield, 2014;Hardeman et al, 2018;Jones, 2000Jones, , 2002. In doing so, we are not accusing practitioners or European blood establishments of holding and/or actively endorsing racist assumptions toward ethnic minorities as individuals or individual organizations.…”

Section: Discussion: From Diagnosis Of Social Problems To Potential For Social Changementioning

confidence: 99%

“…Shifting the focus to systemic factors is important for at least two reasons. First, it draws attention to the possibility that the underrepresentation of non-white, first and second-generation immigrants from the Global South in European blood donor populations is a manifestation of institutionalized (or systemic) racism (within healthcare settings) (Bassett and Graves, 2018;Feagin and Bennefield, 2014;Hardeman et al, 2018;Jones, 2000Jones, , 2002. Second, our approach recognizes insights from recent social theory, which have identified blood procurement as a bounded area of social action: an "organizational field" (Barman, 2007;Busby et al, 2014;Charbonneau and Smith, 2015;Farrell, 2006Farrell, , 2012Hansen-Magnusson, 2010).…”

Section: Introductionmentioning

confidence: 99%

“Missing minorities” in blood donation: Rethinking blood procurement in Europe as a citizenship regime

2021

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Although European blood collection organizations are currently obtaining sufficient and safe blood from the majority population, they report having difficulty recruiting first and second-generation immigrants from non-European countries. Most existing studies on these underrepresented groups, who have been coined the “ missing minorities” in blood donation, have adopted an instrumental approach that focuses on the development of targeted recruitment strategies to overcome specific barriers to donation faced by members of these minorities. Although this approach does offer several short-term benefits, our central argument is that it is one-sided in its questioning of the non-participation of ethnic minorities. The literature currently lacks research on how the blood procurement system is failing to include minorities. Drawing on recent social theory, we seek a broader sociological understanding of minority under-representation in blood donor populations by shifting the analytic focus toward a critical examination of the main pillars of the procurement system within the European context. This paper advances a novel analytical framework based on two general propositions. First, we apply the literature on “citizenship regimes” to argue that blood donation is part of one specific institutionalization of citizenship and solidarity. We then reconceptualize the “problem” of missing minorities in European blood donation as an application for social change, suggesting avenues related to blood collection as a way of renegotiating minority-majority relations of solidarity.

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Uprooting Institutionalized Racism as Public Health Practice

Cited by 31 publications

References 5 publications

The Importance of Teaching History of Inequities in Public Health Programs

The Importance of Teaching History of Inequities in Public Health Programs

Structural racism in precision medicine: leaving no one behind

“Missing minorities” in blood donation: Rethinking blood procurement in Europe as a citizenship regime

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