The Racial Diversity, Equity, and Inclusion in Science Education (RDEISE) project is led and overseen by our Faculty Steering Committee, an interdisciplinary team of top experts.
A social epidemiologist, public health practitioner, and Associate Professor at Charles R. Drew University of Medicine and Science, RDEISE faculty member Dr. Bita Amani advises primarily on the learning cluster “Racism as a Public Health Crisis.”
“I hope RDEISE can spread awareness of the impact of racism and the resulting inequities on all levels of society, inspire the next generation to continue the exploration of knowledge about the topic, and fuel a desire to create a more just society,” says Dr. Amani. “The next-generation of health science scholars and practitioners will lead the way when it comes to reimagining our existing knowledge in service of the equitable world we want to create.”
We spoke to Dr. Amani about her research, the impact of systemic racism on community health, potential solutions to race-based health-care inequalities, and more.
My work examines the ways that health, systems, and politics influence each other. Decades of doing this work have sharpened my focus to think through specifically how state-sanctioned violence creates and maintains public health crises and racial inequity. I apply this framework to questions around the effects of state-sanctioned violence, who and what we define as criminal, how we treat those labeled as criminal, and the impact (in the form of stress) that this has on our most vulnerable, such as infants, youth, pregnant people and parents.
An essential part of this includes the bias that is created within the health science workforce when it comes to workforce development and training, research, and delivery of care. As a result, my work includes thinking through academic curricula (i.e. do they focus on health inequity?), gaps in the workforce (i.e. do we have enough BIPOC lactation educators?), and care (i.e. is the type of care we deliver holistic and in alignment with best evidence-based practices?).
I became involved in RDEISE due to my experience teaching on race and racism, researching criminalization and its impact on health, and implementing projects that center Black and Brown communities. I care about the workforce and see the RDEISE project as a workforce intervention that is timely and has the capacity to extend the ideas taught in the classroom, presented in a paper, and conceived of locally to a much wider audience for greater impact. I also got involved to work with brilliant minds in the field who can bring a valuable perspective to this historical issue of race and the health sciences and rectify its harms.
Community health is defined by the people being cared for (the community), the health-care workforce that educates, advocates for, and treats the community, and the quality and availability of the resources on the community level. When the people being cared for are racially marked as inferior, it impacts the entire community health system from the workforce to the resources.
The term “social determinants of health” refers to the resources and opportunities people need to be able to promote health, prevent disease, and treat illness. Positive social determinants of health, such as access to fresh, healthy food, are not universally guaranteed to all, and are systematically denied to others depending on the community they come from. Who gets what and why is based on race and the system of structural racism.
So, the community health system has to both reinforce racism due to the fact that it is made up of the same ideas of racial inferiority and othering that are part of the larger health system, and it has to try and address the very problems its own structure is producing. This creates tension between the people being served by this system, those that work with it, and the larger health system that has structured things in this way. At the same time though, it also builds rich networks of resilience and aid, organically created and sustained by communities, to compensate for what has been denied because of racism.
The main solutions that have come to light are those that result in more immediate change, and also those that affect change in the long run across the levels of education, capacity, and direct service.
Firstly, when it comes to education, we need to be teaching the history of race and the health sciences to both health-care professionals and larger society more broadly. Everyone should know how racism has come to define every system that organizes society, whether that be in terms of housing, education, or health.
Secondly, we have to think about capacity. Do we have enough of the people needed to provide the services in a way that doesn’t reproduce racial inequity? If not, then we need to increase our capacity ASAP. In the short term, that includes more representation from historically excluded communities across all types of health work and fields of specialization. A long term goal is to also increase the types of workers we need, such as more practitioners concerned with the preventative health fields that often are not compensated justly with respect to the importance and challenging nature of the work.
Finally, when it comes to delivery of care and provision of services, community-based models of care are key. These are models of care that are integrated into the fabric of where people live, work, and play, and therefore are more primed to be attuned to people’s cultures, history, and wishes. A long-term goal is to create and organize the resources so that those models are sustainable.
All of these interventions could still miss their mark on racial equity if we don’t genuinely value all members of our society equally, in particular those that have historically been devalued, and then adjust the whole system accordingly.
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