>> GOOD MORNING.
I'M KATHY ETZ, DIRECTOR OF
NATIVE AMERICAN PROGRAMS,
NATIONAL INSTITUTE ON DRUG
ABUSE.
I WANT TO BEGIN BY THANKING THE
SPEAKERS, MODERATORS, ATTENDEES,
PLANNING COMMITTEE, CONTRACTORS
FOR MAKING THIS MEETING HAPPEN,
AND FOR JOINING YESTERDAY AND
BEING WITH US TODAY.
DR. FARHAT DID A BEAUTIFUL JOB
RECAPPING ALL THAT WE HEARD
YESTERDAY, TOPICS RANGED FROM
ESTABLISHING IMPACT OF
STRUCTURAL RACISM ON HEALTH
OUTCOMES, NUANCES AND CHALLENGES
OF DEFINITIONS, MEASUREMENT,
DATA IN THIS AREA;
MULTI-DISCIPLINARY AND
MULTI-SECTORIAL AND
MULTI-INSTITUTIONAL APPROACHES;
THE ECOLOGY OF RACISM FROM
INDIVIDUAL THROUGH MICRO, MESO,
MACRO LEVELS, EXTENDING TO
POLITICAL CONTEXT;
CONTEXTUALIZING, LEARNING FROM
HISTORY, CONSIDERING
DIFFERENTIAL IMPACT ACROSS THE
LIFE COURSE; SUPPORTING THE
RESEARCH ENTERPRISE BY ENSURING
WORKFORCE DIVERSITY AND
UPLIFTING THE VOICES OF THOSE
WITH LIVED EXPERIENCE AND I
WOULD JUST LIKE TO POINT OUT
MANY SCHOLARS ALSO HAVE RELEVANT
LIVED EXPERIENCE BECAUSE WE
OFTEN TALK ABOUT THE COMMUNITY
AND ACADEMICIANS AS SEPARATE AND
THAT'S NOT ALWAYS THE CASE.
ONE OF THE THINGS WE HEARD
YESTERDAY WAS ABOUT THE
IMPORTANCE EVER CENTERING
COMMUNITY VOICES AND RESEARCH TO
ADDRESS STRUCTURAL RACISM.
I'D LIKE TO TAKE MY TIME TODAY
TO EMPHASIZE THE IMPORTANCE OF
THAT.
A.J. ADKINS-JACKSON SAID
YESTERDAY --
[ NO AUDIO ]
I WANT TO HIGHLIGHT NIH EFFORTS
IN THIS AREA THAT ARE UPLIFTING
COMMUNITY SCIENCE.
SO THE NIH COMMUNITY ENGAGEMENT
ALLIANCE, CEAL PROGRAM,
IDENTIFIES ENGAGEMENT AND
OUTREACH PRACTICES FOR
COMMUNICATING TRUSTWORTHY
SCIENCE-BASED INFORMATION.
CARE FOR HEALTH IS BEING
LAUNCHED FROM THE OFFICE OF THE
DIRECTOR OF THE NIH, SEEKS TO
IMPROVE CLINICAL RESEARCH ACCESS
TO INFORM MEDICAL CARE AND
EXPAND NIH-FUNDED STUDIES.
FINALLY THE NATIVE COLLECTIVIVE
RESEARCH COLLECTIVE FINDS TRIBES
AND NATIVE AMERICANS SERVING IN
ORGANIZATIONS TO ADDRESS OPIOID
AND DRUG OVERDOSE CRISIS
BUILDING RESEARCH CAPACITY AND
INFRASTRUCTURE, SUPPORTING
COMMUNITY PRIORITIZED RESEARCH
AND DATA IMPROVEMENTS, ELEVATING
AND INTEGRATING INDIGENOUS
KNOWLEDGE AND CULTURE.
HEARING DIRECTLY FROM THOSE
EXPERIENCING STRUCTURAL RACISM
IS CRITICAL TO ADVANCING
RESEARCH IN THIS FIELD.
AND AS WE CONSIDER
INTERDISCIPLINARY APPROACHES WE
MUST EXPAND BEYOND ACADEMIC
DISCIPLINES TO ALSO INTEGRATE
LIVED EXPERIENCE AND COMMUNITY
KNOWLEDGE INCLUDING AT LEAST IN
THE FIELD I WORK IN, INDIGENOUS
KNOWLEDGE.
SO WE HAVE AN EXCITING DAY
PLANNED TODAY.
WE'LL CONSIDER ANTI-RACIST
APPROACHES TO DATA AND
MEASUREMENT FOR HEALTH EQUITY,
CULTIVATING CHANGE, RESEARCH
RELATIONSHIPS AMONG
INTERDISCIPLINARY PRACTITIONERS,
AND ALL THOSE PEOPLE WHO NEED TO
BE AT THE TABLE TO ADVANCE THE
SCIENCE, BEST PRACTICES GAPS AND
OPPORTUNITIES IN INTERVENTION
RESEARCH, WE'LL END TODAY WITH A
BREAKOUT SESSION FOR EVERYONE TO
SHARE THEIR PERSPECTIVES AND
RECOMMEND SEDATIONS, AND I --
RECOMMENDATIONS AND I HOPE MANY
OF YOU WILL JOIN.
THANK UPPING FOR ATTENDING THIS
DISCUSSION AND STRIVING TO MAKE
CHANGE THROUGH RESEARCH TO
INFORM POLICY AND PRACTICES.
THANK YOU.
>> THANK YOU FOR JOINING US FOR
DAY 269 WORKSHOP.
WE HAVE ANOTHER GREAT AGENDA
PLANNED FOR TODAY, I HOPE YOU'LL
BE ABLE TO STICK AROUND FOR AS
MUCH AS POSSIBLE.
I'M TIFFANY WALLACE, I WORK AT
THE NATIONAL CANCER INSTITUTE
WITHIN THE CENTER FOR CANCER
HEALTH EQUITY.
I HAVE THE DISTINCT HONOR TODAY
OF INTRODUCING OUR KEYNOTE
SPEAKER, DR. RACHEL HARDEMAN, A
PROFESSOR IN THE DIVISION OF
HEALTH POLICY AND MANAGEMENT AT
THE UNIVERSITY OF MINNESOTA
SCHOOL OF PUBLIC HEALTH, BLUE
CROSS ENDOWED PROFESSOR IN
HEALTH AND RACIAL EQUITY, AND
FOUNDING DIRECTOR OF THE CENTER
OF ANTI-RACISM RESEARCH FOR
HEALTH EQUITY.
DUE TO TIME WE CAN'T GO THROUGH
A FULL INTRODUCTION BUT I DO
ENCOURAGE YOU TO GO TO THE BIOS
FOR ALL OF OUR SPEAKERS, TO HEAR
THEIR AMAZING ACCOMPLISHMENTS.
BEFORE I TURN IT OVER TO DR.
HARDEMAN I WANTED TO REMIND
EVERYONE WE'RE ENGAGING WITH THE
AUDIENCE ON ZOOM, ON VIDEOCAST
THROUGH SLIDO.
IF YOU WEREN'T HERE YESTERDAY OR
FORGOT, YOU CAN SCAN THAT QR
CODE ON THE SCREEN RIGHT NOW,
IT'S ALSO IN THE DESCRIPTION
UNDER THE VIDEOCAST.
WE ENCOURAGE YOU TO SHARE YOUR
QUESTIONS, COMMENTS.
WE PROBABLY WON'T GET TO ALL.
YESTERDAY WE HAD GREAT QUESTIOS
SO THUMBS UP THE QUESTIONS YOU
MOST WANT TO HEAR BECAUSE WE'LL
TRY TO GO IN THAT ORDER.
I'LL TURN IT OVER TO DR.
HARDEMAN.
THANK YOU FOR YOUR PARTICIPATION
TODAY.
>> THANK YOU, TIFFANY, FOR THE
WARM INTRODUCTION, AND TO THE
NIH YOU UNITE TEAM TO THE INVIN
AND SHARE MY THOUGHTS AROUND
STRUCTURAL RACISM, PARTICULARLY
HOW WE LIFT UP THE VOICES OF THE
LIVED EXPERIENCES IN THOSE
CLOSEST TO THE PAIN OF
STRUCTURAL RACISM IN OUR WORK.
SO, I'M AGAIN HONORED TO SHARE
THIS VIRTUAL SPACE WITH YOU ALL
TODAY.
I HAD THE CHANCE TO LISTEN TO A
LOT OF THE PRESENTATIONS
YESTERDAY, AND WAS LEFT
INCREDIBLY EXCITED.
THERE WAS A TIME IN MY CAREER
PARTICULARLY AS A YOUNG DOCTORAL
STUDENT I NEVER COULD HAVE
DREAMED THESE CONVERSATIONS
WOULD BE HAPPENING AT THIS
LEVEL.
TO SEE ALL THE INCREDIBLE
INNOVATIVE WORK THAT'S BEING
DONE AND THE SCHOLARS ENGAGING
IN IT IS REALLY EXCITING.
FOR ME.
A LOT OF THE COMMENTS THAT I HAD
PREVIOUSLY PREPARED FOR THIS
MORNING, MANY WERE SHARED IN
SOME WAY, SHAPE, OR FORM
YESTERDAY, WHICH IS ALSO A
REALLY GOOD THING BECAUSE IT
MEANS AS A FIELD, AN
INTERDISCIPLINARY FIELD, WE'RE
COALESCING AROUND IMPORTANT
IDEAS, AND USING THE DATA WE
HAVE AVAILABLE TO MOVE THIS WORK
FORWARD.
IT ALSO MEANS THAT FOR ME, MY
WHAT I CALL ACADEMIC ANCESTORS
LAID THE GROUND WORK AND SLOWLY
BUT SURELY IT'S COMING TO
FRUITION.
I THINK IT'S IMPORTANT TO A
LITTLE WE'RE HERE, I'M HERE,
ABLE TO TALK ABOUT THIS WORK AND
TO SAY THE WORDS STRUCTURAL
RACISM IN A FORUM LIKE THIS
BECAUSE OF MANY SCHOLARS WHO
HAVE PAVED THE WAY TO CREATE THE
SPACE FOR THIS TO HAPPEN.
SO, THE INNOVATIVE WORK OF
MEASURING STRUCTURAL RACISM
ACHIEVED SORT OF A GROUNDSWELL
IN SO MANY WAYS.
AND I AM GOING TO SHARE A LITTLE
BIT ABOUT SOME OF THE WORK THAT
MY COLLEAGUES AND I ARE DOING AT
THE CENTER FOR ANTI-RACISM
RESEARCH FOR HEALTH EQUITY AT
THE UNIVERSITY OF MINNESOTA, BUT
I'M GOING TO START BY KIND OF
SHARING A LITTLE BIT ABOUT
HOW -- THE BEGINNINGS OF THAT
WORK, FOR ME, WHAT THAT LOOKED
LIKE AS SOMEONE TRAINED AS A
HEALTH SERVICES RESEARCHER AND A
POPULATION STUDIES SCHOLAR.
AND SO I'M BRINGING THOSE
DISCIPLINARY LENSES TO THIS
WORK.
I ALSO BRING THE LIVED
EXPERIENCE OF BEING A BLACK
FEMALE IDENTIFYING SCHOLAR,
WORKING IN PREDOMINANTLY WHITE
SPACES.
I BRING THE LIVED EXPERIENCE OF
BEING A MEMBER OF A BLACK FAMILY
WHERE MY MOTHER AT THE AGE OF 69
IS THE MATRIARCH OF OUR FAMILY
BECAUSE MY GRANDMOTHER AND GREAT
AUNTS ALL DIED FROM PREVENTIBLE
CAUSES RANGING FROM DIABETES TO
DOMESTIC VIOLENCE, WELL BEFORE
THE AGE OF 65.
AND I CARRY THIS REALITY WITH
ME.
AND THE UNRELENTING DESIRE,
REALLY, TO WANT MORE FOR MYSELF
AND FOR MY DAUGHTER, YOU KNOW,
AND THAT'S THE CHANCE TO AGE AND
TO GROW OLD AND TO NOT WORRY
ABOUT THE PREVENTIBLE DEATHS
THAT HAVE PLAGUED SO MANY BLACK
AND INDIGENOUS MEMBERS OF OUR
COMMUNITIES.
THE TITLE OF MY PRESENTATION IS
"WE HAVE RUN OUT OF TIME."
AND THAT TITLE AND THAT PHRASE
COMES FROM THE LATE GREAT
AFRICAN AMERICAN WRITER AND
ACTIVIST JAMES BALDWIN.
OF COURSE ONE OF THE MOST
NOTABLE CIVIL RIGHTS VOICES OF
THE MID-CENTURY, IN NORTH
AMERICA.
AND OVER 30 YEARS AGO JAMES
BALDWIN REFLECTED ON
FRUSTRATIONS WITH LACK OF
PROGRESS ADDRESSING RACISM IN
THE UNITED STATES STATING WHAT
IS IT YOU WANT ME TO RECONCILE
TO?
IT'S TAKEN MY FATHER'S TIME, MY
MOTHER'S TIME, MY UNCLE'S TIME,
MY BROTHERS AND MY SISTERS,
NIECES AND NEPHEWS, HOW MUCH
TIME DO YOU WANT FOR YOUR
PROGRESS?
SO, I REFLECT ON BALDWIN'S
QUESTION, HOW MUCH TIME DO YOU
WANT FOR YOUR PROGRESS.
AS I LOOK AT MY DAUGHTER, YOU
KNOW, GROW TALLER EACH YEAR
KNOWING SHE WILL BE PRESUMED TO
BE OLDER, LESS INNOCENT, AND
LESS IN NEED OF PROTECTION THAN
HER WHITE COUNTERPARTS AS EARLY
AS 5 YEARS OLD.
REFLECT ON BALDWIN'S QUESTION
BECAUSE AS A BLACK PARENT I KNOW
THE RISKS CHILDREN FACE WHEN HE
THEY LEAVE OUR SIDES IS
HEIGHTENED IN SIGNIFICANCE.
I THINK HAS A MOTHER, WE HIDE
THAT DEVASTAION, SILENT
DEVASTATION, AS WE PREPARE OUR
CHILDREN TO GO OUT INTO THE
WORLD KNOWING THAT THERE ARE
RISKS AS BLACKS IN BLACK BODIES.
I BELIEVE WE'VE RUN OUT OF TIME.
THE WORK WE HEARD ABOUT
YESTERDAY AND THE WORK HAPPENING
ACROSS THE COUNTRY IN THIS SPACE
IS INCREDIBLY URGENT AND
IMPORTANT FOR IMPROVING HEALTH
AND WELL-BEING AND SAFETY FOR
OUR COMMUNITIES.
THIS IMAGE MIGHT LOOK FAMILIAR.
I THINK DR. BROWN SHARED
SOMETHING SIMILAR YESTERDAY.
I USE THIS TO WALK US THROUGH,
HELP US THINK ABOUT WHERE WE'VE
BEEN BECAUSE SOMETIMES IT'S EASY
TO THINK WE HAVEN'T MADE THAT
PROGRESS, BUT WHEN I WAS A
DOCTORAL STUDENT, MASTER'S
STUDENT, JUST DIGGING INTO THE
FIELD OF RACIAL HEALTH EQUITY,
WE WERE IN THE SPACE OF
DOCUMENTING RACIAL DISPARITIES.
THEN WE LEARNED FROM STEPHEN
THOMAS WHO YOU'LL HEAR FROM
LATER TODAY ABOUT THE FOURTH
GENERATION OF RACIAL DISPARITY
RESEARCH, TAKING ACTION IN THAT
SPACE.
WE MOVED INTO UNDERSTANDING
RACISM AS A FUNDAMENTAL CAUSE OF
HEALTH INEQUITIES.
AND NOW IN THE SPACE WE HAVE
OPPORTUNITY TO DIG INTO THE
MEASUREMENT OF RACISM AND NOT
RACE, SO NO LONGER REALLY
CONTROLLING FOR RACE IN OUR
MODELS AND NOT TALKING ABOUT
RACISM AND HOW IT IS IMPACTING
HEALTH AND WELL-BEING, AND I
BELIEVE THAT BY FOCUSING OUR
EFFORTS, OUR TIME, OUR ENERGY,
OUR BRILLIANCE, OUR EXPERTISE
AND OUR MONEY, THIS MEASUREMENT
PIECE, WE'RE GOING TO BE ONE
STEP CLOSER TO WHAT I SEE AS THE
ULTIMATE GOAL OF DISMANTLING
RACISM SO EVERYONE LIVES A FREE,
LIBERATED, HEALTHY EXISTENCE IN
THE UNITED STATES AND BEYOND.
SO I THINK A FEW SCHOLARS MAY
HAVE SHOWN SIMILAR TIMELINE FOR
THIS ONE AS WELL, BUT I ALWAYS
MAKE SURE THAT WHEN WE'RE
TALKING ABOUT RACISM AND TALKING
ABOUT HEALTH INEQUITY THAT WE'RE
GROUNDING OURSELVES IN THE
HISTORY OF RACISM BECAUSE IT'S
IMPORTANT TO UNDERSTAND THAT TO
MOVE THE WORK FORWARD.
I DON'T HAVE TIME TODAY TO GO
THROUGH THAT HISTORY IN DETAIL,
IT'S IMPORTANT TO UNDERSTAND OUR
HISTORY OF RACISM AND WHITE
SUPREMACY IN THE UNITED STATES
AS SHAPED WHO WE ARE.
I THINK IT'S IMPORTANT TO ALSO
NOTE OR HAVE THAT IN MIND AS WE
THINK ABOUT THE DATA WE'RE USING
TO MEASURE STRUCTURAL RACISM OR
OTHER FORMS OF RACISM.
SO EVEN THOUGH WE'RE USING THOSE
DATA AND THOSE TOOLS TO
ULTIMATELY DISMANTLE RACISM, WE
HAVE TO BE THINKING ABOUT HOW
AND WHY THEY WERE CREATED AND
WHAT THEY ACTUALLY ARE TELLING
US.
OOPS.
AS WE THINK ABOUT THE TIMELINE
OF RACISM AND HEALTH RESEARCH,
HEALTH SERVICES RESEARCH, I
ALWAYS ENCOURAGE US TO REVISIT
THIS PAPER PUBLISHED IN 2002 BY
DR. CAMARA PHYLLIS JONES, I'VE
BECOME CONVINCED THAT IT IS ONLY
BY NAMING RACISM, ASKING THE
QUESTION HOW IS RACISM OPERATING
HERE, AND THEN MOBILIZINGS WITH
OTHERS TO CONFRONT AND DISMANTLE
THE LASTING IMPACTS ON THE
PERVASIVE RACISM FOR CENTURIES.
IN 2016, 14 YEARS AFTER DR.
JONES' PUBLICATION WHERE SHE
ASKED THAT WE ASK THE QUESTION
HOW IS RACISM OPERATING HERE, I
HAD THE PLEASURE OF WORKING WITH
INCREDIBLE COLLEAGUES AT THE
UNIVERSITY OF MINNESOTA TO LOOK
AT THE PUBLIC HEALTH LITERATURE
TO UNDERSTAND IF HER CLARION
CALL HAD BEEN HEARD.
WHAT WE FOUND IS AFTER LOOKING
AT THE 50 HIGHEST IMPACT PUBLIC
HEALTH JOURNALS, WE FOUND ONLY
25 ARTICLES NAMED STRUCTURAL
RACISM OR SYSTEMIC OR
INSTITUTIONAL RACISM, A SIMILAR
TERM, IN THE TITLE OR ABSTRACT,
BETWEEN 2002 WHEN DR. JONES MADE
THAT INITIAL STATEMENT TO 2015.
WE ALSO FOUND THAT STRUCTURAL
RACISM WAS ONLY REALLY A CORE
CONCEPT IN ABOUT HALF, LESS THAN
HALF OF THOSE 25 ARTICLES THAT
WE EXAMINED.
SO THEN WE FOLLOWED THAT WITH
WORK LED BY DR. MAYA BRUCE AND
COLLEAGUES AT TULANE TO
UNDERSTAND SO WE KNOW ONLY 25
ARTICLES ARE NAMING STRUCTURAL
RACISM, SOME OTHER FORM OF
RACISM, WHAT'S HAPPENING AROUND
THE MEASUREMENT OF STRUCTURAL
RACISM OR OTHER FORMS OF RACISM
IN THE PUBLIC HEALTH LITERATURE.
AND WHAT WE FOUND THERE IS THAT
20 ARTICLES INCORPORATED ACTUAL
MEASURES OF STRUCTURAL RACISM
AND THOSE DOMAINS ARE MANY OF
THE ONES WE HEARD DISCUSSED
YESTERDAY.
SO RESIDENTIAL NEIGHBORHOOD
HOUSING, PERCEIVED RAISESSISM,
SOCIAL INSTITUTIONS, IMMIGRATION
AND BORDER ENFORCEMENT,
POLITICAL PARTICIPATION,
SOCIOECONOMIC STATUS, CRIMINAL
JUSTICE, WORKPLACE ENVIRONMENT.
WHAT WE ALSO NOTED IN THIS
REVIEW MANY MEASURES WERE CHOSEN
BY THE RESEARCHERS DUE TO
AVAILABILITY OF PUBLIC DATA,
WHICH WAS THEN ANALYZED IN THE
CONTEXT OF DIFFERENT EXPERIENCES
ATTRIBUTED TO STRUCTURAL RACISM.
SO, AND WHAT WE ALSO FOUND IS
THAT STRUCTURAL RACISM WAS MOST
COMMONLY SORT OF EVALUATED
WITHIN THE RESIDENTIAL HOUSING
PATTERNS INCLUDING INDICES OF
RACIAL RESIDENTIAL SEGREGATION,
REDLINING OF COURSE, AND I THINK
AS WE DISCUSSED AND LEARNED OVER
THE PAST DAY IN THIS WORKSHOP,
YOU KNOW, MEASURES OF
SEGREGATION DON'T ALWAYS OFFER
THE FULL STORY.
I THINK WE TOOK AWAY FROM THAT
PUBLICATION REALLY THE
OPPORTUNITY AND LEARNING FOR
MORE INNOVATION WITHIN THE
MEASUREMENT SPACE, WHICH I WAS
SO EXCITED TO HEAR ABOUT
YESTERDAY WITH A LOT OF THE WORK
THAT WAS SHARED.
FINALLY, WE DID ONE LAST REVIEW
OF THE LITERATURE, THIS PAPER IS
HOT OFF THE PRESS FROM FEBRUARY
2024, WHERE WE DID A SCOPING
REVIEW AND THIS WORK WAS LED BY
INCREDIBLE COLLEAGUE AT THE
CENTER FOR ANTI-RACISM RESEARCH
FOR HEALTH EQUITY, DR. ANNA
HING.
AND WE WANTED TO SEE IF THE
LANDSCAPE AS MORE ATTENTION WAS
COMING TO THESE ISSUES AROUND
MEASUREMENT OF STRUCTURAL RACISM
AND ITS LINK TO HEALTH OUTCOMES
AND HEALTH EQUITY IF THE
LANDSCAPE HAD SHIFTED AT ALL, AS
MORE ATTENTION AND AWARENESS WAS
COMING TO THESE ISSUES.
WHAT DR. HING AND THE REST OF
THE TEAM IDENTIFIED WERE SEVERAL
THEMES FROM THE RECENT
LITERATURE, CURRENT PREDOMINANT
FOCUS ON MEASURING ANTI-BLACK
RACISM USING RESIDENTIAL
SEGREGATION CONTINUES, AS WELL
AS OTHER SEGREGATION DRIVEN
MEASURES OF AS PROXIES OF
STRUCTURAL RACISM.
LOTS OF WORK IS BEGINNING AROUND
STRUCTURAL RACISM AS A SPATIAL
EXPOSURE, WHICH I'LL TALK ABOUT
A LITTLE BIT MORE.
WE ALSO NOTED AN INCREASING CALL
BY EPIDEMIOLOGISTS AND OTHER
HEALTH RESEARCHERS TO MEASURE
STRUCTURAL RACISM AS A
MULTI-DIMENSIONAL OR MULTI-LEVEL
DETERMINANT OF HEALTH, WHICH WE
ALSO LEARNED A LITTLE BIT ABOUT
YESTERDAY, FROM DR. TYSON-BROWN
AND OTHERS.
AND I THINK WHAT THIS PIECE HAS
DONE, WHAT THIS PARTICULAR STUDY
HAS DONE, IS REALLY LAID OUT
SOME OF THE EXCITING AND
IMPORTANT OPPORTUNITIES FOR MORE
WORK BEING DEVELOPED IN THIS
FIELD.
SORRY ABOUT THAT I THINK THIS IS
THE LAST PAPER, BUT AS THIS
PAPER WRITTEN BY MYSELF, DR.
TYSON BROWN, DR. PATRICIA HOMAN,
DR. CHANTARAT AND DR. DAVIS, WE
CALLED FOR RESEARCH ON STUDIES
ON THE LINKS BETWEEN RACISM AND
HEALTH BY OUTLINING OUR THOUGHTS
AND OFFERING OUR THOUGHTS AROUND
METHODOLOGICAL APPROACHES THAT
WILL MOVE THE FIELD FORWARD.
I'M GOING TO SHARE SOME OF OUR
THOUGHTS FROM THIS PAPER, BUT
MORE SO AS OPPORTUNITIES I THINK
FOR FUTURE WORK AND INNOVATION,
FOR RESEARCHERS AND ACADEMICS.
I THINK THERE'S AN OPPORTUNITY
TO REALLY THINK ALSO, FOR
FUNDERS, RIGHT, WHAT ARE THE
DIRECTIONS WE SHOULD BE HEADING
WITH THIS WORK AND HOW DO WE
KNOW IT'S TRULY AUTHENTIC, YOU
KNOW, AND COMING FROM AND
REPRESENTING THE PEOPLE WHO ARE
MOST MARGINALIZED AND HARMED BY
RACISM IN OUR SOCIETY.
SO, IN THIS PAPER WE TALK, WE
FIRST HIGHLIGHT HOW THE HISTORY
OF RACISM IN THE U.S. AFFECTS
THE WAYS THAT WE SHOULD BE
APPROACHING THE MEASUREMENT OF
STRUCTURAL RACISM AND ITS
EFFECTS ON HEALTH.
WE HEARD SOME OF THAT FROM DR.
PARIS JACKSON YESTERDAY WHEN SHE
TALKED ABOUT HER WORK IN
UNDERSTANDING HISTORICKIC
LUNCHING AND ITS IMPACT ON
HEALTH OUTCOMES AND OTHER WORK
AS YOU CAN SEE ON THE SLIDE THAT
HAS ALSO SPOKEN TO THAT
HISTORICAL CONTEXT.
THERE'S IMPORTANT OPPORTUNITIES
TO CONTINUE UNDERSTANDING
HISTORY OF RACISM IN THE UNITED
STATES AND THE LONG-TERM IMPACT
THAT IT'S HAD AND GENERATIONAL
IMPACT ON HEALTH AND WELL-BEING
FOR BLACK COMMUNITIES IN
PARTICULAR, FROM FORCED
STERILIZATION TO UNEQUAL
TREATMENT IN THE CRIMINAL LEGAL
SYSTEM, AND BEYOND.
AND SO THINKING ABOUT WHAT
STUDIES ARE ACCURATELY AND
AUTHENTICALLY GETTING AT SOME OF
THOSE HISTORIC REALITIES IS
INCREDIBLY IMPORTANT FOR MOVING
THIS WORK FORWARD.
AND THEN OF COURSE WE HAVE THE
GEOGRAPHY CONUNDRUM.
WE KNOW THAT STRUCTURAL RACISM
MANIFESTS ITSELF IN DIFFERENT
WAYS ACROSS GEOGRAPHIC CONTEXTS,
MEANING WE HAVE TO DETERMINE HOW
SPACE AND PLACE, ADMINISTRATIVE
AND CULTURE AND CIVIC BOUNDARIES
OPERATE AND INTERACT TO PRODUCE
AND MAINTAIN THE STRUCTURES OF
INEQUITY AND STRUCTURES OF
RACISM.
THIS IS SOMETHING THAT OUR TEAM
AT THE CENTER HAS BEEN GRAPPLING
WITH AND THINKING ABOUT QUITE A
LOT.
THERE ARE NO EASY ANSWERS OTHER
THAN TO SAY WE HAVE TO ENSURE
THE GEOGRAPHIC UNITS THAT WE'RE
STUDYING ARE ALIGNED WITH THE
APPROPRIATE THEORY AND RESEARCH
QUESTIONS THAT WE'RE USING TO
MEASURE STRUCTURAL RACISM.
AND, YOU KNOW, I THINK I WOULD
ENCOURAGE THE FUNDERS WHO ARE
JOINING US TODAY AS YOU'RE
REVIEWING PROPOSALS AND
APPLICATIONS ASKING IS THIS
GEOGRAPHIC UNIT OF MEASUREMENT
BEING PROPOSED ALIGNED WITH THE
THEORY, THE COMMUNITY, THE
RESEARCH QUESTIONS BEING
PROPOSED.
ALSO IN THIS PAPER DR. BURDETTE
DAVIS WRITES ABOUT THE MEASURING
OF STRUCTURAL RACISM AT
DIFFERENT GEOGRAPHIC SCALES, SO
CENSUS TRACT, COUNTY OR STATE,
AND PARTICULARLY SHE RAISES THE
MODIFIABLE AREA UNIT PROBLEM
THAT CONTRIBUTES TO, AS WE KNOW,
INCONSISTENT FINDINGS CONCERNING
THE HEALTH IMPACTS ON STRUCTURAL
RACISM, OR DUE TO STRUCTURAL
RACISM.
AND THAT PROBLEM ARISES BECAUSE
OF THE BOUNDARIES DESIGNED TO
GROUP POPULATIONS ARE QUITE
ARBITRARY, APPROXIMATIONS OF
DEMOGRAPHICS OF UNDERLYING
POPULATION, AS BOUNDARIES CHANGE
THE DENOMINATORS AND NUMERATORS
THAT ARE BEING MEASURED ARE ALSO
CHANGING, WHICH, YOU KNOW,
CAUSES CHALLENGES IN HOW THE
WORK IS DONE.
AND WE OFFER THE PAPER REAL LIFE
EXAMPLE OF THE MODIFIABLE AREA
UNIT PROBLEM, WHICH IS ALSO
IRONICALLY A SOURCE,
REDISTRICTING AND GERRYMANDERING
TO CHANGE POLITICAL LANDSCAPES
BY CHANGING WHICH RESIDENTS ARE
WITHIN WHICH BOUNDARIES OF A
GIVEN COMMUNITY OR NEIGHBORHOOD.
SO, WE'RE REALLY ENCOURAGING
THEORY-DRIVEN APPROACHES IN
WHICH THE APPROPRIATE GEOGRAPHIC
UNIT IS SELECTED ON THE BASIS OF
THE PROPOSED UNDERLYING
MECHANISMS OF STRUCTURAL RACISM.
AND I THINK THIS ALSO OFFERS AN
OPPORTUNITY TO BRING IN THAT
COMMUNITY VOICE AND THAT LIVED
EXPERIENCE VOICE IN A VERY
INTENTIONAL WAY TO SORT OF THINK
ABOUT AND MAKE SURE THAT ALL OF
THOSE PIECES ARE APPROPRIATELY
ALIGNED.
WE LEARNED A LOT ABOUT NOVEL
METHODS BEING USED TO MEASURE
RACISM OVER THE LAST DAY, AND
I'M SEEING THAT NEW AND EXCITING
METHODS COMING OUT ALL THE TIME
NOW, WHICH IS, YOU KNOW, REALLY
EXCITING.
SO I'M NOT GOING TO SPEND A TON
OF TIME HERE.
I WILL SAY THAT WHAT -- YOU
KNOW, THOSE THREE REVIEW PAPERS
I SHARED WITH YOU A FEW MINUTES
AGO, YOU KNOW, HAVE REALLY FOUND
THAT WE'VE STUCK TO THE SORT OF
LANE OF THOSE, YOU KNOW, FEW
DOMAINS THAT WE HAVE PUBLIC
DATA, YOU KNOW HAVE ACCESS TO AS
SORT OF THE WAYS THAT WE'RE
MEASURING STRUCTURAL RACISM.
AND SO I THINK THERE ARE SO MANY
OPPORTUNITIES TO GET CREATIVE
WITH THE DATA THAT WE -- EVEN
PUBLICLY AVAILABLE DATA, AND TO
THINK ABOUT THINGS A LITTLE BIT
DIFFERENTLY, AND SO I AM
ENCOURAGED TO SEE WHAT'S
HAPPENING ACROSS THE FIELD RIGHT
NOW IN THAT SPACE.
I THINK ONE OF THE THINGS WE'VE
LEARNED HERE IS IN MINNESOTA IS
IN THAT CREATIVITY -- A LOT OF
THAT CREATIVITY AND INNOVATION
AND SORT OF NEW FRESH IDEAS FOR
HOW STRUCTURAL RACISM IS SHOWING
UP IN PEOPLE'S LIVES, THEIR
NEIGHBORHOODS, THEIR
COMMUNITIES, REQUIRES COMMUNITY
INPUT.
SO, A FEW YEARS AGO HERE IN THE
TWIN CITIES WE HOSTED COMMUNITY
CONVERSATIONS TO TALK ABOUT
STRUCTURAL RACISM AND HOW IT
STARTED SHOWING UP IN DIFFERENT
WAYS IN THE COMMUNITIES
SURROUNDING THE UNIVERSITY OF
MINNESOTA.
WE LEARNED A LOT FROM THE FOLKS
WHO PARTICIPATED IN THOSE GROUPS
ABOUT SORT OF THE DIFFERENT
DOMAINS OF STRUCTURAL RACISM
THAT WE HAD NOT YET BEEN ABLE TO
CAPTURE, YOU KNOW,
QUANTITATIVELY BECAUSE SOME OF
THEM ARE JUST -- FIRST THEY ARE
DYNAMIC, CHANGING OVER TIME, AND
ALSO, YOU KNOW, I THINK THERE'S
NUANCES THAT ARE VERY MUCH
COMMUNITY BASED OR NEIGHBORHOOD
BASED THAT ARE REALLY
CHALLENGING TO CAPTURE BUT COULD
END UP BEING ONE -- YOU KNOW,
SOME OF THE MOST SALIENT OR
IMPORTANT CONCERNS FOR A GIVEN,
YOU KNOW, COMMUNITY.
SO I'M GOING TO SPEND THE LAST
BIT OF MY TIME WITH YOU ALL
SHARING A FEW EXAMPLES OF HOW WE
ARE -- I WILL SAY IMPERFECTLY
INCORPORATING COMMUNITY INTO THE
WORK WE'RE DOING AROUND THE
MEASUREMENT OF STRUCTURAL
RACISM.
I SAY IMPERFECTLY BECAUSE IT
TAKES A LOT OF WORK AND
INTENTION, TIME, RESOURCES, TO
DO THIS IN THE RIGHT WAY.
AND SO WE'VE HAD SOME -- I'VE
PERSONALLY HAD A LOT OF
LEARNINGS AND SORT OF, YEAH,
LEARNINGS ALONG THE WAY AROUND
SORT OF HOW TO DO THIS WELL.
SO IT'S A WORK IN PROGRESS.
BEFORE I START WITH THAT I HAVE
TO -- I LOVE THIS STATEMENT BY
DR. PARIS ADKINS JACKSON
YESTERDAY WHERE SHE SAID AFTER
TALKING ABOUT ALL OF THE
INCREDIBLE QUANTITATIVE WORK SHE
WAS DOING AROUND THE MEASUREMENT
OF STRUCTURAL RACISM, SHE SAID
THE BEST WAY TO MEASURE
STRUCTURAL RACISM IS
QUALITATIVELY.
PERIOD.
AND SO I HAD TO PUT THAT IN
THERE BECAUSE I FULLY AGREE.
I THINK BOTH ARE IMPORTANT, YOU
KNOW, I WOULD REFER TO MYSELF AS
A MIXED METHODS RESEARCHER, BUT
THE QUALITATIVE, THE STORIES,
THE PEOPLE, AND GETTING TO KNOW
THE PEOPLE, WHAT THEY ARE
DEALING WITH AND GRAPPLING WITH
ON A DAY-TO-DAY BASIS IS REALLY
CRITICAL FOR INFORMING THIS WORK
MOVING FORWARD.
AND SO ONE EXAMPLE OF THAT, THAT
WE'RE DOING HERE IN MINNESOTA,
WELL, IN A COUPLE OTHER PLACES
AS WELL, IS THE BEARING WITNESS
STUDY, WHICH IS A
COMMUNITY-CENTERED RESEARCH
STUDY WHERE WE ARE AIMING TO
IDENTIFY HOW STRUCTURING AND
INSTITUTIONAL RACISM AFFECT
REPRODUCTIVE HEALTH FOR BLACK
WOMEN AND BLACK BIRTHING PEOPLE,
AND THE GOAL OF THE STUDY IS TO
CENTER THE STORIES AND LIVED
EXPERIENCES ABOUT ACCESSING
HEALTHCARE DELIVERY SYSTEMS OVER
THE COURSE OF PREGNANCY,
POSTPARTUM PERIOD, BEFORE
BLACK-BIRTHING PEOPLE AND TO
REALLY DEVELOP AN UNDERSTANDING
OF THE LANGUAGE OF THE
EXPERIENCES OF RACISM THAT CAN
BE USED TO INFORM HOW WE
MEASURE -- HOW WE'RE
OPERATIONALIZING AND MEASURING
STRUCTURAL INSTITUTIONAL RACISM
AS A FUNDAMENTAL CAUSE OF HEALTH
INEQUITIES.
SO, WE'RE CURRENTLY FINISHING UP
DATA COLLECTION ACROSS THREE
SITES, UNIVERSITY OF PITTSBURGH
SITE IS RUN BY DR. SARAH MENDEZ,
THE SACRAMENTO SITE OUT OF
UC-DAVIS IS RUN BY DR. KIMBERLY
CHAMBERS, HOW STRUCTURAL AND
OTHERS FORM OF RACISM ARE
IMPACTING REPRODUCTIVE HEALTH
OUTCOMES FOR BLACK WOMEN IN
CALIFORNIA.
OUR FINDINGS WILL BUILD ON THAT
MODEL, AND WE'RE ALREADY SEEING
SOME MORE DOMAINS AND ELEMENTS
THAT WE'LL BE BRINGING INTO THAT
WORK BASED ON WHAT WE'RE HEARING
FROM THE PARTICIPANTS IN OUR
SISTER CIRCLES.
THE MINIMUMS DATA COLLECTION AND
LEADERSHIP IS BEING LED BY DR.
JE JETSON AND ROON MAKHAL AND A
SHOUT OUT TO DR. PARIS ADKINS
JACKSON TO DEVELOP THE IDEAS FOR
SISTER CIRCLES IN THE INITIAL
WORK IN THIS STUDY.
BUT WHAT WE'RE -- OVERALL WE'RE
SEEING REALLY INTERESTING AND
ROBUST DIALOGUES RELATED TO HOW
STRUCTURAL INSTITUTIONAL RACISM
MANIFESTS IN BLACK PREGNANT AND
BIRTHING PEOPLE'S LIVES.
WE'RE SEEING SOME INTERESTING
SIMILARITIES.
WE HAVE THIS EAST COAST SITE,
MIDWEST SITE, AND A WEST COAST
SITE.
WHAT WE'RE SEEING IS ABSOLUTELY
THERE ARE SOME SIMILARITIES
AROUND -- ACROSS ALL THOSE
GEOGRAPHIC LOCATIONS AROUND HOW
RACISM IS EXPERIENCED.
YOU KNOW, SO THINGS LIKE IN THE
SCHOOL SYSTEM, EDUCATION SYSTEM,
PRISON AND INCARCERATION,
WORKPLACE, MEDICAL FACILITIES,
BUT THEN WE'RE ALSO GETTING TO
PICK UP ON INTERESTING NUANCES
THAT WE'LL TALK ABOUT IN FUTURE
PUBLICATIONS ACROSS THESE
GEOGRAPHIC REGIONS WHICH I THINK
WILL BE IMPORTANT FOR HELPING TO
INFORM US IN THAT SORT OF --
THOSE GEOGRAPHY QUESTIONS AND
CHALLENGES THAT I PREVIOUSLY
MENTIONED.
ANOTHER WAY WE ARE THINKING
ABOUT AND TRYING TO LEAD THE
CHARGE AND THE MEASURING OF
STRUCTURAL RACISM AND INFORMING
AND ENSURING THAT COMMUNITY IS
WALKING THAT PATH WITH US IS
THROUGH THIS PROGRAM, IGNITE THE
PARK SCHOLARS PROGRAM.
WE JUST YESTERDAY OR THE DAY
BEFORE MADE THE ANNOUNCEMENT OF
THESE INCREDIBLE SIX SCHOLARS,
JUNIOR SCHOLARS, WHO HAVE BEEN
FUNDED THROUGH OUR PROGRAMMING.
SO THE MISSION OF IGNITE THE
SPARK SCHOLARS PROGRAM IS TO
BUILD UP CAPACITY AMONG EARLY
CAREER SCHOLARS COMMITTED TO
DEVELOPING NOVEL MEASURES AND
APPROACHES TO STUDYING
STRUCTURAL RACISM AND ITS IMPACT
ON POPULATION HEALTH.
AND SO OUR VISION AND OUR GOAL
HERE IS REALLY TO EXPAND THE
FIELD KNOWLEDGE BASE ON
STRUCTURAL RACISM, AND ITS
IMPACT ON HEALTH, WHILE ALSO
INCLUDING COMMUNITY PARTNERS IN
LEADING THAT WORK.
SO EACH OF THE SCHOLARS THAT
WERE FUNDED AS YOU SEE ON THE
SCREEN BRING WITH THEM A
COMMUNITY PARTNER, SO DR. LEAH
BELL'S COMMUNITY PARTNER IS IOWA
BLACK DOULA COLLECTIVE HELPING
WITH THE STUDY IN THE
REPRODUCTIVE HEALTH SPACE.
DR. GONZALEZ, HER COMMUNITY
PARTNER IS COMMUNITY PARTNER.
DR. LEBRON WILL BE WORKING WITH
ENVIRONMENTAL -- SOME
ENVIRONMENTAL JUSTICE GROUPS.
AND OTHER SCHOLARS WORKING WITH
LACTATION SUPPORT SERVICES,
NEWARK ORGANIZATION FOR
COMMUNITY SOLUTIONS AND SO ON.
THIS IS A REALLY EXCITING
OPPORTUNITY BOTH TO LEARN FROM
AND WORK ALONGSIDE JUNIOR
SCHOLARS WHO ARE BEING REALLY
INNOVATIVE WITH WHAT THEY ARE
PROPOSING AND HOW THEY ARE
THINKING ABOUT MAKING THESE AND
UNDERSTANDING THESE LINKS
BETWEEN STRUCTURAL RACISM AND
HEALTH OUTCOMES, AND ALSO THEY
ARE COMING IN WITH A DEEP
RELATIONSHIP WITH A COMMUNITY
PARTNER WHO IS JUST AS INVESTED
IN THE WORK AND WILL BE WALKING
ALONGSIDE THEM AS THEY DEVELOP
THEIR RESEARCH.
SO, STAY TUNED FOR MORE AS WE --
YOU KNOW, AS THAT PROGRAM MOVES
ON.
SO THEN I WILL CLOSE WITH A
COUPLE OF -- SORT OF LAST WAY
WE'RE THINKING ABOUT THE
MEASUREMENT OF RACISM AS WELL AS
SORT OF WHAT THAT MEANS FOR OUR
COMMUNITIES.
I WAS GOING TO USE CLICK ON THE
LINK BUT IT WILL BE TOO TOO MUO
NAVIGATE TO THE VIDEO.
I HAD THE OPPORTUNITY TO SPEAK
AT ASPEN HEALTH AND SHARE WORK
WE'RE DOING AT THE CENTER FOR
ANTI-RACISM RESEARCH AND HEALTH
INEQUITY.
WE'VE STRUGGLED FOR A LONG TIME
TO ANSWER DR. CAMARA JONES'S
QUESTION, HOW IS RACISM
OPERATING HERE, AND I
APPRECIATED DR. TYSON BROWN'S
CLOSING SLIDE YESTERDAY, HE
SUGGESTED WE REALLY NEED TO BE
MOVING FORWARD WITH SOME SORT OF
DATA INFRASTRUCTURE TO BE ABLE
TO EFFECTIVELY MEASURE RACISM
AND ITS IMPACT ON HEALTH OR
OTHER OUTCOMES.
AND THAT'S EXACTLY WHAT WE'RE
DOING AT THE CENTER FOR
ANTI-RACISM RESEARCH FOR HEALTH
EQUITY.
WE'RE A FEW YEARS INTO THE WORK.
IT'S INCREDIBLY CHALLENGING BUT
WE'RE WORKING ON CREATING THE --
THERE WE GO -- THE MEASURING
RACISM DATA PORTAL, WHICH HAS A
GOAL, WE HAVE THE GOAL OF
CREATING A DATA REPOSITORY OF
VARIABLES THAT ARE
OPERATIONALIZED AS WELL AS
MEASURES, MULTI-DIMENSIONAL
MEASURES OF STRUCTURAL RACISM
MIGHT LIVE IN THE DATA PORTAL AS
WELL.
IT WILL BE A NATIONAL
POPULATION-LEVEL GEO DATABASE OF
QUANTIFIABLE MEASURES, OF
VARIABLES OF STRUCTURAL RACISM
LINKED WITH HEALTH DATA,
CLINICAL DATA.
AND MY COMMITMENT TO COMMUNITY
AND OUR COMMITMENT TO COMMUNITY
MEANS THAT THIS DATA PORTAL WILL
NOT BE BUILT SIMPLY FOR THOSE
WHO ARE RESEARCHERS LIKE US, BUT
REALLY TO MAKE IT USABLE FOR
ANYONE WHO WANTS TO ANSWER THE
QUESTION OF HOW IS RACISM
OPERATING HERE IN THEIR
COMMUNITY, IN THEIR
NEIGHBORHOOD, IN THEIR CENSUS
TRACT, IN THEIR STATE, ACROSS
THE COUNTRY.
SO, YOU KNOW, JUST AS I WOULD
IMAGINE ANY OF US, YOU KNOW,
USING THAT DATA TO ANSWER OUR
OWN RESEARCH QUESTIONS, YOU
KNOW, I WOULD SEE A STAFF MEMBER
FOR COMMUNITY ORGANIZATION IN
MINNESOTA PERHAPS WHO WANTS TO
UNDERSTAND HOW REDLINES AS A
RACIST POLICY IMPACTED RACIAL
INEQUALITIES AND PRE-TERM BIRTH
RATES AND WOULD BE ABLE TO COME
USE THE PORTAL TO SEARCH ON
REDLINES, RESIDENTIAL
SEGREGATION, HOME MORTGAGE,
DOWNLOAD THAT DATA, OR USE DATA
VISUALIZATION TO TELL THE STORY
THEY NEED TO TELL FOR A GRANT
APPLICATION, REPORT,
PRESENTATION OF SOME SORT.
THIS WORK IS BEING LED BY --
CO-LED BY MYSELF, DR. ANNA HING
AND JULIA STAN TOZNIK, AND OUR
PARTNERS, MANY OF WHO YOU SEE ON
THE SLIDE, PERFECT TIMING, I'M
GETTING THE WRAP-IT-UP CHIMES.
NONE OF THE WORK WE DO CAN BE
DONE ALONE.
THIS IS A SLIDE OF OUR PARTNERS,
OUR STAFF, OUR STUDENTS, WHO I'M
INCREDIBLY GRATEFUL FOR, I ALSO
NEED TO SHOUT OUT OUR FUNDERS,
PARTICULARLY FOR THE DATA PORTAL
WORK, BEARING CONDITIONS FUNDED
BY THE COMMONWEALTH FUND, WE'RE
GRATEFUL TO THE NATIONAL
INSTITUTES OF HEALTH, BLUE
CROSS, GOOGLE HEALTH, MASONIC
INSTITUTE FOR THE DEVELOPING
BRAIN.
I THINK I WILL CLOSE THERE.
I LOOK FORWARD TO YOUR
QUESTIONS.
THANK YOU.
>> THANK YOU FOR A POWERFUL AND
INFORMATIVE PARTICULAR.
TALK.
I'LL ENCOURAGE PEOPLE TO
CONTINUE TO SUBMIT QUESTIONS
THROUGHOUT THE Q&A.
I THINK WE HAVE FIVE MINUTES FOR
QUESTIONS, BUT I'M GOING TO GO
IN ORDER OF WHAT I HAVE
HIGHLIGHTED HERE.
SO THE FIRST QUESTION WE HAVE IS
CAN YOU SPEAK TO THE DIFFERENCE
IN TERMINOLOGY WHEN USING
INSTITUTIONAL VERSUS STRUCTURAL
RACISM?
>> SURE.
I'M GLAD THAT THAT QUESTION WAS
ASKED.
I THINK AS A FIELD, AS A
DISCIPLINE, I'M A HEALTH
SERVICES RESEARCHER.
FIELD OR DISCIPLINE I'M TALKING
ABOUT HEALTH RESEARCH, PUBLIC
HEALTH BROADLY.
WE'VE NOT COALESCED AROUND
SPECIFIC DEFINITIONS OF
STRUCTURAL RACISM VERSE U.S.
INSTITUTIONAL RACISM VERSUS
SYSTEMIC.
AND WE STRUGGLED WITH THAT IN A
LOT OF OUR -- IN OUR -- THE
THREE REVIEW PAPERS THAT I
SHARED AND DECIDED TO BROADEN
THE SCOPE OF THE USE OF THOSE
TERMS.
FOR ME PERSONALLY WHEN I THINK
ABOUT STRUCTURAL RACISM, I'M
THINKING ABOUT -- YOU KNOW, I'M
THINKING ABOUT DR. BAILEY'S
DEFINITION, TOTALITY OF WAYS
DIFFERENT PARTS OF THE SOCIETY
PERPETUATE INEQUITY WHETHER
THROUGH HEALTH CARE,
INCARCERATION, YOU KNOW, HOME
LENDING PROCESSES.
WHEN I THINK ABOUT INSTITUTIONAL
RACISM, I'M THINKING OR SPEAKING
MORE TO SORT OF THE WAYS THAT
VARIOUS INSTITUTIONS WHETHER
IT'S THE ACADEMY OR POLICING AS
AN INSTITUTION ARE INFORMING OR
PERPETUATING HARM IN THE
RACIALLY DIFFERENCES.
WE USE BOTH TERMS AND ASK IN TE
CIRCLES WHAT FOLKS SEE AS A
DIFFERENCE THERE.
IT'S BEEN INTERESTING.
I HAVEN'T LOOKED AT ALL OF THE
DATA YET, BUT BASED ON WHAT SOME
OF OUR TEAM MEMBERS ARE SHARING
MOST FOLKS, MOST LAYPEOPLE,
AREN'T MAKING THAT DISTINCTION.
I THINK A LOT OF YOU WILLS IN
THE ACADEMY AREN'T EITHER.
BUT FOR US WE WERE INTENTIONAL
IN TEASING OUT BOTH IN THAT
STUDY BECAUSE I WAS CURIOUS TO
KNOW SORT OF WHAT'S HAPPENING IN
THE -- YOU KNOW, AROUND THE
HEALTHCARE DELIVERY SPACE AS
WELL AS SORT OF WHAT'S HAPPENING
OUTSIDE OF THAT SPACE, YOU KNOW,
EVERYDAY LIFE, THE WORKPLACE,
THE NEIGHBORHOOD, YOU KNOW, THAT
PEOPLE -- MORE OF THE SOCIAL
CONTEXT AND STRUCTURAL INEQUITY
PIECE AS WELL.
>> THANK YOU.
I HAVE A QUICK ONE I'LL THROW AT
YOU.
WHEN WILL THE PORTAL BE READY TO
USE?
>> OH, THAT'S ACTUALLY THE
HARDEST QUESTION EVER.
I DON'T KNOW.
WE'RE MOVING TOWARDS A MINIMAL
VIABLE PRODUCT RIGHT NOW.
SO IT'S NOT PUBLIC YET BUT WE
CAN GO IN THERE AND SORT OF
CLICK AROUND.
AND WE'RE STARTING SLOWLY, AND
ADDING PUBLICLY AVAILABLE DATA
AND THEN DATA THAT'S BEING
SHARED IN AGREEMENT WITH
PARTNERS.
I I DON'T WANT TO SAY A TIMELINE
RIGHT NOW BECAUSE I DON'T WANT
Y'ALL TO HOLD ME TO IT.
>> FAIR ANSWER.
THAT'S FINE.
>> IF FOLKS HAVE IDEAS, THIS IS
A TEAM SPORT.
EVEN -- MANY SPEAKERS WHO WE
HEARD FROM YESTERDAY HAVE
SUPPORTED AND ENGAGED WITH US IN
THIS WORK, AND WE'LL BE PUTTING
OUT MORE CALLS AROUND THAT AS
WELL.
SO STAY TUNED BECAUSE THERE'S A
LOT OF GREAT WORK HAPPENING THAT
WE CAN ALL -- YOU KNOW, IDEAS,
IT'S FOR THE PUBLIC DOMAIN.
IT'S FOR ALL OF US TO BE ABLE TO
USE IN THE WAYS THAT WE NEED IT.
>> OKAY.
WE HAVE TIME FOR ANOTHER
QUESTION.
I'LL DOUBLE CHECK WHEN WE'RE
DONE.
CAN YOU SPEAK TO THE CHALLENGE
FOR EARLY CAREER SCHOLARS FOR
ESTABLISHING RELATIONSHIPS WITH
COMMUNITY ORGANIZATIONS?
THESE RELATIONSHIPS CAN TAKE
YEARS TO ESTABLISH AND SOMETIMES
THIS POSES A CHALLENGE FOR THOSE
WHO ARE EARLY CAREER AND DEVOTED
TO DOING THIS WORK BUT HAVE NOT
YET HAD THE TIME.
>> YEAH, I MEAN, I'M GETTING THE
MESSAGE WE'RE AT TIME, AND THIS
IS A QUESTION THAT TAKES A LOT
OF TIME TO ANSWER.
IT IS HARD.
AND IT'S COMPLETELY IMPERFECT.
AND I THINK A LOT OF OUR
INSTITUTIONS DON'T VALUE THE
TIME IT TAKES TO DO THAT WELL.
AND AS A RESULT, IT EITHER
DOESN'T HAPPEN OR DOESN'T HAPPEN
IN REAL AND AUTHENTIC WAYS.
AND I THINK FOR US, EVEN IN
FUNDING THE SPARC PROGRAM, SPARC
SCHOLARS, THAT WE CERTAINLY HAD
APPLICANTS WHO DIDN'T HAVE A
STRONG ENOUGH PARTNERSHIP
ALREADY, RIGHT?
AND WHEN YOU'RE TALKING ABOUT A
15-MONTH TIMELINE FOR THE WORK,
YOU HAVE TO COME IN WITH THAT.
AND IT'S REALLY, REALLY HARD TO
DO THAT.
I'M SEEING MORE DOCTORAL
STUDENTS ACTUALLY BEING
INTENTIONAL ABOUT BUILDING THOSE
RELATIONSHIPS SO BY THE TIME
THEY ARE IN THE FACULTY SPACE
THAT RELATIONSHIP IS STRONG.
BUT I THINK WE HAVE A LOT OF
WORK TO DO STILL, YOU KNOW, AS
RESEARCHERS TO CREATE THE SPACE
AND OPPORTUNITY AND THE TIME TO
BUILD THAT.
I WOULD LOVE TO SEE THAT BEING
MORE WIDELY ACCEPTED IN LIKE,
YOU KNOW, GRANT PROPOSALS,
RIGHT?
SO IN THAT FIRST YEAR OR TWO
THAT RELATIONSHIP IS, YOU KNOW,
BEING BUILT BECAUSE THAT TAKES
TIME AND THAT TAKES, YOU KNOW,
MONEY AND ENERGY AND ALL OF THE
THINGS.
>> THANK YOU SO MUCH.
WE'RE AT TIME.
THAT WAS REALLY GREAT.
>> THANK YOU SO MUCH FOR HAVING
ME.
>> ABSOLUTELY.
WE'RE GOING TO MOVE TO OUR NEXT
SESSION WHICH IS ACTUALLY A
PANEL DISCUSSION.
I'M GOING TO TURN IT OVER TO THE
CO-MODERATORS DR. MONICA WEBB
HOOPER AND I BELIEVE BARBARA
OUDEKERK IS HERE TO JOIN US.
THANK YOU SO MUCH.
>> THANK YOU, TIFFANY.
WHAT A GREAT SESSION TO START
DAY 2 OF THE WORKSHOP.
SO I AM DELIGHTED TO BE HERE
THIS MORNING TO CO-MODERATE THIS
SESSION, WHICH IS SESSION 4 ON
CULTIVATING CHANGE.
WE WILL FOCUS ON RESEARCH
RELATIONSHIPS AMONG
INTERDISCIPLINARY RESEARCHERS,
COMMUNITY PARTNERS, GOVERNMENT
AGENCIES, AND THE PRIVATE AND
NON-PROFIT SECTORS.
I'M EXCITED BECAUSE I THINK THIS
SESSION CAPTURES THE SPIRIT OF
THE WORKSHOP, WITH A PANEL WHO
WORK AND SERVE COMMUNITIES WITH
INTERDISCIPLINARY APPROACHES AND
HAVE HISTORIES OF ACADEMIC
COMMUNITY PARTNERSHIPS, AND THEN
WE WILL HAVE A VOICE FROM THE
NIH PERSPECTIVE TO ADD TO THE
CONVERSATION.
OUR PANELISTS TODAY ARE -- LET'S
SEE, ADAOBI ANAKWE, ASSISTANT
PROFESSOR OF HEALTH MANAGEMENT
AND POLICY AT DREXEL UNIVERSITY.
CHRISTIN FARMER IS FOUNDER OF
BIRTHING BEAUTIFUL COMMUNITIES,
IN CLEVELAND, OHIO.
WE HAVE STEPHEN THOMAS,
PROFESSOR OF HEALTH POLICY AND
MANAGEMENT AND DIRECTOR OF THE
CENTER FOR HEALTH EQUITY AT THE
UNIVERSITY OF MARYLAND IN
COLLEGE PARK.
AND WE HAVE CHERYL BOYCE,
ASSISTANT DIRECTOR FOR
REENGINEERING THE RESEARCH
ENTERPRISE, PART OF THE COMMON
FUND AT THE NATIONAL INSTITUTES
OF HEALTH.
I'LL TURN IT OVER TO MY
CO-MODERATOR TO MOVE US INTO THE
DISCUSSION.
>> THANK YOU, DR. WEBB HOOPER.
GOOD MORNING.
I'M BARBARA OUDEKERK, I WORK ON
THE NATIVE COLLECTIVE RESEARCH
EFFORT TO ENHANCE WELLNESS
PROGRAM MENTIONED THIS MORNING
IN THE OPENING BY DR. ETZ.
I'M GOING TO ASK EACH PANELIST
PROVIDE A FIVE-MINUTE
INTRODUCTION, KEEPING IT TO FIVE
MINUTES SO WE HAVE LOTS OF TIME,
AND TELL US ABOUT YOUR
EXPERIENCE AS IT RELATES TO
ENGAGING IN RESEARCH, INVOLVING
MULTI-DISCIPLINARY PARTNERSHIPS
TO PROMOTE HEALTH EQUITY AND IF
YOU'D LIKE, A LITTLE BIT ABOUT,
AGAIN, BRIEFLY, WHAT EXCITES YOU
ABOUT BEING ON THIS PANEL TODAY?
I WILL PASS IT FIRST TO
MS. CHRISTIN FARMER, IF THAT'S
OKAY.
>> GOOD MORNING, EVERYONE.
THANK YOU FOR INVITING ME TO BE
PART OF THIS PANEL.
IT IS AN HONOR AND PLEASURE.
I'M CHRISTIN FARMER, I'M IN
CLEVELAND, OHIO.
I'M A GRASSROOTS GIRL TO MY
CORE.
I HAVE DONE COMMUNITY WORK FOR
WELL OVER A DECADE.
I WANT TO SAY TWO DECADES,
REALLY.
AND I HAVE WORKED A GREAT DEAL
ALONGSIDE UNIVERSITIES, FOUNDER
OF A NON-PROFIT ORGANIZATION
THAT WORKS TO REDUCE INFANT
MORTALITY AND POOR BIRTH
OUTCOMES, PARTICULARLY IN BLACK
COMMUNITIES.
SO I AM A THREE-TIME CO-AUTHOR
PUBLISHED RESEARCH JOURNALS THAT
I'VE WORKED ON WITH
UNIVERSITIES.
AND I AM NO LONGER A BIRTH
WORKER, I SAY I TRANSITIONED,
FROM BEING A BIRTH WORKER TO A
LIGHT WORKER, BECAUSE AFTER
WORKING SO LONG IN THE
NON-PROFIT FIELD, PARTICULARLY
AROUND BIRTH, MY QUESTION WAS
WHY ARE BLACK BABIES DYING, AND
THAT QUESTION EVOLVED TO WHY DO
BLACK PEOPLE HAVE THE WORST
OUTCOMES IN EVERYTHING.
AND WHEN I ASKED THAT QUESTION,
I WENT ON A THREE-YEAR SORT OF
SPIRITUAL JOURNEY THAT LED ME
OUT OF NON-PROFITS AND BACK TO
GRASS ROOTS WORK ON THE GROUND,
HELPING PEOPLE HEAL FROM WITHIN
BECAUSE I FELT WE SPENT A LOT OF
TIME TALKING ABOUT STRUCTURAL
RACISM, WHICH IS FINE, BUT THEN
WE GIVE WAY TOO MUCH POWER TO
IT.
MY MISSION NOW IS TO HELP PEOPLE
CALL THEIR POWER BACK ON THE
INDIVIDUAL LEVEL, AND HELPING
COMPANIES OR ORGANIZATIONS TO
UNDERSTAND WHERE THE HEALING
ACTUALLY REALLY OCCURS, WHICH IS
FROM WITHIN.
AND HELPING PEOPLE NAVIGATE SO
WE AREN'T CONSTANTLY OTHERING
PEOPLE WHICH WE DO A LOT
INTENTIONALLY, AS IF THEY NEED
HELP AND WE DON'T, BUT WE ALL
NEED HELP BECAUSE WE'VE ALL BEEN
AFFECTED BY STRUCTURAL RACISM TO
SOME DEGREE, SOME LEVEL.
SO MY WORK LIES IN COACHING
PEOPLE AND HELPING PEOPLE TO
HEAL ON THEIR HEALING JOURNEY,
AGAIN CALLING BACK THEIR POWER.
AGAIN, THANK YOU ALL FOR
INVITING ME HERE, DR. MONICA
SPECIFICALLY.
THANK YOU SO MUCH FOR HAVING ME
HERE ON THIS PANEL.
>> THANK YOU, CHRISTIN.
I'M DELIGHTED THAT YOU ACCEPTED
THE INVITATION TO JOIN THIS
PANEL.
ON A PERSONAL NOTE WHEN I MET
CHRISTIN FARMER SOME YEARS AGO,
I WAS BLOWN AWAY BY ALL THE WORK
SHE DOES, BY THE COMMITMENT, THE
PASSION SHE HAS, WHICH IS
AUTHENTIC AND REAL, AND THE
AMAZING ORGANIZATION SHE STARTED
TO ASSIST WITH OUR CRISIS OF
INFANT MORTALITY IN THE U.S. AND
IN PARTICULAR THE AREA IN WHICH
SHE WAS WORKING.
I'M HAPPY THAT YOU ARE HERE.
OKAY.
SO WE'D LIKE TO HAVE
INTRODUCTORY COMMENTS FROM
ADAOBI.
>> HEY, EVERYONE.
THANK YOU.
THANK YOU, MONICA, FOR INVITING
ME TO THIS PANEL.
THANK YOU FOR JOINING, EVERYONE,
TODAY.
I TRULY FEEL HONORED AND EXCITED
TO BE HERE TODAY.
I'M LOOKING FORWARD TO AN
ENLIGHTENING AND ENGAGING
SESSION.
AS MONICA MENTIONED, MY NAME IS
ADAOBI ANAKWE, ASSISTANT
PROFESSOR AT DREXEL UNIVERSITY,
SCHOOL OF PUBLIC HEALTH, JOINED
AFTER COMPLETING MY DOCTORATE
AND POSTDOC, DOING ENGAGEMENT
WORK SINCE I WAS A MASTER'S
STUDENT, UNIVERSITY OF MISSOURI.
THAT WAS SINCE 2016.
MINE WORK FOCUSES ON HEALTH OF
BLACK MEN WITHIN THE CONTEXT OF
FATHERHOOD AND HOW STRUCK STEURL
DETERMINANTS OF HEALTH IMPACT
HEALTH AS WELL AS UNDEREXPLORED
IMPACT ON WOMEN'S HELD,
CURRENTLY EXAMINING HEALTH
DEVELOPMENT OF BLACK MEN DURING
TRANSITION TO FATHER HIDE WHERE
COMMUNITY PARTNERS LOCALLY AND
INTERNATIONALLY, THROUGH MY
DISSERTATION WORK, AREA
COMMUNITY OF ENGAGED RESEARCH
WHERE I LEARNED BLACK MEN WHO
WANT TO HAVE CHILDREN IN THE
FUTURE HAVE POORER
PRE-CONCEPTION HEALTH THAN WHITE
AND HISPANIC MEN, SUGGESTING
BLACK MEN WILL ENTER PREGNANCY
WITH DISPROPORTIONATELY POORER
HEALTH THAN WHITE COUNTERPARTS
WHICH CAN NEGATIVELY IMPACT
MATERNAL AND CHILD OUTCOMES.
SECOND BLACK FATHERS WISH THEY
UNDERSTOOD WHAT IS MEANT TO BE A
FATHER PRIOR TO BECOMING ONE
AND
DESIRE TO HAVE RESOURCES TO
EQUIP THEM FOR FATHERHOOD.
ED THIS STUDY CONDUCTED IN
ST. LOUIS HIGHLIGHTS TOO LITTLE
IS KNOWN ABOUT WHY AND HOW BLACK
MEN BECOME FATHERS, WHAT
IMPLICATIONS FATHERHOOD HAS FOR
THEM, PARTNERS AND CHILDREN, HOW
COMMUNITY-BASED ORGANIZATIONS
ALREADY WORKING WITH BLACK
FATHERS CAN BE BOLSTERED TO
CATER TO THE NEEDS EARLIER AND
THROUGHOUT STAGES OF FATHERHOOD.
THIS FINDING INFORMS MY CURRENT
WORK LOOKING AT TRANSITIONING TO
FATHERHOOD SPACE.
IN ORDER TO UNDERSTAND THE
EMERGENCE OF BLACK FATHERHOOD IN
AMERICAN SOCIETY, IT SHOULD BE
VIEWED AS AN ADAPTATION TO
MULTI-FACETED EXTERNAL FACTORS
THAT CONTINUE TO INVALIDATE AND
UPHOLD THE INVISIBILITY.
FOLLOWING THE LANDMARK STUDY,
1965, BLACK FATHERS WERE
IDENTIFIED AS THE PROBLEM OF THE
BLACK FAMILY, MANY LAWS AND
POLICIES WERE ENACTED, PROGRAMS
SUBSEQUENTLY DEVELOPED, THAT
BUILD STRUCTURES TO DISADVANTAGE
AND PERPETUATE NEGATIVE
STEREOTYPING OF THESE MEN TO THE
DETRIMENT OF BLACK FAMILIES AND
COMMUNITIES.
IN ORDER TO ADDRESS THE BLACK
MATERNAL HEALTH CRISIS, ALSO
IMPROVE THE HEALTH OF BLACK MEN,
MORE TRANSFORMATIVE UPSTREAM
WORK IS NECESSARY TO UNRAVEL AND
DISRUPT THE WAYS STRUCTURAL
RACISM HAS SHAPED AND CONTINUES
TO SHAPE THE COLLECTIVE HEALTH
OUTCOMES OF THE BLACK FAMILY
UNIT.
MY WORK WOULD BE IMPOSSIBLE
WITHOUT MAKING THE COMMUNITY AND
INTEGRAL PART OF THE RESEARCH
PROCESS, ENGAGING
MULTI-DISCIPLINARY TEAMS, SERVES
AS LINK BETWEEN THE COMMUNITY
AND INSTITUTION BEING ABLE TO
SPEAK THE ACCEPTABLE ACADEMIC
AND POLICY GRANT LINGO, AND
COMMITMENT TO SHARED OWNERSHIP
OF RESEARCH.
IN OUR STUDY WE CONDUCTED
RECENTLY, WE EXAMINED BLACK
FAMILIES' EXPERIENCES WITH THE
PANDEMIC.
WE PARTNERED WITH A FAITH-BASED
WELLNESS PROGRAM THAT'S
ADMINISTERED BY THE BOONE COUNTY
HEALTH DEPARTMENT IN MISSOURI,
I'M EXCITED TO SHARE WITH AND
LEARN FROM YOU, AN EXCELLENT
TEAM, THAT I INVESTED IN THIS
MODELING STRUCTURAL RACISM
THROUGH COMMUNITY-DRIVEN
APPROACHES.
AS DR. BAILEY SAID, THE SYSTEMS
THAT CURRENTLY EXIST WERE
CO-CREATED AND REINFORCED BY
MULTI-SECTORIAL APPROACHES.
>> WE'RE EXCITED THAT YOU'RE
HERE.
I'LL PASS TO DR. STEPHEN THOMAS.
>> GOOD MORNING, CAN YOU HEAR ME
OKAY?
WELL, YOU KNOW IT'S EXCITING FOR
ME TO BE HERE, THE CHANCE TO BE
IN THIS SPACE.
I CALL THIS A SOLUTION SPACE.
I WATCHED THE SHOW YESTERDAY,
I'M JUST GOING TO SAY WOW.
YOU KNOW, OUR CENTER FOR HEALTH
EQUITY AT THE UNIVERSITY OF
MARYLAND SCHOOL OF PUBLIC HEALTH
IN COLLEGE PARK HAS A MOTTO.
BUILDING BRIDGES, BUILDING
TRUST, BUILDING HEALTHY
COMMUNITIES.
YOU CAN'T DO THAT WITHOUT TRUE
AUTHENTIC PARTNERSHIP.
I GOT MY COMMUNITY WATCHING THIS
ACADEMIC SHOW, AND THEY TOLD ME,
DR. T, THEY GAVE ME A NICKNAME
BECAUSE I WORK IN THE
BARBERSHOPS, DR. T, TELL THE
TRUTH.
TELL OUR TRUTH TO THIS PANEL.
AND THAT'S WHAT I'M GOING TO DO
TODAY.
AND REMIND MYSELF OF SOMETHING
THAT ABIGAIL ECHO HAWK SAID AT
THE WHITE HOUSE SPEAKING TRUTH.
SHE SAID IN ORDER TO GET THE
TRUTH, YOU MUST FIRST WALK
THROUGH, IN ORDER TO GET THE
TRUST YOU MUST FIRST WALK THE
TRUTH.
IN ORDER TO GET TO TRUST YOU
MUST FIRST WALK THROUGH THE
TRUTH.
WHAT'S THE TRUTH?
THAT THIS MORNING'S NEWSPAPER,
FRONT PAGE, WASHINGTON POST, THE
STORY OPENS WITH THE WORDS
"BLACK BARBERSHOP."
WHO COULD IMAGINE THAT TODAY,
MONICA?
IT'S ABOUT WHAT'S HAPPENING IN
BLACK BARBER SHOPS THAT THE
CONVERSATIONS HAPPENING THERE
ARE GOING TO SHAPE THIS
POLITICAL ENVIRONMENT WE'RE IN.
YOU KNOW WHAT THEY ARE ASKING IN
THE BARBERSHOPS?
HOW DID THE BLACK POWER RAISED
FIST BECOME A WHOLE DIFFERENT
SYMBOL?
HOW DID A POOR BOY FROM OHIO
RAISED IN A RURAL AREA NOW A
VICE PRESIDENTIAL CANDIDATE,
INTRODUCE HIS MOM AS CLEAN AND
SOBER, WE'RE WITNESSING IN REAL
TIME THE SHIFT FROM RACE AS
INDIVIDUAL SKIN COLOR
PIGMENTATION, ET CETERA, TO
CLASS.
ISABEL WILKERSON'S BOOK WAS
REFERENCED YESTERDAY, THE WARMTH
OF OTHER SONS, STILL A RACE
STORY RELEVANT TODAY, STILL OUR
DILEMMA.
BUT HER SECOND BOOK WAS WHAT?
CLASS.
THE SWITCH HAS OCCURRED, RIGHT
BEFORE OUR VERY EYES.
IN AMERICA WE DON'T LIKE TO TALK
ABOUT CLASS.
IN THE OPIOID EPIDEMIC WE CAN
UNPACK THIS TRANSITION, I'M SO
OLD I REMEMBER WHEN WE TALKED
ABOUT CRACK BABIES.
WE'RE NOT TALKING ABOUT CRACK
BABIES NOW.
NOW WE'RE TREATING OPIOID
ADDICTION AS A PUBLIC HEALTH
ISSUE.
I'M GOING TO SALUTE THAT EVEN
THOUGH IN THE BLACK COMMUNITY
THERE'S THE IRONY, WHY WASN'T A
PUBLIC HEALTH ISSUE WHEN WE WERE
DYING?
WHY WASN'T IT A PUBLIC HEALTH
ISSUE WHEN OUR KIDS WERE DYING?
AND SO IT IS WHAT IT IS.
ONCE IT AFFECTS THE MAJORITY,
IT'S GOING TO BE AN ISSUE THAT
WILL MOVE THE NEEDLE.
AND THAT'S WHAT'S HAPPENING
RIGHT NOW.
I'M SO EXCITED ABOUT THE
CONVERSATION WE'RE GOING TO
HAVE.
I WANT TO THANK NIH FOR THE
SUPPORT THEY HAVE GIVEN ME OVER
THE YEARS TO ACTUALLY BUILD THE
HAIR NETWORK, HEALTH ADVOCATES
IN RESEARCH.
WE'LL TALK MORE ABOUT THAT AS WE
GO ALONG.
>> THANK YOU, DR. T.
ALWAYS GOOD TO HEAR WHAT YOU
HAVE TO SAY, BRINGING COMMUNITY
VOICES TO US IS WHAT WE WANT TO
HEAR IN THIS SESSION.
SO APPRECIATE THAT.
AND CHERYL BOYCE, WOULD YOU
PLEASE OPEN US WITH YOUR
COMMENTS.
>> SO, GOOD MORNING.
IT'S GREAT TO HEAR THE MEETING
FROM YESTERDAY, I'M PLEASED TO
BE HERE WITH MY DISTINGUISHED
COLLEAGUES, I WANT TO THANK YOU
FOR ORGANIZING THE MEETING AND
THIS SESSION.
IT'S REALLY EXCITING TO HAVE
THESE CONVERSATIONS TO THINK
ABOUT HOW WE'RE GOING TO BUILD
PARADIGMS IN TERMS OF NIH AND
THE RESEARCH, SO IT'S TRULY A
PLEASURE.
I AM CURRENTLY ASSISTANT
DIRECTOR IN THE COMMON FUND, I
DON'T KNOW HOW MANY HAVE HEARD
OF COMMON FUND, THINKING ACROSS
NIH FOR COLLABORATIVE WORK
ACROSS INSTITUTES AND CENTERS, A
ROLE I VALUE BECAUSE IT'S A WAY
OF BUILDING SCIENCE AND HEALTH
EQUITY IN WAYS WE'VE NEVER DONE
BEFORE.
IT'S BEEN MY HONOR, I WORKED AT
NIH FOR OVER 20 YEARS, ALL THAT
WORK HAS INCLUDED HEALTH EQUITY.
AND I'VE LED SOME RECENT KNISH
INITIATIVES PERTINENT TO OUR
CONVERSATION.
THE DEVELOPMENT OF THE NIH
COMMON FUND COMPASS PRACTICE IS
THE FIRST OF ITS KINDS
INITIATIVE FUNDING DIRECTLY,
THEY GET TO SEE THE KEY ISSUES,
AND WHILE WE HAVE A HISTORY OF
COURSE COMMUNITY PARTICIPATORY
RESEARCH, COMMUNITY ENGAGEMENT,
THIS HIGHLIGHTS THE IMPORTANCE
OF BRINGING FUNDING AND
INFRASTRUCTURE DIRECTLY TO THE
COMMUNITY.
WE ALSO FUNDED THE
TRANSFORMATIVE RESEARCH TO
ADDRESS HEALTH EQUITIES, IN
RESPONSE TO THE CALL FROM UNITE,
TO THINK ABOUT CREATIVE
RESEARCH, INTERVENTIONS THAT
TACKLE HEALTH DISPARITIES,
MAKING SURE THAT WE ARE
BROADENING PARTICIPATION IN
COMMUNITIES, IN RESEARCH, AND
HOW WE THINK ABOUT THESE ISSUES
AND HOW WE FUND OUR RESEARCH
PROJECTS IN THE FUTURE.
SO, IT'S A PLEASURE TO BRING
THOSE MOST RECENT INITIATIVES
AND HAVE THIS DIALOGUE HERE
TODAY WITH THESE COLLEAGUES.
SO THANK YOU.
I WILL TURN IT BACK OVER TO OUR
CHAIR OF THE SESSION.
>> THANK YOU, CHERYL.
I'M SO EXCITED TO HERE MORE
ABOUT COMPASS TODAY, AND THE
SPACE NIH HAS ENTERED IN TERMS
OF FUNDING COMMUNITY DIRECTLY.
WE HEARD MORE THIS MORNING
AROUND CREW AND CARE.
EXCITED TO HEAR MORE.
FOR THE SAKE OF TIME I'LL JUMP
TO SOME PREPARED DISCUSSION
QUESTIONS.
AND WE'RE HOPING TO GET THROUGH
A FEW OF THESE QUESTIONS.
AS WE SEE MORE QUESTIONS COME IN
FROM THE AUDIENCE, IF YOU'RE IN
THE AUDIENCE TODAY PLEASE
REMEMBER YOU CAN SUBMIT
QUESTIONS THROUGH SLIDO, AS
QUESTIONS COME IN IF YOU WOULD
GIVE THE THUMBS UP TO THE ONES
YOU'RE MOST INTERESTED IN WE'LL
START TO ASK THOSE QUESTIONS IN
A LITTLE BIT.
FIRST, WHAT INSPIRED YOU TO GET
INVOLVED IN COLLABORATIVE
RESEARCH WITH INTERDISCIPLINARY
RESEARCHERS AND COMMUNITY
PARTNERS, AND I WILL START WITH
ADAOBI, AND EVERYONE CAN JUMP IN
AFTER.
>> SO I CAME HERE, THANK YOU FOR
THAT QUESTION, I CAME TO THE
U.S., I'M INTERNATIONAL STUDENT
FROM NIGERIA IN 2015.
I HAD THE OPPORTUNITY OF WORKING
WITH -- SO MY BACKGROUND WAS
MICROBIOLOGY, AND I HAD THE
PRIVILEGE OF WORKING WITH A
MENTOR WHO DID A LOT OF
COMMUNITY-BASED WORK.
AND THAT GOT ME STARTED, YOU
KNOW, BOTH MY INTRODUCTION TO
COMMUNITY-BASED,
COMMUNITY-INVOLVED WORK AS WELL
AS QUALITATIVE RESEARCH.
IT WAS A STRUGGLE, TRYING TO
FIGURE OUT, YOU KNOW, WHAT --
HOW TO DO THE QUALITATIVE WORK,
AND UNDERSTAND, YOU KNOW, THE
VOICES OF COMMUNITY.
HOWEVER, IN DOING THAT WORK, IN
LOOKING AT SOME OF THE
INTERVIEWS THAT WE'RE REVIEWING,
THAT STUDY WAS FROM SOUTH
AFRICA, WE HAD SOME, YOU KNOW,
NEW EMERGENT FINDINGS AROUND
FETAL ALCOHOL SPECTRUM
DISORDERS.
I HADN'T REALLY HEARD ABOUT IT
BEFORE BUT I WENT INTO LOOKING
FOR WHO WAS AN EXPERT, WHO COULD
I WORK WITH TO, YOU KNOW, DO
MORE AROUND THAT SPACE.
WE DID GET SOME GRANT FUNDING TO
DO SOME OF THAT WORK IN SOUTH
AFRICA.
FAST FORWARD TO WHEN I DID MY
Ph.D. AT ST. LOUIS UNIVERSITY,
I AGAIN HAD THE OPPORTUNITY, NOW
WAS TRAINED IN EPI, BUT WAS 100%
ADOPTED BY A MENTOR IN HEALTH
MANAGEMENT AND POLICY.
AND THAT MENTOR INGRAINED
COMMUNITY ENGAGEMENT WORK,
COMMUNITY-DRIVEN RESEARCH IN ME,
I STARTED THIS WORK BUT WORKING
WITH HER AND WORKING WITH THE
COMMUNITIES, PARTICULARLY BLACK
COMMUNITIES IN ST. LOUIS, WAS A
WHOLE OTHER EXPERIENCE.
I STARTED TO UNDERSTAND THAT FOR
RESEARCH TO BE MEANINGFUL OR, I
FOUND THIS FOR MYSELF TO BE
MEANINGFUL IT IT IT TO BE
TRANSPORTED, BOOTS ON THE GROUND
WITH COMMUNITY MEMBERS, THE
VOICES I COULD SERVE AS A LINK
IN A WAY TO MAKE SURE THEIR
VOICES ARE HEARD.
SO, AGAIN, THAT ONE APPROACH IS
NOT ENOUGH TO ACTUALLY
UNDERSTAND THE FULL PICTURE OF
WHATEVER IS THE ISSUE.
AND IN THIS CASE, THE FACT --
THE EFFECTS OF STRUCTURAL
RACISM.
>> THANK YOU.
WOULD ANYONE ELSE LIKE TO ADD?
>> YOU KNOW, YOU GUYS ARE MAKING
ME FEEL OLD.
I'M SAYING THAT BECAUSE AS YOU
MENTIONED DR. BLUE, YOU
MENTIONED OUR COLLEAGUE DARA
MENDEZ, MY ACADEMIC SONS AND
DAUGHTERS.
AND THEY ARE NOW PRODUCING
GRANDCHILDREN.
I THINK THAT'S THE ONLY WAY WE
SHOULD THINK ABOUT THIS.
IT'S PROGENY, A JOURNEY.
FOR ME AS A BLACK MAN I GO TO
THE BARBERSHOP.
I WOULD JUST GO AS A BLACK MAN.
ONE DAY I WASN'T INTO THE
BARBERSHOP AND RECOGNIZED THAT,
WOW, YOU KNOW, NO SELF
RESPECTING BARBER WOULD SAY I'LL
GET YOU OUT IN TEN MINUTES,
DOESN'T MATTER HOW MUCH HAIR YOU
HAVE.
COME ON, SISTER, YOU'RE GOING TO
BE THERE ALL DAY.
DURING THE PANDEMIC WE REALIZED
WHY NOT GO WHERE PEOPLE ALREADY
HAVE TRUST.
WHY NOT GO WHERE THEY NEVER MISS
THEIR APPOINTMENT?
AND THAT WAS THE RECOGNITION IN
THOSE SHOPS, IN THE SACRED
SPACES, SOCIAL NORMS ARE BEING
SHAPED.
THAT WAS 25+ YEARS AGO, I
REALIZED THAT AND BEGAN WORKING
IN BARBERSHOPS, BEAUTY SALONS.
FOR THAT NOW TO BE RECOGNIZED
DURING THE PANDEMIC AS A WHITE
HOUSE INITIATIVE WITH SHOTS AT
THE SHOP WE TRAINED OVER A
THOUSAND BARBERSHOPS AND SALONS
ACROSS THE COUNTRY.
AND YOU KNOW WHAT THEY SAID TO
US, ADAOBI?
IF YOU CAN BRING A LIFE-SAVING
VACCINE INTO A BARBERSHOP AND
BEAUTY SALON, ARE YOU GOING TO
LEAVE US WITH THE CANCER?
ARE YOU GOING TO LEAVE US WITH
THE DIABETES?
ALL THOSE UNDERLYING CONDITIONS.
AT THAT POINT, WE MADE A
COMMITMENT, GRANT FUNDING OR
NOT, WE WERE NOT GOING TO
ABANDON THEM.
AND THEY NOW CALL THEMSELVES
WELLNESS WARRIORS.
AND THEY ARE CERTIFIED COMMUNITY
HEALTH WORKERS.
BUT WE STILL HAVEN'T FIGURED OUT
HOW TO GET THEM PAID.
I'M HERE ASKING FOR HELP.
WE HAVE COMMUNITY HEALTH WORKERS
AT THE LAST MILE THAT ARE
LINKING PEOPLE TO CARE, BUT THEY
ARE OUTSIDE OF THE REIMBURSEMENT
SYSTEM.
WE'VE GOT TO RECONNECT IN WAYS
THAT SUSTAIN THE RESEARCH
INFRASTRUCTURE AND SERVICE
INFRASTRUCTURE THAT IS MADE
POSSIBLE BY THESE PARTNERS, AND
NOT ABANDON THEM AS THE GRANTS
GO UP AND DOWN, UP AND DOWN,
BECAUSE HERE'S WHAT THEY ARE
SAYING.
WE HAVE ENOUGH COMMUNITY
ENGAGEMENT, YOU ACADEMICS.
WE WANT COMMITMENT.
BUT THAT'S ME CLEANING IT UP.
HERE IS HOW THEY REALLY SAY IT.
DO IT LIKE BEYONCE, IF YOU LIKE
WHAT YOU SEE, PUT A RING ON IT.
THEY WANT A COMMITMENT FROM US.
NOT EPISODIC ENGAGEMENT.
I THINK THAT'S THE LESSON WE'VE
GOT TO COME AWAY OUT OF THIS
CONFERENCE WITH, DOCUMENTING THE
SCIENCE OF RACISM, STRUCTURAL
INEQUALITY, THAT WE NEED
COMMITMENT.
I'M LOOKING FOR PARTNERS.
>> WELL, THANK YOU FOR SAYING
THAT, AND I'M THINKING ABOUT
WHAT THAT RING WOULD BE.
BUT LET ME MOVE TO THE NEXT
QUESTION.
I WANT TO ASK YOU ANOTHER
QUESTION AND BRING CHRISTIN IN
TO ANSWER FOR ME.
YOU CONDUCTED A LOT OF RESEARCH
IN BARBERSHOPS, YOU HAVE VIDEOS
DOCUMENTS THE WORK YOU'VE DONE.
CAN YOU TALK ABOUT SCIENTIFIC
AREA, YOU'VE DONE WORK IN
CANCER, FOR EXAMPLE, CAN YOU
GIVE AN EXAMPLE OF SCIENTIFIC
AREA, SUCCESSFUL RESEARCH
PROJECT THAT RESULTED FROM
PARTNERSHIPS AND TALK ABOUT WHAT
MADE IT SUCCESSFUL.
>> THAT QUESTION IS FOR WHO?
>> FOR YOU.
AND THEN I'M GOING TO CHRISTIN.
>> OH, OKAY.
AGAIN, I'LL COME FROM THE
PANDEMIC AND SAY THAT WE
LITERALLY CLOSED THE RACIAL
DISPARITY GAP IN VACCINATIONS
RELATED TO THE HYPERLOCAL
STRATEGIES WE USED AND RECENTLY
PUBLISHED WITH COLLEAGUES FROM
THE CENTERS FOR DISEASE CONTROL
ON HYPERLOCAL COMMUNITY
ENGAGEMENT.
WE GOT TO GET SMALLER.
WE GOT TO GET RIGHT DOWN INTO
THAT NEIGHBORHOOD.
AND WHEN YOU TALK TO THE BARBERS
AND STYLISTS THEY WILL TELL YOU
THEY WERE MARINATING IN MIS AND
DISINFORMATION AT A TIME AND
TOTALLY OPPOSED TO THE VACCINE.
AND SO HOW THEY WENT FROM
TOTALLY OPPOSED TO THE VACCINE
TO VACCINE EVANGELISTS IS A
LONGER STORY.
BUT IT COMES DIRECTLY FROM OUR
WILLINGNESS TO LISTEN, DR. WEBB.
WE DID NOT GO IN DICTATING.
WE WENT IN LISTENING.
IT ALSO HELPED THAT WE HAD A
RELATIONSHIP WITH THEM BEFORE
THE PANDEMIC.
THERE'S THE OTHER LESSON.
MAKE YOUR FRIENDS BEFORE YOU
NEED THEM.
AND WE THEN TREATED PEOPLE WITH
DIGNITY AND RESPECT.
WE IN PUBLIC HEALTH SOMETIMES
DON'T DO THIS, DON'T DO THAT.
AS ONE BARBER SAID GOING TO THE
DOCTOR TAKES THE SMILE OFF MY
FACE.
WE HAVE TO CHANGE THE PARADIGM.
AND SO IN MANY CASE THE
BARBERSHOP AND SALON IN THE
BLACK COMMUNITY IS NOT A
REPLACEMENT FOR HEALTH CARE.
IT'S JUST A NEW DOORWAY.
IT'S A NEW DOORWAY BECAUSE WHEN
THEY WALK THROUGH THE DOORWAY OF
THESE POLLS, THEY KNOW THEY ARE
GOING TO COME OUT FEELING
BETTER.
THEY DON'T ALWAYS FEEL THAT WAY
GOING TO A CLINIC OR HOSPITAL.
SO I THINK THAT THE SUCCESS WAS
TREATING PEOPLE WITH DIGNITY AND
SUCCESS, USING ZOOM TO INTRODUCE
THEM TO LEADERS THAT OTHERWISE
THEY WOULD NEVER HAVE MET.
AND ACTUAL FORMAL TRAINING TO
BECOME CERTIFIED COMMUNITY
HEALTH WORKERS.
GUESS WHAT, WE PAID THEM!
YES!
WE COMPENSATED THEM FOR THEIR
TIME AND DID NOT JUST USE THEIR
PASSION OF SAVING THEIR OWN
COMMUNITY.
AND TREAT THAT LIKE THAT WAS
JUST A GIVEN.
AND NOW THEY ARE DEMANDING THAT
THEIR TIME BE RESPECTED, AND
COMPENSATED, AND WE SHOULD DO
THAT.
SO, THERE'S EVIDENCE THAT WE
HAVE, WE'RE NOW IN THOSE SHOPS
MANAGING TYPE 2 DIABETES WITH
SUPPORT FROM THE CDC, AND,
AGAIN, WITH ALL THE WORK NIH HAS
DONE WE'RE USING SMARTPHONE
ARTIFICIAL INTELLIGENCE
TECHNOLOGY, EVERYBODY'S GOT A
CELL PHONE!
THEY JUST HAVEN'T UNLOCKED THE
MAGIC OF THIS PHONE.
WE'RE DOING THAT FOR THEM RIGHT
NOW.
SO WE'RE RECRUITING 240
DIABETICS THAT WILL HAVE BARBERS
AND STYLISTS A AS LIFESTYLE
COACHES, TRAINED AS CERTIFICATE
FIGHT COMMUNITY DIABETES
COORDINATORS, WE'RE HELP PREVENT
AMPUTATIONS, END STAGE RENAL
DISEASES, BLINDNESS, ALL THESE
THINGS HAPPENING TO BLACK
PEOPLE, PREVENTIBLE MANAGING
DIABETES.
WE'RE ON THE GROUND RIGHT NOW.
>> SOUNDS GREAT.
SOUNDS AMAZING.
CHRISTIN, MAY I ASK YOU TO SHARE
WITH US FROM YOUR EXPERIENCE
WORKING WITH FROM A GRASSROOTS
ORGANIZATION, WORKING WITH
RESEARCHERS AT UNIVERSITIES
ABOUT SOMETHING SUCCESSFUL, THAT
RESULTS FROM YOUR WORK WITH THEM
AND WHY IT WAS SUCCESSFUL?
>> UH-HUH.
WELL, I HONESTLY WOULD SAY THAT
IT DEPENDS WHAT OUR DEFINITION
OF SUCCESS IS.
I WOULD SAY THAT WE WERE
ABSOLUTELY SUCCESSFUL IN
TRAINING OVER 100 WOMEN TO
BECOME DOULAS, ABSOLUTELY
SUCCESSFUL IN TRAINING MY ENTIRE
TEAM AND THE ENTIRE, YOU KNOW,
OUR SCOPE, IN CUYAHOGA COUNTY,
MORE WOMEN TO BECOME COMMUNITY
HEALTH WORKERS.
WE'VE BEEN SUCCESSFUL IN
PROVIDING DOULA SERVICES TO
WOMEN WHO NEED THOSE DOULA
SERVICES.
SO THAT HAS BEEN SUCCESSFUL.
HOWEVER, WHEN I THINK ABOUT
SUCCESS, I THINK ABOUT HAS THERE
BEEN SOME PHYSICAL EVIDENCE OF
TRANSFORMATION.
AND WHEN I LOOK IN MY COMMUNITY
BECAUSE I LIVE IN A COMMUNITY
THAT I SERVE, I DON'T SEE THAT
SUCCESS.
YOU KNOW, IN THAT PERSPECTIVE.
SO THAT'S WHAT CAUSED ME TO GO
DEEPER BECAUSE I DID WHAT I CALL
SORT OF THE SURFACE-LEVEL WORK
WHERE WE PROVIDE THESE SERVICES
AND THAT'S GREAT BECAUSE PEOPLE
NEED REALTIME IMMEDIATE HELP,
THEY NEED SUPPORT TODAY.
YOU'RE A PREGNANT MOM, YOU NEED
A DOULA TODAY, YOU NEED AN UBER
TODAY, YOU NEED A RIDE TO THE
GROCERY STORE TODAY.
BUT THEN WHAT ARE WE DOING TO
PREVENT PEOPLE FROM NEEDING
CERTAIN SERVICES, NOT
NECESSARILY DOULAS BECAUSE
BABIES ARE GOING TO ALWAYS BE
BORN, RIGHT IN THE BUT WE ALSO
WORKED ON LEAD POISON AND OTHER
ISSUES THAT HAVE BEEN PLAGUING
OUR COMMUNITIES, AND ARE WE
REALLY DOING THE NECESSARY WORK,
WHAT I CALL DETAILING WORK
THAT'S NECESSARY TO PREVENT
PEOPLE FROM NEEDING IMMEDIATE
SERVICES IN A WAY WE NEED
IMMEDIATE SERVICES.
SO THE WORK THAT HAS BEEN PUT
INTO ALL THE PROPOSALS HAS BEEN
SUCCESSFUL.
YOU KNOW, WE TRAINED A NUMBER --
WE HIT THOSE MARKS.
WE'VE HIT THOSE INDICATORS THAT
WE SPECIFY TO SAY, OH, THIS IS
WHAT WILL HELP TO DRIVE THE
NUMBERS DOWN.
BUT I'VE BEEN AT THIS WORK FOR A
LONG TIME, AND IT'S STILL NOT
HITTING EXACTLY AT THE CORE OF
WHAT I WOULD LIKE TO SEE WHAT
I'M WORKING ON NOW.
IN FACT WE WERE COVERED BY THE
NEWS YESTERDAY BECAUSE I'M
WORKING ON AN INITIATIVE CALLED
HEALED CLEVELAND, AND SOMETHING
I JUST MADE UP BECAUSE THERE WAS
A REPORT THAT CAME OUT THAT SAID
CLEVELAND WAS THE MOST STRESSED
CITY IN THE UNITED STATES.
FOR THE FOURTH YEAR IN A ROW.
SO WHEN I LOOK AT REPORTS OR
DATA LIKE THAT, THEN WHAT IS
SUCCESS, RIGHT?
IF WE HAVE -- IF THERE'S STILL A
TREND OF THIS STRESS OR THESE
ISSUES, WHAT CAN WE DO ON A NOTE
IN WHICH WE HAVE -- WHERE WE CAN
DO SOMETHING DIFFERENT THAN WHAT
WE'VE DONE BEFORE, I SAY LIKE
THE USUAL SORT OF SUSPECTS WHAT
WE'VE DONE BEFORE BUT LOOKING TO
DO SOMETHING DIFFERENT BECAUSE I
HAD ANOTHER DEFINITION OF
SUCCESS.
SUCCESS, TO ME, IS WHEN I CAN
WALK THROUGH MY COMMUNITY AND I
SEE PEOPLE WHO ARE IN POWER, WHO
ARE UPLIFTED, WHO ARE TAKING
THEIR HEALTH INTO THEIR OWN
HANDS, AND WHO HAVE DECIDED THAT
THEY WANT A BETTER LIFE FOR
THEMSELVES, AND THAT THEY HAVE
THE POWER TO CREATE THAT BETTER
LIFE FOR THEMSELVES.
YOU KNOW, AGAIN MY WORK HAS
REALLY TRANSITIONED AND EVOLVED
FROM DOING THE IMMEDIATE NEEDS,
I WANT TO GET -- I WANT TO DIVE
IN THE WATER AND PREVENT PEOPLE
FROM JUMPING IN IT.
SO WHEN I SEE THAT LEVEL OF
SUCCESS, THEN I WILL SAY THAT
WE'VE BEEN SUCCESSFUL.
IN OUR COMMUNITY.
>> CAN I ADD SOMETHING TO THAT?
FIRST I WANT TO THANK YOU SO
VERY MUCH.
I DON'T KNOW IF YOU'RE SEEING
THIS BUT I KNOW I AM.
AND THAT IS, TRAUMA AND
DISENFRANCHISED GRIEF COMING
INTO THE SHOPS AS PEOPLE SIT IN
THE CHAIR.
AND, AGAIN, THE MERE FACT WE'RE
TALKING ABOUT THAT NOW, LIFTING
THAT UP, I THINK THAT'S A
MEASURE OF SUCCESS.
HERE'S ANOTHER ONE.
HOW TO GET THE LOCAL SMALL
GROUPS PAID.
OUR UNIVERSITY SYSTEMS DON'T
CHANGE THEIR CONTRACTING
MECHANISMS.
IT IS NOT EASY TO DO THE W-9.
WE DON'T EVEN WRITE ABOUT THAT.
IF YOU DON'T GET THAT RIGHT YOU
CAN'T GET MONEY INTO THE HANDS
OF THE VERY PEOPLE WE NEED.
SO I'M GOING TO CONSIDER THAT
SUCCESS.
HELPING THEM GET PAPER READY SO
THEY CAN ACTUALLY RECEIVE FUNDS,
HAVE THEM BE USED ACCOUNTABLY,
AND BRING THOSE DOLLARS RIGHT
DOWN TO THE HYPERLOCAL LEVEL.
>> TOUCHING ON ECONOMICS, WHERE
WE HOPE TO GO NEXT, IN TERMS OF
YOU BROUGHT UP CHALLENGES AROUND
COMMUNITIES WANT COMMITMENT, NOT
FIVE OR TWO-YEAR GRANT PERIODS,
AND HOW TO PAY COMMUNITIES, HOW
TO BUILD CAPACITY FOR
COMMUNITIES, TO ACCEPT MONEY.
YOU BROUGHT UP OTHER CHALLENGES
TO.
I WANT TO THROW THE QUESTION
HEAD-ON THERE.
WHAT CHALLENGES ARE YOU SEEN IN
WORKING ON THESE PARTNERSHIPS,
NOT JUST THE CHALLENGE, HOW DO
YOU OVERCOME SOME OF THOSE
CHALLENGES?
AND I THINK WE CAN -- BECAUSE
YOU WERE JUST TALKING ON THIS,
CHRISTIN, IF YOU DON'T MIND I'LL
PASS IT TO YOU FIRST AND THEN
I'D LOVE TO HEAR FROM ADAOBI AS
WELL.
>> SURE, THANK YOU.
THERE'S SOME CHALLENGES
HIGHLIGHTED, I THINK THIS IS
REALLY ONE THAT STICKS WITH ME,
WE USE A LOT OF DISEMPOWERING
LANGUAGE, WE CONSISTENTLY SAY
UNDERREPRESENTED,
UNDERPRIVILEGED, MINORITY, AT
RISK, YOU KNOW, AND SO THOSE
WORDS, IT'S LIKE YOU CAN'T EVEN
GET FUNDING IF YOU'RE NOT USING
THOSE WORDS, BUT THOSE WORDS ARE
VERY DISEMPOWERING TO PEOPLE
BECAUSE PEOPLE ARE WHOLE PEOPLE.
I WANT TO SPEAK LIFE INTO MY
COMMUNITY.
I DON'T WANT TO CALL THEM
MARGINALIZED PEOPLE.
THEY ARE NOT HALF PEOPLE.
THEY ARE WHOLE PEOPLE.
THEY ARE NOT UNDERPRIVILEGED.
THEY ARE NOT UNDERREPRESENTED.
I GET IT FROM A COMMERCIAL
STANDPOINT IT MAY LOOK THAT WAY
BUT WE CAN CHANGE OUR LANGUAGE
TO REFLECT WHAT WE WANT TO SEE
IN OUR COMMUNITIES VERSUS WHAT
WE'RE CURRENTLY SEEING BECAUSE
THE MORE WE USE THOSE WORDS THE
MORE PEOPLE LEAVE THAT THAT'S
WHO THEY ARE, AND SO THAT'S WHO
THEY SHOW UP AS, AS AN
UNDERREPRESENTED,
UNDERPRIVILEGED AT-RISK
MINORITY, YOU KNOW.
SO I THINK THAT THAT'S ONE OF
THE BIGGEST CHALLENGES THAT I
FEEL LIKE I HAVE FACED IN THIS
SPACE.
AND THEN THE SECOND THING TOO
WHICH STILL GOES ALONG THE SAME
LINE IS THAT, YOU KNOW, THERE IS
A LOT OF MONEY THAT GOES INTO
RESEARCH.
YOU KNOW, TO DR. T'S POINT, EVEN
AROUND HOW DO WE PAY PEOPLE, WE
COULD PAY PEOPLE IF WE SWITCH
THE MODEL, THERE ARE MILLIONS OF
DOLLARS IN RESEARCH INSTITUTIONS
THAT NEVER MAKE IT INTO THE
HANDS OF THE COMMUNITY.
WE GET THE DATA, AND WE GET THE
RESEARCH, AND WE WRITE ABOUT IT.
MIND YOU, GENERALLY THESE
RESEARCH PAPERS THAT WE'RE
CREATING, THAT WE'RE DOING, THEY
ARE NOT EVEN BEING READ BY THE
PEOPLE THAT THEY ARE ABOUT.
THIS IS NOT FOR THE PEOPLE WHO
WE'RE EXTRACTING THE DATA FOR.
THIS IS FOR US WHO ARE THE
RESEARCHERS SO WE CAN INFORM ONE
ANOTHER ABOUT WHAT'S GOING ON
VERSUS THE FUNDING, MONEY BEING
REDIRECTED INTO THE COMMUNITY.
THERE'S ONE COMMUNITY IN
PARTICULAR THAT I WORKED FOR,
FOR YEARS, AND I KNOW THERE'S
BEEN A LOT OF MONEY THAT
RESEARCH HAS COME OUT OF.
AND SO BUT THAT COMMUNITY STILL
LOOKS THE SAME, STILL LOOKS NOT
SO GREAT.
YOU KNOW, BECAUSE NONE OF THAT
MONEY HAS BEEN INVESTED INTO THE
ACTUAL COMMUNITY OR THE ACTUAL
PEOPLE.
THAT'S ANOTHER CHALLENGE, THOSE
TWO THINGS, HOW FUNDING IS
DISTRIBUTED, WORDING AND
LANGUAGE TO DESCRIBE THE
COMMUNITIES THAT WE SAY WE WANT
TO UPLIFT AND CHANGE.
>> THANK YOU.
I'LL ADD ANOTHER TERM, HARD TO
REACH POPULATIONS.
TERRIBLE.
CHERYL, YOU HAVE COMMENTS AS
WELL, I'LL PASS TO YOU NEXT AND,
ADAOBI, I'D LIKE TO HEAR FROM
YOU TOO.
I SEE QUESTIONS COMING IN FROM
THE CHAT.
MONICA, WOULD IT MAKE SENSE TO
MOVE TO THAT AFTER THIS?
>> YES, SURE.
>> I JUST WANTED TO ADD IN TERMS
OF THINKING ABOUT SOME OF THE
ISSUES THAT THE PANEL JUST
MENTIONED WE WERE ABLE TO IN
SOME MORE RECENT FUNDING
INITIATIVES USE OTHER
TRANSACTION AWARDS, AND USE
OTHER WAYS TO TRY TO FUND
COMMUNITIES, THAT'S HOW WE WERE
ABLE TO DO THINGS MORE DIRECTLY.
ALSO WE THINK MORE ABOUT
TECHNICAL ASSISTANCE, EFFORTS
SUCH AS CEAL, BUILT INTO
COMPASS, WE HAVE HUBS.
AND REALLY COMING FROM A
STRENGTH-BASED PERSPECTIVE AS WE
JUST TALKED ABOUT, HOW WE CAN
REALLY ASSIST COMMUNITIES TO
ACHIEVE THE GOAL IN TERMS OF
HEALTH OUTCOMES AS PARTNERS AND
BUILDING IN THOSE TYPES OF
SUPPORT TO GET THROUGH THE
BUREAUCRACY AND TO BUILD
CAPACITY TO CONTINUE TO PARTNER
WITH COMMUNITIES IN A
STRENGTH-BASED FRAMEWORK.
I JUST WANTED TO ADD THAT.
>> THANK YOU.
ADAOBI, DID YOU HAVE ANYTHING TO
ADD TO THIS?
>> I WOULD SAY, YOU KNOW, I
WROTE WHAT DR. FARMER SAID ABOUT
LACK OF ACADEMIC INFRASTRUCTURE,
BUT BECAUSE I DO SOME WORK
INTERNATIONALLY AS WELL, WE HAVE
THE ISSUE OF BEING ABLE, AND I
THINK HAVE THAT ISSUE HERE AS
WELL, BEING ABLE TO BUILD
CAPACITY AT LOCAL LEVEL FOR
PEOPLE TO ACTUALLY DO LIKE THE
DATA ANALYSIS.
SO, THINK ABOUT WORKING IN THE
COMMUNITY THAT HAS A LOT OF
POVERTY AND NEEDS -- AND LACK OF
JOBS, YOU SAY, HEY, YOU HAVE
THIS DATA, YOU HAVE THE LOCAL
KNOWLEDGE, I'D LIKE TO PAY YOU,
I'LL TRAIN YOU.
YOU KNOW, THAT TWO-WAY STREET,
WE'LL GIVE YOU THE TRAINING
WHILE WE DO THE ANALYSIS, GAIN
THAT SKILL WHILE AT THE SAME
TIME BUILDING CAPACITY AT LOCAL
LEVEL IN THAT WAY.
BUT THEN YOU COME UPON, YOU
KNOW, THE INSTITUTIONAL
BARRIERS, IN BEING ABLE TO
PROVIDE PAYMENT BECAUSE
STRUCTURES DON'T NECESSARILY
EXIST, OR HAVEN'T BEEN THOUGHT
ABOUT, TO SUPPORT COMMUNITIES IN
THAT WAY.
AND MORE IN THE COMMUNITY SIDE,
I THINK ANOTHER CHALLENGE THAT
WE DON'T REALLY TALK ABOUT OFTEN
IS WILL WE HAVE PERHAPS TO
NAVIGATE CHANGES IN LEADERSHIP,
WHATEVER IS HAPPENING IN THE
COMMUNITY ORGANIZATIONS, AND HOW
THEIR PRIORITIES MIGHT SHIFT,
HOW WE NEED TO BE FLEXIBLE TO
WHATEVER SHIFTS THEY HAVE TO
NAVIGATE.
I DON'T KNOW THAT WE HAVE -- OR
WE HAVE SUPPORTED COMMUNITIES
WELL, TO KNOW HOW TO DO THAT,
WHILE AT THE SAME TIME WORKING
WITH INSTITUTIONS, I DON'T KNOW
IF THAT MAKES SENSE.
>> SO I WANT TO SAY IT MAKES A
LOT OF SENSE.
AND THE INFRASTRUCTURE ISSUE IS
HUGE.
EVEN ISSUE FOR ACADEMIC
INSTITUTIONS WHICH MAY BE LOW
RESOURCED AS WE CALL THEM
INSTITUTIONS, MINORITY-SERVING
INSTITUTIONS, IF YOU'RE NOT A
RESEARCH-1 UNIVERSITY DO YOU
HAVE THE INFRASTRUCTURE AND TO
BETWEEN COMMUNITIES AND AND
COMMUNITY ORGANIZATIONS WOULD
HAVE THE INFRASTRUCTURE BUILD
IN, IT'S NOT THERE, IT'S ABOUT
CAPACITY BUILDING.
COMPASS IS BUILDING OUT CAPACITY
BUILDING MAKING RESOURCES
AVAILABLE, HUBS, BUILDING
MATERIALS, THE COORDINATING
CENTER, THE DISSEMINATION IS NOT
ALWAYS GREAT BECAUSE WE'RE NOT A
MARKETING AGENCY.
MAKING SURE WE BUILD
PARTNERSHIPS, FOR INSTANCE WITH
OUR FELLOW AGENCIES, BUILDING
COMMUNITY WITH OTHER AGENCIES
WHO MAY NOT DO RESEARCH BUT HAVE
A STRONGER REACH IN COMMUNITIES
AND PARTNERING WITH
ORGANIZATIONS THAT HAVE, THAT
REACH INTO COMMUNITIES, IF WE
WANT TO MAKE SURE THAT WE HAVE
STRUCTURAL INTERVENTION AND
REALLY GET THINGS UPSTREAM WE'RE
GOING TO HAVE TO THINK
DIFFERENTLY ABOUT BUILDING
CAPACITY AND RECOGNIZING
BUILDING CAPACITY INVOLVES
COMMUNITY MEMBERS, COMMUNITY
PARTNERS, NOT JUST BUILDING
RESEARCHERS THAT ARE IN THE
TRADITIONAL SENSE OF ACADEMIA.
AND THERE ARE SOME PROJECTS
WHERE IF YOU ASK PEOPLE WORKING
ON THE RESEARCH, YOU SAY
COMMUNITY HEALTH WORKERS, WHAT
IS YOUR TITLE, WHAT DO YOU WANT
TO BE CALLED, THEY SAY
RESEARCHERS.
YOU CAN BE A RESEARCHER IN YOUR
COMMUNITY AND HAVE A VERY
DIFFERENT TYPE OF TRAINING AND
CAPACITY BUILDING THAN
TRADITIONAL ACADEMIA.
WE HAVE TO VALUE THAT AND GOING
BACK TO MY COLLEAGUE STEPHEN
THOMAS TALKING ABOUT MAKING SURE
IT'S PAID AT THAT CAPACITY AND
PAID AT THE LEVEL THAT IT
DESERVES IF YOU'RE WORKING IN
THE COMMUNITY.
>> YOU KNOW, WE COME IN WITH OUR
LANGUAGE, AND SO DURING THE
PANDEMIC THE HEALTH PROFESSIONAL
ARRIVED AND WERE TALKING ABOUT
HERD COMMUNITY.
THIS IS FEBRUARY, IN THE MIDST
OF THE PANDEMIC, HERD COMMUNITY.
WHAT'S FEBRUARY?
BLACK HISTORY MONTH.
WHAT'S ON TV?
SLAVERY TO FREEDOM.
YOU KNOW WHAT THE BARBER SAID TO
ME?
DR. T, HERD COMMUNITY, WE'RE NOT
ANIMALS, WE'RE NOT COWS.
I THOUGHT THAT WAS INTERESTING.
I BEGAN TO EXPLAIN WHAT HERD
IMMUNITY MEANT.
YOU KNOW WHAT THEY SAID BACK TO
ME?
MMM, THAT SOUNDS LIKE COMMUNITY
IMMUNITY.
THAT BECAME THE T-SHIRT.
SO MY POINT IS IF WE LISTEN,
THEY WILL GIVE US THE LANGUAGE
THAT WE NEED THAT DOESN'T
MARGINALIZE MS. FARMER, AS YOU
DESCRIBED, THAT LIFTS UP THEIR
OWN GIFTS.
IF I HAD IMAGES OF A STAINED
GLASS WINDOW INSTEAD OF BARBER
POLES YOU WOULD UNDERSTAND THE
POWER OF THE CHURCH, THE BLACK
CHURCH IS NOT INTEGRATED IN
HEALTH OUTREACH, NOBODY THINKS
TWICER BIT.
THE BARBERSHOP IS THE OTHER
SACRED SPACE IN THE AFRICAN
AMERICAN COMMUNITY, WHERE THEY
HAVE AGENCY.
THESE ARE SMALL BUSINESSES, THEY
ARE NOT NON-PROFITS.
WHY HAVEN'T WE TALKED MORE ABOUT
THE LOCAL CHAMBER OF COMMERCE?
WHY HAVEN'T WE TALKED MORE ABOUT
THE SMALL SMALL BUSINESS
ADMINISTRATION AND LOOKING AT
THE DISMANTLING OF THE VERY
EFFORTS TO ADDRESS STRUCTURAL
RACISM, IT'S GOING ON RIGHT NOW
AS WE SPEAK.
THE ABANDONMENT OF THE D.E.I.
FROM JOHN DEERE, UNDERMINING OF
OF MINORITY SET-ASIDES IN THE
SMALL BUSINESS ADMINISTRATION,
ALL THIS IS AFFECTING US IN
HEALTH.
SO I THINK THE COMMUNITY CAN
GIVE US NEW LANGUAGE.
AND HERE'S THE OTHER THING IN
ADDITION TO OUR ARTICLES AND
JOURNALS, WE'VE BEEN
COLLABORATING WITH ARTISTS AND
WE'VE TURNED OUR QUALITATIVE
RESEARCH FINDINGS INTO GRAPHIC
NOVELS.
THE BARBERSHOP STORYBOOK, AND
EVEN A COLORING BOOK.
SO WE NEED DIFFERENT FORMATS TO
DELIVER OUR SCIENCE BACK TO THE
COMMUNITY SO THEY CAN LITERALLY
SEE HOW THEIR VOICES WERE LIFTED
UP TO MAKE CHANGE.
>> THIS IS A REALLY FASCINATING
CONVERSATION.
ON SLIDO THERE'S LOTS OF
INTERACTION, PEOPLE ARE REACTING
TO WHAT YOU'RE SHARING.
IN THE INTEREST OF TIME WE'LL
TRANSITION OVER TO TAKE AS MANY
QUESTIONS AS WE CAN FROM WHAT'S
COME FROM THE AUDIENCE.
SINCE YOU WERE JUST SPEAKING,
DR. T, I'LL GO BACK TO YOU.
THERE'S A QUESTION ASKING
WHETHER YOU CAN ELABORATE ON
WHAT YOU MEAN WHEN YOU SAY THAT
OUR COUNTRY HAS TRANSITIONED TO
A FOCUS ON CLASS.
WOULD IT BE POSSIBLE TO PROVIDE
EXAMPLES HOW OR WHERE CLASS IS
AN EXPLICIT FOCUS?
>> I THINK THAT IT'S A GUT
RESPONSE TO WHAT I'M SEEING ON
TV.
AND IN THE POLITICAL ENVIRONMENT
THAT WE'RE IN RIGHT NOW.
THE RECOGNITION THAT, YOU KNOW,
WHITES ARE NOT A MONOLITH.
WE'VE ALWAYS HAD POOR WHITES WHO
SUFFERED LIKE POOR BLACK PEOPLE
IN GENERAL.
BUT THAT DISTINCTION HAS
SOMETIMES BEEN USED TO DIVIDE
US.
BUT TO WITNESS IT IN REAL TIME,
TO SEE, YOU KNOW, OUR LANGUAGE,
OUR SYMBOLISM, OUR KIND OF CIVIL
RIGHTS APPROACH DEMONSTRATING,
BEING USED IN A WHOLE OTHER WAY.
I THINK WE'LL BE BEHIND THE
CURVE IF WE DON'T RECOGNIZE THAT
CLASS MATTERS, AND ISABEL
WILKERSON LAID OUT A ROAD MAP
MOVING FORWARD.
NOW GENTRIFICATION AND REDLINING
USING TO BLACK-WHITE.
NOW IF YOU CAN AFFORD TO LIVE
OVER HERE WE DON'T CARE WHAT
COLOR YOU ARE.
NOW WE'RE INTO THE ECONOMICS OF
OPPORTUNITY.
AND SO WE MAY WELL NEED TO
CHANGE SOME TACTICS, TAKE A LOOK
AT THIS.
WHO COULD HAVE IMAGINED WHEN WE
HAVE A LAW TO BAN MENTHOL
CIGARETTES IN THE BLACK
COMMUNITY, WE ALL KNOW THE
DEVASTATION TOBACCO CAUSES IN
OUR COMMUNITY, RIGHT?
WHO COULD HAVE IMAGINED THERE
WOULD BE BLACK CIVIL RIGHTS
ORGANIZATIONS OPPOSED TO THE
BAN?
HOW DID THAT GET ALL TWISTED UP?
I THINK WE HAVE TO SPEAK TO THAT
IN THE NAME OF OUR PUBLIC HEALTH
APPROACH, BUT ALSO RECOGNIZE
POLITICS ON THE GROUND.
WE'RE PUSHING SUGAR IN OUR
COMMUNITIES, ANOTHER ADDICTIVE.
SO WE MAY WELL FIND THAT A
REFRAMING IS NECESSARY MOVING
FORWARD.
WHEN WE REFRAME, LET'S SAY
ADDICTIONS, I SEE A WHOLE LOT OF
WHITE FOLKS PROMISING YOUNG
WHITE KIDS WHO ARE NOW ADDICTED,
LITERALLY WALKING THE STREETS IN
BALTIMORE CITY, IT IS A SAD
SIGHT TO SEE, BUT IT'S A
FUNCTION OF CLASS.
AND HOW YOU FALL OUT OF THE
MIDDLE CLASS AND HOW YOU CAN END
UP ON THE STREET IN SPITE OF
ONE'S REAL OR PERCEIVES
PRIVILEGE.
IT WOULD TAKE TIME FOR THIS
CLASS FRAME TO RESONATE, I DON'T
THINK ANYONE'S PUTTING IT IN
THEIR GRANTS RIGHT NOW.
RIGHT NOW WE'RE TALKING
BLACK-WHITE.
I GET IT.
BUT WE NEED TO REALLY WATCH
WHAT'S HAPPENING IN THE CONTEXT
OF CLASS.
>> THANK YOU.
WE'LL GO TO THE MOST POPULAR
QUESTION ON SLIDO, WHAT DO WE DO
WHEN COMMUNITIES GET STUDIED TO
DEATH AND DON'T RECEIVE
RESOURCES TO HELP?
AND TO WHOEVER WANTS TO TAKE IT
FIRST.
>> THEY CALL THAT EXTRACTION.
I HAD TO LOOK IN THE MIRROR
MYSELF.
HAVE I BEEN EXTRACTING?
HAVE I JUST BEEN DOCUMENTING THE
SUFFERING, WRITING IT UP, BUT
NOT HAVING A SOLUTION?
BECAUSE I THINK THAT'S SOMEBODY
ELSE'S JOB?
AND THEN EARLY IN MY CAREER
THAT'S ACTUALLY HOW I WAS
MENTORED.
AND I REMEMBER EVEN SOME YOUNG
SCHOLARS TOLD IF YOU WORK IN THE
COMMUNITY YOU'LL NEVER GET
TENURED, IN YOU TRY SOLVE IT.
WE HAVE TO GET AWAY FROM THAT.
NIMHD HAS HELPED, ENCOURAGING
INVESTIGATORS TO DO REAL WORLD
INTERVENTIONS.
SO LET'S BE AWARE OF EXTRACTING
WITHOUT ADDING VALUE BACK, AND
AVOID THAT WHEN POSSIBLE.
AND PARTNER WITH THOSE WHO CAN
COME IN AND ACTUALLY ADDRESS
SOME OF THE SOLUTIONS.
>> OR MAKE IT PART OF THE MODEL,
RESEARCH MODEL, IN TERMS OF
EMPOWERING OR THINKING ABOUT
UPSTREAM CHANGING POLICY, MAKING
SURE THAT THE KIND OF RESEARCH
THAT'S DONE WILL REALLY INFORM
STRUCTURAL CHANGES, AND ADDRESS
STRUCTURAL RACISM.
IF WE BUILD IT IN THE WAY THAT
IT WILL DO THAT, THAT'S
IMPORTANT.
HOWEVER, LIKE YOU SAID, IF
YOU'RE NOT BUILDING IT THAT WAY,
YOU'LL GET THE RESULT YOU'RE
GOING TO GET.
I THINK THERE'S A LOT OF
OPPORTUNITY TO MAKE THAT PART OF
OUR RESEARCH MODEL, IN TERMS OF
THE SOLUTION, INTERVENTIONS THAT
WORK UPSTREAM, AND THAT IS THE
RESEARCH THAT HAS TO HAPPEN.
>> THAT MAKES ESSENTIAL, CHERYL.
THERE'S THE POWER TO MAKE THAT
HAPPEN, THE COMMUNITY CAN THAT
BE RESOURCE IF WE'RE STRUCTURING
THAT WAY, RIGHT, SO IMPORTANT.
HOW CAN WE SUPPORT AND RAISE UP
THE VALUE OF LIVED EXPERIENCE S
A RECOGNIZED FORM OF DATA?
>> I WANT TO GET IN ON THIS
BECAUSE WE DID USE LIVED
EXPERIENCE, AND I KNOW WE TALKED
ABOUT THAT BEFORE IN THIS
MEETING, ABOUT LIVED EXPERIENCE
IN TERMS OF THINKING ABOUT
RESEARCH.
I MEAN, WE KNOW IT'S OF VALUE,
INTEGRATED INTO LISTENING
SESSIONS AND REVIEW, TO
INTEGRATE INTO ALL PARTS OF WHAT
YOU'RE DOING, CHANGING THE
RESEARCH, THE WAY YOU FRAME THE
QUESTION.
WE HAVE TO MAKE SURE PEOPLE
UNDERSTAND THE DATA, WHETHER
QUALITATIVE, AND MAKE SURE THOSE
WITH LIVED EXPERIENCE ARE PART
OF THE ENTIRE PROCESS FROM
RESEARCH INITIATIVES ALL THE WAY
TO THINKING ABOUT IMPACTFUL
POLICY.
THAT REALLY IS THE ONLY WAY TO
DO THIS.
WE ARE MAKING SURE WE INVOLVE
LIVED EXPERIENCE, SOME
INSTITUTES HAVE THEM, PEOPLE
WITH LIVED EXPERIENCE ON REVIEW
COMMITTEE, SO THERE'S A LOT OF
EXAMPLES HOW WE CAN DO THIS.
>> DOES ANYONE WANT TO ADD TO
THAT?
>> YEAH, I WOULD JUST ADD I
THINK THE LIVED EXPERIENCE IS
CONNECTED TO THE PREVIOUS
QUESTION, AROUND I WOULD SAY
COMMUNITY EXHAUSTION, SO TO
SPEAK.
I THINK THAT IF INSTITUTIONS
DON'T CHANGE THEIR MODELS SOON
THAT THE COMMUNITY WILL
ABSOLUTELY REJECT RESEARCHERS
COMING INTO THE COMMUNITY,
BECAUSE PEOPLE ARE LITERALLY IN
SURVIVAL MODE BECAUSE OF THE
TRAUMAS THEY HAVE EXPERIENCED
THROUGH THEIR LIVED EXPERIENCE,
AND TALKING ABOUT THAT FOR THE
GAIN OF RESEARCH, I THINK IT
HELPS THE INSTITUTION AND WE
WANT TO BELIEVE IT WILL THEN
MOVE UP TO A POLICY LEVEL AND,
YOU KNOW, THAT WOULD BE FINE BUT
WE'RE DEALING WITH REAL PEOPLE
WHO HAVE REAL ISSUES, IN REAL
TIME AND REAL LIFE.
AGAIN, I THINK THAT WE'RE SO
SMART, AND I THINK SOMETIMES
WE'RE SO SMART WE FORGET THE
MOST SIMPLE THING WHICH IS THAT
WE'RE HUMAN, RIGHT?
AND SO, YOU KNOW, COMING FROM
THAT LENS AND THAT PERSPECTIVE
PEOPLE REALLY DO WANT TO GET OUT
OF THEIR HELLISH REALITY.
IF RESEARCH CAN SUPPORT THAT,
THEN I THINK THAT THERE SHOULD
BE MORE RESEARCH DONE
NECESSARILY, YOU KNOW, IN THAT
LANE.
AGAIN, I THINK THERE HAS TO BE A
SHIFT IN THE PARADIGM AND MODEL
SO THAT COMMUNITIES WANT TO
CONTINUE WORKING WITH
RESEARCHERS SO THEY DON'T FEEL
LIKE THEY ARE BEING TAKEN
ADVANTAGE OF AND I HAVE
LITERALLY HEARD THIS
CONVERSATION FOR THE ENTIRE TIME
THAT I HAVE BEEN WORKING IN
COMMUNITY BECAUSE I DON'T SEE
MYSELF APART FROM THE COMMUNITY.
I AM THE COMMUNITY.
AND I HAVE THE MOST INTERACTION
WITH PEOPLE WITHIN THE COMMUNITY
THOUGH I WALK THIS FINE LINE
BETWEEN INSTITUTION AND
COMMUNITY.
IT GIVES ME THAT ADVANTAGE SO
I'M LISTENING TO WHAT THE
COMMUNITY IS SAYING AND THEN I'M
TRANSLATING IT TO THE OTHER
SIDE, INSTITUTIONS, AND VICE
VERSA, AND PEOPLE ARE EXHAUSTED
BECAUSE THEY HAVEN'T SEEN ANY
REAL CHANGE.
AGAIN, THAT'S WHY I STARTED TO
FOCUS MY EFFORTS AND MORE TIME
ON, WELL, WHAT CAN YOU CHANGE,
WHAT'S IN YOUR POWER TO CHANGE?
YOU DON'T HAVE TO WAIT FOR A
POLICY OR RESEARCH IN ORDER TO
CHANGE HOW YOU FEEL ABOUT
YOURSELF AND TO HEAL YOUR
TRAUMA, AND TO EMPOWER AND
UPLIFT YOURSELF AND YOUR
COMMUNITY BECAUSE I THINK
SOMETIMES WE FORGET THE
COMMUNITY IS MADE UP OF
INDIVIDUAL PEOPLE, RIGHT?
WE SAY COMMUNITY AS A BLANKET
STATEMENT BUT WE ARE INDIVIDUAL
PEOPLE, WHO MAKE UP THAT
COMMUNITY.
AND IT'S IMPORTANT FOR US TO
ACKNOWLEDGE AND HONOR ALL OF US
AS SUCH, AS INDIVIDUALS WITH
THESE LIVED EXPERIENCES, AND SO
THAT IT WON'T FEEL LIKE
EXTRACTION OR THAT THE COMMUNITY
DOESN'T FEEL LIKE THEY ARE BEING
TAKEN ADVANTAGE OF, BUT I WOULD
SAY FROM A GENERAL CONSENSUS
THAT IS HOW A LOT OF COMMUNITY
MEMBERS FEEL.
>> YOU KNOW, MS. FARMER, YOU'RE
REMINDING ME OF SOMETHING.
I'M SO GLAD I MET YOU HERE.
WE HAVE TO LOVE THE COMMUNITY.
LET'S DEFINE THAT IN A DIFFERENT
WAY, AS MAYOR OF -- FORMER MAYOR
OF TUSKEGEE, ALABAMA SAID TO ME.
LOVE.
LEAVING OTHERS VERY ENCOURAGED.
LET'S LOVE THE COMMUNITY.
LET'S MAKE SURE WE LEAVE SACRED
SPACES OR HAVE GRACIOUS SPACE
EVEN IF THE STUDY WE'RE DOING IS
AN EXTRACTION, SOMETHING WE'RE
COLLECTING BIOLOGICAL MATERIALS
THAT WON'T BENEFIT THE
INDIVIDUAL BUT CONTRIBUTE TO THE
OVERALL SCIENCE.
WE CAN STILL LOVE THE COMMUNITY,
WE CAN STILL LEAVE THEM VERY
ENCOURAGED.
I WANT TO THANK NIDA FOR WILLING
TO HAVE A NEW PARADIGM WE WERE
ACTUALLY COLLECTING HAIR SAMPLES
IN THE BARBERSHOP MEASURING
CORTISOL, STRESS.
WE FRAMED IT AT STRESS, IT WAS
TAKING BARBERS AND STYLISTS TO
NIDA LABORATORIES IN BALTIMORE
TO SEE THE SCIENTISTS AND SEE
WHERE THE HAIR WAS ANALYZED.
THE NIDA SCIENTISTS THEN CAME O
THE BARBERSHOP AND DID A MASSIVE
HEALTH FAIR WITH A POSTCARD
THANKING THE PARTICIPANTS FOR
CONTRIBUTING TO THE SCIENCE.
THAT'S A NEW WAY OF DOING
BUSINESS.
WE NOW HAVE TRUST.
NOW WE MUST BE TRUSTWORTHY.
IF WE ABANDON THEM NOW WE MAY
NOT GET THIS DOOR OPENED AGAIN
BECAUSE WE DID MOVE THE NEEDLE
DURING THE PANDEMIC.
AND EVEN THE HEALTH
PROFESSIONALS WHO CAME TO THE
COMMUNITY, YOU KNOW WHAT THEY
SAID?
DR. T, WE LOVE COMING OUT TO THE
NEIGHBORHOODS.
OH BY THE WAY, THAT'S THE
NICKNAME THE BARBERS GAVE ME.
ONCE YOU GET A NICKNAME YOU KNOW
YOU'RE IN.
SO WE HAVE TO BE THERE FOR THE
LONG TERM COMMITMENT.
>> SO WE STARTED --
>> SORRY.
>> GO AHEAD PLEASE.
>> VERY QUICKLY, I REALLY WANT
US TO START THINKING ABOUT
SHIFTING OUR LANGUAGE IN THE
SENSE THAT THE COMMUNITY IS NOT
SEPARATE FROM THE INSTITUTION.
WE ARE THE COMMUNITY.
AS RESEARCHERS, YOU ARE THE
COMMUNITY.
BECAUSE I THINK THAT, AGAIN, WE
DO A LOT OF OTHERING, AND THAT
IS WHAT CREATES A BARRIER
BECAUSE THEN WE'RE LOOKING AT
PEOPLE LIKE THOSE PEOPLE OVER
THERE, THEY ARE THE ONES THAT
NEED THE HELP.
THEY ARE THE ONES THAT NEED THE
SUPPORT.
WHEN, NO, WE ALL -- IF SOMETHING
HAPPENS TO ONE OF US IT HAPPENS
TO ALL OF US, TO ALL OF US.
IF WE LOOKED AT IT THAT WAY WE
WOULD APPROACH THE WORK
DIFFERENTLY, WE WOULDN'T LOOK AT
OURSELVES SEPARATE FROM THE
RESEARCH THAT NEEDS TOP HA.
WE WOULD BE INCLUDED IN IN A
RESEARCH NOT BECAUSE OF OUR SKIN
COLOR, NOT BECAUSE OF OUR
RELIGION OR GENDER BUT BECAUSE
WE'RE ALL ONE AND WANT TO WORK
TO SOLVE ISSUES HAPPENING IN OUR
COMMUNITY.
JUST REMINDER FOR US FROM MY
PERSPECTIVE THAT WHEN WE START
TO SEPARATE OURSELVES AND PUT
OURSELVES IN BUCKETS AND
CATEGORIES, THAT'S WHEN THE
DISCONNECT HAPPENS.
PEOPLE CAN FEEL THAT.
PEOPLE DON'T FEEL THE
AUTHENTICITY, SO GOING INTO
COMMUNITIES PEOPLE CAN SMELL
AUTHENTICITY BECAUSE THEY HAVE
BEEN AROUND THE BLOCK.
WE WORKED WITH INSTITUTIONS AND
RESEARCHERS FOR DECADES, FOR
YEARS.
THE SOONER WE CAN TAKE OFF OUR
HATS AND STRIP OURSELVES OF
TITLES, VERY IMPORTANT TO ME, I
REMEMBER TELLING MY STAFF I'M
GOING TO TAKE AWAY EVERYBODY'S
TITLE BECAUSE IF THAT WHAT'S IS
HINDERING YOU FROM DOING THE
WORK THAT NEEDS TO BE DONE WITH
PEOPLE, NO ONE IN HERE WILL HAVE
A TITLE BUT ME.
WE CAN'T ALLOW OUR TITLES TO
DICTATE HOW WE INTERACT WITH
COMMUNITY BECAUSE WE'RE HUMANS,
IT DOESN'T MATTER THE NUMBER OF
DEGREES WE HAVE, DOESN'T MATTER
THE WORK, THOSE THINGS DON'T
MATTER WHEN IT COMES TO
COMMUNITY BECAUSE THEY ARE JUST
LOOKING AT YOU AS WHO ARE YOU
AND WHAT DO YOU WANT FROM US.
>> I COULD LISTEN TO YOU TALK
ALL DAY.
WE'RE TALKING A COUPLE EXTRA
MINUTES BECAUSE WE STARTED A
LITTLE LATE, AND I DO WANT TO
ASK EVERYONE TO MAYBE OFFER ONE
MINUTE, MAX, CLOSING COMMENTS.
CHERYL, THERE'S SO MANY THINGS
IN SLIDO WE WON'T GET TO, A LOT
OF QUESTIONS AROUND THE PAYMENT
FOR COMMUNITY PARTNERS, SOMEONE
INDICATED THAT IN THE STATE OF
WASHINGTON THERE A STATUTORY
REQUIREMENT FOR COMPENSATION FOR
COMMUNITY MEMBERS WITH LIVED
EXPERIENCE WHO WORK AS COMMUNITY
HEALTH WORKERS.
WE WON'T BE ABLE TO COVER THAT
BUT WE'RE CAPTURING ALL THE
QUESTIONS.
AS YOU CLOSE, ESPECIALLY CHERYL,
ONE OF THE THINGS WE OFTEN HEAR
AND THERE'S A QUESTION ABOUT
THIS, ALSO PRETTY POPULAR, IS
ABOUT THE NIH REVIEW PROCESS,
AND WHETHER OR NOT THE EXTENT TO
WHICH THESE TYPES OF TOPICS,
ROLE OF NARRATIVE RESEARCH,
STORYING TELLING, COMMUNITY
RESEARCHERS, PROPER
COMPENSATION, WHAT
RECOMMENDATION ALSO ARE THERE,
WHAT CAN YOU SHARE ABOUT
ENSURING NIH REVIEWERS AND
PEOPLE MAKING FUNDING DECISION
ALSO APPRECIATE ALL OF THESE
THINGS AND ACTIVELY SUPPORT
THESE APPROACHES.
I'LL START WITH YOU AND ASK
EVERYONE TO CLOSE US OUT WITH
FINAL THOUGHTS.
>> THAT'S A REALLY GOOD
QUESTION, SOMETHING WE STRUGGLED
WITH DESIGNED COMPASS.
THE OTHER TRANSACTION AWARD
AUTHORITY DOES ALLOW FOR MORE
FLEXIBILITY.
THAT'S WHY WE CHOSE THAT WHEN IT
CAME TO FUNDING THE COMMUNITY
HEALTH, HEALTH EQUITY STRUCTURAL
INTERVENTION SITES, 25 OF THEM.
OTHER MODELS WHERE PEOPLE MAY
USE OTHER TRANSACTION AWARD AND
GIVE IT TO AN ENTITY AND THEN
THEY GIVE IT TO OTHER COMMUNITY.
CEAL SOMETIMES USE US THAT AS
WELL.
I DO THINK IT'S IMPORTANT NOT
ONLY TO USE FLEXIBLE MECHANISMS
NOW AVAILABLE TO THINK ABOUT
CONTRACTS, SMALL BUSINESS, THINK
ABOUT EVERYTHING.
AND HOW THAT COULD BE USED IN
COMMUNITIES.
BUT ALSO MAKE SURE THAT WHEN A
PROPOSAL IS SUBMITTED, THAT IN
TERMS OF HOW YOU LAY OUT YOUR
BUDGET THAT YOU DO GIVE VALUE TO
COMMUNITY HEALTH WORKERS OR
WHOEVER IS IMPORTANT IN TERMS OF
THE SALARY AND JUST JUSTIFY IT.
THERE'S A LOT OF EDUCATION,
WE'RE TALKING ABOUT A CULTURE
CHANGE HERE SO IT'S IMPORTANT IN
APPLICATION NO MATTER WHAT TYPE
OF FUNDING INSTRUMENT WE'RE
GOING TO USE THAT IT'S
JUSTIFIED, AND THAT IT'S WELL
JUSTIFIED, AND AS PART OF WHAT
WE'RE DOING, WE'RE DOING
EVALUATION, THE BEST WAY TO DO
IT.
THIS IS ONE MODEL.
THERE'S SEVERAL MODELS IN TERMS
OF MAKING SURE THERE'S ADEQUATE
COMPENSATION FOR ALL THE
RESEARCHERS, INCLUDING COMMUNITY
HEALTH WORKERS WHO ARE
RESEARCHERS, WELL COMPENSATED,
BUILT INTO THE INFRASTRUCTURE
AND AS WE BUILD CAPACITY.
>> YOU'LL HAVE TO PING PONG TO
CALL ON SOMEBODY.
MONICA, WHO IS NEXT?
>> LET'S GO TO ADAOBI.
>> CLOSING THOUGHTS, AM I
CORRECT?
>> YES.
>> I THINK I REALLY LIKED THE
QUESTION ABOUT, YOU KNOW, HOW DO
WE RAISE UP THE VALUE OF LIVED
EXPERIENCES BECAUSE I THINK AS
RESEARCHERS, ESPECIALLY WE GET
STUCK IN OUR HEAD A LOT, AND
FAIL TO UNDERSTAND THE WHY OF
OUR WORK AND WHO IS IT FOR, WHO
IS GOING TO USE IT, AND I THINK
VERY IMPORTANTLY WE NEED TO STEP
AWAY FROM WHAT WE THINK WE KNOW
ABOUT THE COMMUNITIES, ABOUT THE
PEOPLE THAT WE SERVE, FREQUENTLY
LOOK INWARD WITH FRESH EYES,
PARTICULARLY WITH CULTURAL
HUMILITY, AND BE OPEN TO DATA
AND INFORMATION FROM WHAT ARE
CONSIDERED NON-TRADITIONAL
SOURCES.
AND, YOU KNOW, REDUCE OUR
RELIANCE ON WHAT WE CONSIDER
RELIABLE OR STEREOTYPICAL
INFORMATION.
SO THAT'S MY TWO CENTS FOR THIS
SESSION.
>> YEAH, I THINK WE HAVE TO
ACKNOWLEDGE THE GIANT SHOULDERS
WE STAND ON, JUST YESTERDAY WAS
THE OBITUARY OF PETER BUXTON,
PUBLIC HEALTH SERVICE
PROFESSIONAL AT THE CDC, WHO AS
THE PAPER SAID BLEW THE WHISTLE
ON THE U.S. PUBLIC HEALTH
SERVICE SYPHILIS STUDY AT
TUSKEGEE.
I POSTED TO LINKED IN.
SOMEONE SELD DON'T FORGET BILL
GENERAL SINCE, THE BLACK CDC
PERSON, INSIDE FIGHTING TO
EXPOSE THE ATROCITIES OF THE
TUSKEGEE STUDIES, ALSO PASSED
AWAY.
WE STAND ON THEIR SHOULDERS.
WE MUST LOOK IN THE MIRROR,
BROTHERS AND SISTERS, AND
RECOGNIZE THERE'S BOTH DANGER
AND OPPORTUNITY.
THE DANGER TO ASSUME CHANGES IF
THEY VENTS HAPPENED IMMEDIATELY
BECAUSE THERE'S SOMETHING WRONG
WITH THE COMMUNITY.
THINKING THERE'S SOMETHING WRONG
WITH BEING UNDERREPRESENTED,
DISENFRANCHISED, SOMETHING
INNATELY WRONG WITH THEM.
WE REJECT THAT.
THE OPPORTUNITY IS TO STREET
THIS AS A DISASTER, CATASTROPHE,
MEET IT AS OTHER DISASTERS AND
CATASTROPHES ARE MET, WITH
ADEQUATE RESOURCES.
DON'T YOU REMEMBER WARP SPEED?
IT WAS A MIRACLE, TO GET A
LIFE-SAVING VACCINE IN RECORD
TIME.
WARP SPEED.
WE WANT QUANTUM SPEED FOR THE
COMMUNITY.
THEY REMOVED ALL THE BARRIERS
FOR THE COMPANIES TO GET THAT
VACCINE.
LET'S REMOVE ALL THE BARRIERS
AND COME TOGETHER AROUND
AUTHENTIC COMMUNITY ENGAGEMENT
THAT LEADS TO COMMITMENT AND
ULTIMATELY HEALTH EQUITY.
>> I WILL CLOSE WITH SAYING THAT
WE DO NEED AUTHENTIC COMMUNITY
PARTNERS, AS INDIVIDUALS ARE
AUTHENTIC.
THAT MEANS BEING WHO WE ARE,
EXACTLY WHO WE ARE, RIGHT?
NOT, YOU KNOW, TRYING TO PUT ON
A MASK BECAUSE MANY OF US SHOW
UP WITH MASKS, AND BECAUSE WE
JUST HAVE BEEN CONDITIONED TO DO
THAT.
AND BEING AUTHENTICALLY WHO YOU
ARE WILL AUTOMATICALLY LEAD TO
AUTHENTIC COMMUNITY
PARTNERSHIPS.
AND I THINK, AGAIN, THAT, YOU
KNOW, MY MINISTRY RIGHT NOW IS
JUST HEALING.
IT'S THE DEEP-ROOTED WORK.
YOU KNOW, I THINK WE HAVE A LOT
OF RESOURCES IN TERMS OF DEALING
WITH IMMEDIATE NEEDS, SURFACE
LEVEL NEEDS, AND I THINK THERE'S
NOT BEEN ENOUGH ATTENTION TO THE
DEEP HEALING WORK THAT NEEDS TO
OCCUR WITHIN EACH AND EVERY ONE
OF US, AND THAT'S WHY I LOVE
HEALING.
I LOVE TALKING ABOUT HEALING
BECAUSE IT'S THE ONE INCLUSIVE
THING, THE ONE THING THAT
EVERYONE NEEDS, NO ONE IS EXEMPT
FROM IT.
IT DOESN'T ALLOW US TO "OTHER"
PEOPLE.
IT ALLOWS US TO SAY WE'RE IN
THIS.
THESE ARE OUR ISSUES.
AND IN ORDER FOR US TO EFFECT
REAL CHANGE AND TRANSFORMATION
THE SUCCESS OF THAT
TRANSFORMATION WITHIN OUR
COMMUNITIES, THEN WE HAVE TO DO
IT ON AN INDIVIDUAL LEVEL, THAT
THEN WILL PROJECT ON OUT INTO
THE COMMUNITY AND I'LL JUST
LEAVE WITH THE LAST PIECE, WHEN
I FIRST STARTED ON THIS
INITIATIVE AROUND INFANT
MORTALITY TEN YEARS AGO, THE
INITIATIVE WE DECIDED TO CALL
IT, AND HOW ARE THE CHILDREN,
AND THAT CAME FROM THE TRIBE IN
AFRICA, THE MASASI TRIBE,
INSTEAD OF SAYING HELLO THEY
SAY, AND HOW ARE THE CHILDREN?
I STILL USE THAT BECAUSE IF WE
ASK EACH OTHER THAT ON A DAILY
BASIS, HOW ARE THE CHILDREN,
THAT WILL KEEP US HONEST.
BECAUSE IF YOU ASKED ME TODAY I
WOULD SAY THE CHILDREN ARE DOING
TERRIBLE, RIGHT?
LEAD POISONING, INFANT
MORTALITY, EDUCATION, AND WE
HAVE A PROBLEM BEING HONEST,
BECAUSE THAT MEANS WE HAVE TO
REFLECT ON OURSELVES, SOMETHING
WE DON'T LIKE DOING.
WE LIKE TO REFLECT ON OTHER
PEOPLE, NOT OURSELVES.
THAT'S A HUMAN THING, RIGHT?
BUT I THINK IF WE REALLY WANT TO
SEE A HEALTHY UNITED STATES,
HEALTHY PEOPLE 2030, HONESTY AND
AUTHENTICITY IS REQUIRED.
IT'S GOING TO TAKE THE NECESSARY
WORK ON THE DEEP LEVEL, ALSO
CONTINUING TO DO THE WORK ON A
SURFACE LEVEL FOR US TO ACHIEVE
THAT GOAL AND I COULD BE CRAZY
BUT I'M CRAZILY OPTIMISTIC, WE
CAN DO IT.
I THINK WE CAN REALLY
TRANSFORMED OUR COMMUNITIES,
THAT'S WHY I'M SO COMMITTED
STILL TO THIS WORK, EVEN AFTER
LEAVING THE NON-PROFIT SECTOR
BECAUSE I NEEDED TO UNDERSTAND
WHY THIS IS HAPPENING ARE TO OUR
BABIES AND TO US AS A CULTURE.
AND WHY THESE THINGS ARE
HAPPENING TO US AS A COMMUNITY.
SO I'M GOING TO CLOSE WITH OUR
NEED OF HEALING ON INDIVIDUAL
LEVEL.
WE THINK WE CAN COME TO WORK
WITHOUT BRINGING OUR PERSONAL
LIVES, BUT THAT'S NOT TRUE.
WE ARE WHO WE ARE WHEREVER WE
GO.
AND WE HAVE WORK TO DO.
>> WOW, MS. FARMER, WE SNAP.
LET'S SNAP THE COMMUNITY OUT
THERE, PEOPLE.
THE BARBERS, STYLISTS, SNAP THEM
UP.
THE TROY STANTON OF THE WORLD,
GROUPS HAVE SUSTAINED THEMSELVES
IN SPITE OF BARRIERS, WE NEED
CASE STUDIES OF THEIR WORK.
THANK YOU SO MUCH.
>> OKAY.
SO I HATE TO STOP THE
CONVERSATION BUT WE HAVE TO DO
THAT BECAUSE SUPPOSED TO TAKE A
BREAK AND COME BACK AT 12:10.
THANK YOU SO MUCH.
I MEAN THAT AUTHENTICALLY, FOR
PARTICIPATING IN THIS PANEL,
ENERGIZING FOR ME PERSONALLY AND
HOPEFULLY FOR THE AUDIENCE.
THANK YOU ALL.
WE'LL SEE YOU BACK AT 12:10.
>> WELCOME BACK, I'M DR. VANESSA
MARSHAL, A PROGRAM OFFICER AT
THE NATIONAL INSTITUTE OF
MINORITY HEALTH AND HEALTH
DISPARITIES.
I'M THE MODERATOR FOR BEST
PRACTICES, GAPS, OPPORTUNITIES,
INTERVENTION RESEARCH ADDRESSIG
STRUCTURAL RACISM AND HEALTH
DISPARITIES, HONOR TO INTRODUCE
THE SPEAKERS.
VIEW THEIR FULL BIOS ON THE
WORKSHOP WEBSITE AGENDA.
FIRST IS DR. MICHELLE MORSE,
CHIEF MEDICAL CENTER, EXECUTIVE
DEPUTY COMMISSION NEW YORK CITY
DEPARTMENT OF HEALTH AND MENTAL
EYE GENE.
DR. DEREK GRIFFITH, FOUNDING
CO-DIRECTOR OF THE RACIAL
JUSTICE INSTITUTE, FOUNDER AND
DIRECTOR OF THE CENTER FOR MEN'S
HEALTH EQUITY, PROFESSOR OF
HEALTH MANAGEMENT AND POLICY AT
GEORGETOWN UNIVERSITY.
DR. RUTH SHIM, LUKE AND GRACE
KIM PROFESSOR IN CULTURAL
PSYCHIATRY, PROFESSOR OF
CLINICAL PSYCHIATRY, DEPARTMENT
OF PSYCHIATRY AND BEHAVIORAL
SCIENCES, UNIVERSITY OF
CALIFORNIA IN DAVIS, ALSO
ASSOCIATE DEAN OF DIVERSE AND
INCLUSIVE EDUCATION AT THE
UNIVERSITY OF CALIFORNIA DAVIS
SCHOOL OF MEDICINE.
MS. ADDIE ROLNICK, PROFESSOR OF
LAW, BOYD SCHOOL OF LAW,
UNIVERSITY OF NEVADA, LAS VEGAS.
PLEASE USE THE SLIDO TO SUBMIT
YOUR QUESTIONS.
AND WE LIKE TO BEGIN WITH THE
FIRST SPEAKER, DR. MICHELLE
MORSE.
>> THANKS, DR. MARSHALL, FOR THE
KIND INTRODUCTION, HONORED TO BE
AMONGST A DISTINGUISHED PANEL
AND SPEAK ABOUT OUR ANALYSIS AND
WORK IN NEW YORK CITY, AS
RELATES TO THIS VERY, VERY BIG
AND OPEN QUESTION, WAS THE
PANDEMIC A PORTAL TO HEALTH
JUSTICE, PROGRESS, BACKLASH IN
OUR CURRENT MOMENT.
I'M AN INTERNAL MEDICINE DOCTOR
BY TRAINING, PRACTICE AT KING'S
COUNTY HOSPITAL, A LOT OF WHAT I
SPEAK ABOUT TODAY IS INFORMED BY
MY EXPERIENCES IN THE FRONT LINE
CLINICIAN WORKING IN A SAFETY
NET INSTITUTION IN NEW YORK
CITY.
LET'S JUMP RIGHT IN.
I'M GOING TO TRY MY BEST TO
SPEAK QUICKLY BUT ALSO CLEARLY.
I DO HAVE A PRETTY AMBITIOUS
LIST OF THINGS TO TALK ABOUT BUT
I ALWAYS START BY GROUNDING
OURSELVES IN SOMETHING FROM A
LONG HISTORY AND RECENT HISTORY,
WE DUBOISE, PUBLISHED IN 1899,
PHILADELPHIA NEGRO, SEEKING TO
REALLY EXPLAIN WHY BLACK HEALTH
IN PHILADELPHIA WAS WORSE THAN
THE HEALTH OF EVERYONE ELSE, WHY
IT WAS NOT A BIOLOGICAL OR
GENETIC INFERIORITY ISSUE BUT
ONE OF SOCIAL CONDITIONS.
HE STATED THE MOST DIFFICULT
SOCIAL PROBLEM IN THE MATTER OF
NEGRO HEALTH IS THE PECULIAR
ATTITUDE OF THE NATION TOWARD
THE WELL-BEING OF THE RACE.
THERE HAVE BEEN FEW OTHER CASES
IN THE HISTORY OF CIVILIZED
PEOPLE WHERE HUMAN SUFFERING HAS
BEEN VIEWED WITH SUCH PECULIAR
INDIFFERENCE, AND MORE RECENTLY
IN JUNE OF 2020 AFTER THE MURDER
OF GEORGE FLOYD KEEANGA TAYLOR
SAID JUSTICE IS NOT NATURAL PART
OF THE LIFE CYCLE OF THE UNITED
STATES NOR A PRODUCT OF
EVOLUTION; IT'S ALWAYS THE
OUTCOME OF STRUGGLE.
INCREDIBLY HELPFUL OPPORTUNITIES
TO LOOK BACK, TO LOOK FORWARD,
PARTICULARLY IN THIS MOMENT, AND
TO HELP US ANSWER THAT QUESTION
OF WHETHER OR NOT THE PANDEMIC
HAS BEEN A PORTAL FOR US.
SO, LET'S TALK ABOUT THE SOCIAL
STRUCTURAL CONTEXT AND SOME CASE
STUDIES, EXAMPLES OF RACE
CONSCIOUS STRATEGIES THAT I'VE
BEEN INVOLVED IN, I WANT TO
HIGHLIGHT TODAY.
SO, THIS IS NO LONGER REALLY
NEEDED, PARTICULARLY AMONGST THE
AUDIENCE TODAY, BUT JUST A
REMINDER AGAIN PARTICULARLY FOR
THOSE WHO ARE TRAINED AS
PHYSICIANS SO MUCH OF OUR
TRAINING IS FOCUSED ON THE
BIOLOGICAL AND BEHAVIORAL, SO
SO
LITTLE ON STRUCTURAL AND SOCIAL.
IT'S EASY TO PERPETUATE THE
NARRATIVE OF INDIVIDUAL BEHAVIOR
CHANGE AS THE SOLUTION,S OR, YOU
KNOW, IN SOME CASES EVEN GOING
AS FAR AS TO BLAME THE VICTIM
WITHOUT RECOGNIZING THE WAY
STRUCTURES AND SOCIAL DECISIONS
AND CULTURE ACTUALLY SHAPE THE
CHOICES THAT ALL OF US MAKE, AND
THE PATTERNS, RACIALIZED
PATTERNS OF CHOICES AS WELL.
WITH THAT IN MIND RIGHT IN FRONT
OF OUR FACES IS ONE OF THE MOST
GLARING RACIAL INEQUITIES AND
INJUSTICES I HEAR IN NEW YORK
CITY.
RACIAL HEALTH INEQUITIES
UNFORTUNATELY HAVE NOT IMPROVED
OVER TIME IN NEW YORK CITY.
WHAT YOU SEE HERE IS DEATHS
BEFORE THE AGE OF 65, HOW WE
DEFINE PREMATURE MORTALITY, IN
THE NEW YORK CITY HEALTH
DEPARTMENT.
LONG BEFORE THE PANDEMIC IN
2020.
THE LIFE EXPECTANCY AS WELL AS
PREMATURE MORTALITY RATE FOR
BLACK NEW YORKERS WAS
SIGNIFICANTLY HIGHER THAN ALL
OTHER RACIAL AND ETHNIC GROUPS.
UNFORTUNATELY THAT CONTINUED.
WE NEED TO BE ABLE TO UNDERSTAND
AND ARTICULATE WHY.
AGAIN, DO WHAT DEBOIS WAS TRYING
TO DO, THIS IS NOT ABOUT
GENETICS, BIOLOGY, IT'S ON
STRUCTURE AND SYSTEMIC RACISM.
CRITICAL RACE THEORY IS ONE OF
THE FRAMEWORKS HELPFUL IN OUR
ABILITY TO UNDERSTAND AND
EXPLAIN WHY THESE RACIALIZED
DIFFERENCES EXIST IN PREMATURE
MORTALITY AND IN SO MANY OTHER
AREAS.
I WANT TO JUST UNDERLINE SOCIAL
CONSTRUCTION OF RACE BEING ONE
OF THOSE TENETS THAT'S
PARTICULARLY HELPFUL FOR YOU
WILLS US IN THE MEDICAL SPACE,
WE SAY RACE IS SOCIALLY
CONSTRUCTED BUT ACTUALLY
OPERATIONALIZE THAT IN WAYS THAT
ARE DISJOINTED AND INCONSISTENT
ACROSS MEDICINE.
PUBLIC HEALTH CRITICAL RACE
PRACTICE DEVELOPEDDED BY DR.
FORD AND COLLINS IS ONE OF THE
FRAMEWORK HELPFUL HELPING US
UNDERSTAND WHY THESE RACIAL
INEQUITIES PERSIST.
IT ALLOWS US TO APPLY CRITICAL
RACE THEORY TO PUBLIC HEALTH AND
AGAIN ENGAGES US IN THIS
QUESTION OF HOW CAN WE GENERATE
KNOWLEDGE FROM OUTSIDE A
DISCIPLINE'S CORE KNOWLEDGE
BASE.
LET'S GET INTO SPECIFIC
EXAMPLES.
CHECK LISTS AND COLOR BLIND
APPROACHES ARE NEVER GOING TO
GET US TO RACIAL JUSTICE AND
RACIAL EQUITY IN HEALTH
OUTCOMES.
THE RECENTLY RELEASED REPORT
UPDATING UNEQUAL TREATMENT
TREATMENT DESCRIBES CLEARLY THE
INEQUITIES IN RACIAL HEALTH
OUTCOMES PERSIST DESPITE 20
YEARS OF US KNOWING THESE
INEQUITIES ARE A PROBLEM AND
SHOULD BE A PRIORITY.
AND YET AGAIN WHAT I'M PROPOSING
HERE AND WHAT MANY OF MY
COLLEAGUES HERE TODAY AND MANY
OTHER COLLEAGUES HAVE BEEN
PROPOSING FOR A LONG TIME OF
COURSE IS THAT RACE CONSCIOUS
STRATEGIES, NOT COLOR-BLIND
STRATEGIES, IS WHAT WE NEED TO
END RACIAL INEQUITIES IN HEALTH
OUTCOMES.
LET'S LOOK SPECIFICALLY FOR THE
PANDEMIC, MOST RECENT EMERGENCY.
THIS IS DATA FROM MAY OF 2020.
I'M SURE MANY OF YOU CAN THINK
BACK TO WHERE YOU WERE AND WHAT
YOU WERE DOING AT THAT PHASE OF
THE PANDEMIC.
IT WAS THE FIRST WAVE OF THE
PANDEMIC IN NEW YORK CITY
SPECIFICALLY.
AND THIS PATTERN WAS REPRODUCED
OVER AND OVER AGAIN BUT
SPECIFICALLY WHEN LOOKING AT
CASES, HOSPITALIZATIONS, AND
THEN DEATHS, IN NEW YORK CITY,
PARTICULARLY BLACK AND HISPANIC
PEOPLE SUFFERED
DISPROPORTIONATELY IMPACT IN
INFECTION, HOSPITALIZATION AND
DEATH.
THE CASE IS MANY PLACES.
WE DO NOT HAVE INDIGENOUS HEALTH
DATA AND YOU DON'T SEE THEM ON
THIS GROUP EVEN THOUGH NEW YORK
CITY HAS THE LARGEST INNER CITY
POPULATION OF INDIGENOUS PEOPLE
IN THE COUNTRY.
I WANT TO ACKNOWLEDGE THAT DATA
GAP.
AGAIN, THIS IS A REMINDER WHERE
WE WERE JUST FOUR YEARS AGO.
WITH THAT IN MIND OF COURSE WE
WERE LOOKING AT THE VACCINATION
INEQUITIES IN NEW YORK CITY.
THIS DATA IS FROM ABOUT SIX
MONTHS INTO THE VACCINATION
CAMPAIGN IN NEW YORK CITY.
THIS WOULD HAVE BEEN AROUND JUNE
OF 2021, THIS DATA IS
REPRESENTING, ON THE RIGHT YOU
SEE THE HEAT MAP VERSION.
ON THE LEFT YOU SEE THE RACIAL
AND ETHNIC BREAK DOWN OF THE
PEOPLE WHO HAD AT LEAST ONE DOSE
OF THE VACCINE AS OF JUNE 2021.
THIS IS EXACTLY WHY OUR HEALTH
STRATEGY IN THE CENTER FOR
HEALTH EQUITY AND COMMUNITY
WELLNESS IN THE NEW YORK CITY
HEALTH DEPARTMENT IS FOCUSED ON
RACE AND PLACE AS KEY DRIVERS
AND KEY AREAS OF FOCUS FOR
INTERVENTION, FOR ADVANCING
RACIAL EQUITY, AND FOR
ACKNOWLEDGING AND CHANGING THE
IMPACT OF STRUCTURAL RACISM.
WE DECIDED THAT OF COURSE OUR
ANALYSIS WAS THAT THE LOW BLACK
VACCINATION RATE WAS NOT DUE TO
FAILURES OR EVEN CHOICE.
BUT THAT A LOT OF IT WAS DUE TO
STRUCTURES AND HISTORY OF
UNTRUSTWORTHINESS OF PUBLIC
HEALTH.
WITH THAT IN MIND WE DEVELOPED
RACE CONSCIOUS INTERVENTION, THE
PUBLIC HEALTH CORPS.
THE IDEA WAS TO FUND AND DEPLOY
AND TRAIN COMMUNITY HEALTH
WORKERS EMBEDDED IN
COMMUNITY-BRACED ORGANIZATIONS
ALL ACROSS THE CITY, IN PRIOR
NEIGHBORHOODS WHERE MORE BLACK
AND LATINX PEOPLE LIVED AND IN
THE NEIGHBORHOODS YOU SAW ON THE
HEAT MAP WITH LOWER RATES OF
VACCINATION.
AND WE WERE ABLE TO DEMONSTRATE
SIGNIFICANT IMPROVEMENT IN
VACCINATION RATE BECAUSE OF THIS
INTERVENTION AS WELL AS SEVERAL
OTHERS.
AND WERE ABLE TO GET TO A POINT
EARLY IN THE VACCINATION
CAMPAIGN ABOUT A YEAR OUT FROM
THE START OF IT WHERE WE HAD
CLOSE TO EQUITY IN TERMS OF
VACCINATION RATES CITY WIDE AS
COMPARED TO THE NATIONS AGAIN
WITH LOWER VACCINATION RATES,
AND GOT THE BLACK VACCINATION
RATE TO BE ABOVE 80%.
ANOTHER EXAMPLE OF A
RACE-CONSCIOUS STRATEGY IS THE
USE OF THE BLACK RACE VARIABLE
IN THE KIDNEY FUNCTION
CALCULATOR, ESTIMATED GLOMERULAR
FILTRATION RATE.
YOU MAY BE AWARE OF THE EFFORTS
AROUND UNDERSTANDING WHY THE USE
OF BLACK RACE HAPPENED IN THE
FIRST PLACE IN THIS EQUATION AND
WHY IT NEEDED TO BE CHANGED.
THE ORIGINAL PUBLICATION IN 1999
IN THE ANNALS OF INTERNAL
MEDICINE INCLUDED BLACK MODIFIER
BECAUSE AT THE TIME THE
UNDERSTANDING WAS REGRESS MODEL
ALLOWED FOR BETTER PREDICTION
ESSENTIALLY OF WHAT KIDNEY
FUNCTION LOOKED LIKE WHEN THE
BLACK RACE VARIABLE WAS
INCLUDED.
HOWEVER, THE CHALLENGE OF COURSE
WAS THAT THERE WERE ONLY 197
PEOPLE WHO WERE IDENTIFIED AS
BLACK IN THAT ORIGINAL STUDY,
AND ETHNICITY WAS ASSIGNED BY
THE STUDY PERSONNEL, NOT
SELF-IDENTIFIED RACE, PART OF
THE WAY THEY EXPLAINED THE
INCLUSION OF THE BLACK RACE
VARIABLE IN THIS EQUATION WAS
THE THEORY THAT BLACK PEOPLE HAD
GREATER MUSCLE MASS AND THEY
CITED THREE STUDIES IN THAT
ORIGINAL PUBLICATION.
ALL OF WHICH WERE SMALL STUDIES,
SOMEWHAT POORLY CONDUCTED, OF
COURSE WERE NOT -- ARE NOT WHAT
WE CONSIDER RIGOROUS SCIENCE.
AND MANY STUDENTS IN PARTICULAR,
MEDICAL STUDENTS AND TRAINEES,
HAVE ADVOCATED ON A NATIONAL
SCALE OVER THE PAST 7 TO 8 YEARS
TO CHANGE THIS EQUATION.
AND AS WE ALREADY KNOW, THERE
ARE SIGNIFICANT RACIAL
INEQUITIES IN THE INCIDENCE AND
PREVALENCE OF CHRONIC KIDNEY
DISEASE WITH BLACK PEOPLE HAVING
MUCH HIGHER RATES, BUT
INTERESTINGLY SIMILAR RATES OF
PREVALENCE OF STAGE 1 AND 2
CHRONIC KIDNEY DISEASE BUT THEN
SIGNIFICANTLY HIGHER RATES OF
END STAGE RENAL DISEASE, PART OF
THAT OF COURSE IS SOCIAL AND
STRUCTURAL.
PART IS VERY LIKELY THIS BLACK
RACE MODIFIER WAS DELAYING
REFERRAL FOR EVALUATION BY A
KIDNEY SPECIALIST, CERTAINLY
DELAYING FOR KIDNEY TRANSPLANT
EVALUATION AND LISTING ON THE
KIDNEY TRANSPLANT LIST BECAUSE
BLACK RACE MODIFIER MADE BLACK
PEOPLE'S KIDNEYS LOOK HEALTHIER
CAN THE SAME MEASURED VALUE OF
CREATININE.
THAT CONTRIBUTED TOWARDS THOSE
INEQUITIES IN CHRONIC KIDNEY
DISEASE, END STAGE RENAL
DISEASE.
A NEW EQUATION WAS DEVELOPED,
AND PUBLISHED, IN THE NEW
ENGLAND JOURNAL IN 2022.
AND, EXCUSE ME, 2021, THAT
EQUATION DOES NOT USE THE BLACK
RACE MODIFIER, JUST AS ACCURATE
IN TERMS OF PREDICTING THE
ACTUAL HEALTH AND STATUS OF
KIDNEY FUNCTION, AND, AGAIN, IS
MUCH MORE ALIGNED WITH A SOCIAL
POLITICAL DEFINITION OF RACE,
RATHER THAN A BIOLOGICAL
DEFINITION OF RACE.
AND THEN WHAT WE'VE BEEN DOING
IN NEW YORK CITY ABOUT THIS
TOPIC IS TRYING TO BRIDGE THE
GAPS IN OUR SILOED HEALTH SYSTEM
INSTEAD OF ASKING FOR A WAY TO
CHANGE THE EQUATION IN EMR,
CHANGE GUIDANCE, ET CETERA, WE
PUT TOGETHER A COALITION AND
LAUNCHED IT IN THE FALL OF 2021,
PUBLISHED INAUGURAL REPORT IN
2022 WITH THESE NINE MEMBERS
INCLUDING THE SIX LARGEST HEALTH
SYSTEMS IN NEW YORK CITY, THEY
AGREED TO WORK TOGETHER TO
ACCELERATE WITH THREE
ALGORITHMS, INCLUDING PULMONARY
FUNCTION TEST SPIROMETRY THAT
USED BLACK, LATINX AND ASIAN
RACE.
THE FINAL EXAMPLE IS AROUND RACE
CONSCIOUS INTERVENTIONS IN
INSTITUTIONAL RACISM AND HEART
FAILURE CARE, BEFORE COMING TO
THE NEW YORK CITY HEALTH
DEPARTMENT I WORKED FOR ABOUT 15
YEARS AS FACULTY MEMBER AT
BRIGHAM AND WOMEN'S HOSPITAL.
I WAS ASKED TO CO-LEAD
DEPARTMENT OF MEDICINE HEALTH
EQUITY COMMITTEE IN 2016.
IN 2017 BECAUSE OF ADVOCACY OF
TRAINEES AND RESIDENTS TO DO
MORE ON ANTI-RACISM IN OUR
INSTITUTION WITHIN OUR WALLS WE
LOOKED AT HEART FAILURE CARE
BECAUSE IT'S THE NUMBER ONE MOST
COMMON ADMISSION DIAGNOSIS FOR
PATIENTS COMING INTO OUR
HOSPITAL, AND WE KNEW THERE WERE
DIFFERENCES IN OUTCOMES SO THE
PATIENTS WITH HEART FAILURE ON
OUR HOSPITALIST GENERAL MEDICINE
SERVICE WHERE I WORKED AT THE
TIME, AND CARDIOLOGY SERVICE,
WITH LOWER READMISSION RATES,
HIGHER CARDIOLOGY FOLLOW-UP FOR
THOSE ON THE CARDIOLOGY SERVICE
WITH CARDIOLOGY SPECIALISTS,
NURSE PRACTITIONERS, OUTPATIENT
PHARMACY SUPPORT SAND -- AND
FOLLOW-UP ET CETERA.
WHAT WE FOUND IN ANALYSIS, 2/3
OF WHITES SENT TO CARDIOLOGY
WITH HALF OF BLACK AND LATINX,
AN EXAMPLE OF APPROXIMATE
INSTITUTIONAL RACISM BECAUSE
IT'S AN UNFAIR DISTRIBUTION OF A
RESOURCE IN A PATTERN THAT IS
RACIALIZED.
SO WHAT WE SAID WAS THIS IS AN
EXAMPLE OF INSTITUTIONAL RACISM.
WE NEED TO DO SOMETHING ABOUT
IT.
MY COLLEAGUE AND I DEVELOPED A
FRAMEWORK BUILDING ON THE WORK
OF OTHERS ON REPARATIONS, THE
HEALING ARC, ACKNOWLEDGING
REDRESS AND CLOSURE, THE
APPROACH IS MEANT TO BE A
FRAMEWORK FOR ACTION.
WHEN AN INSTITUTIONAL RACISM
EXAMPLE IS UNCOVERED IN HEALTH
CARE, THIS FRAMEWORK GIVES YOU
GUIDANCE ON HOW TO ADDRESS IT,
FIX IT, END IT, NOT JUST STUDY
IT.
AND THAT'S WHAT WE'VE BEEN
PUSHING TO DO EVER SINCE.
THE WAY WE IMPLEMENTED THE
HEALING ARC APPROACH TO OUR
EXAMPLE OF INSTITUTIONAL RACISM
AT BRIGHAM AND WOMEN'S TO
INSTITUTE A BEST PRACTICE ALERT
IN MEDICAL RECORDS SYSTEM,
PUBLISHED IN THE NEW ENGLAND
JOURNAL CATALYST ABOUT THIS
APPROACH, A COUPLE YEARS AGO,
IT'S THE FIRST EXAMPLE WE'RE
AWARE OF, OF USING CLINICAL
DECISION SUPPORT TOOLS TO
ADVANCE RACIAL EQUITY AND HEALTH
JUSTICE.
THIS BEST PRACTICE ACLARITY
COMES BACK WHEN AN EMERGENCY
ROOM CLINICIAN IS ADMITTING A
PATIENT WITH HEART FAILURE,
BLACK OR LATINX, RETHINK, THIS
PATIENT IS FROM A GROUP
HISTORICALLY EXCLUDED, CONSIDER
SENDING THEM TO CARDIOLOGY.
WE EXPERIENCED BLACK LASH FROM
RIGHT WING AND WHITE SUPREMACIST
GROUPS SAYING IT WAS UNFAIR TO
WHITE PEOPLE.
WE HAD GROUPS LIKE EQUAL HEALTH,
GLOBAL CAMPAIGN AGAINST RACISM
THAT CAME TO OUR SIDE TO
ADVOCATE FOR RACE CONSCIOUS WORK
TO HAPPEN.
JUST A COUPLE FINAL REFLECTIONS,
WE'RE ENCOURAGESSED BY INCREASE
IN DECLARATION AS A PUBLIC
HEALTH CRISIS.
WE KNOW THESE WILL NOT END
STRUCTURAL RACISM.
NEW YORK CITY BOARD RESOLUTION
HAD POWERFUL RESOLUTIONS,
STATEMENTS, EIGHT ACTIONS
REQUIRED OF THE NEW YORK CITY
HEALTH DEPARTMENT TO CONTINUE TO
TAKE AS OUR CONTRIBUTION TOWARDS
ENDING THE IMPACTS OF RACISM ON
PUBLIC HEALTH IN NEW YORK CITY,
ENCOURAGE YOU TO TAKE A LOOK.
LAST BUT NOT LEAST, JUST FINAL
REFLECTION, ANTI-RAISIN TUITION
CHANGE IS ESSENTIAL, IF WE'RE
SERIOUS ABOUT ACHIEVING EQUITY
WE MUST ALSO PURSUE
INSTITUTIONAL ACTION.
I HOPE THAT THESE REFLECTIONS
WERE USEFUL, THEY DON'T FULLY
ANSWER THE QUESTION ABOUT
WHETHER OR NOT THE PANDEMIC WAS
A PORTAL BUT CERTAINLY HOPEFULLY
GIVE SOMETHING TO CHEW ON.
I APPRECIATE THE OPPORTUNITY TO
BE WITH YOU TODAY AND THANK YOU
FOR INVITING ME.
AND I WILL PASS BACK TO DR.
MARSHALL TO CONTINUE WITH THE
SESSION.
>> THANK YOU VERY MUCH FOR THE
EXCELLENT PRESENTATION, DR.
MORSE.
NEXT SPEAKER IS DR. DEREK
GRIFFITH.
>> SORRY, HAVING TROUBLE
UNMUTING.
GOOD AFTERNOON.
THANK YOU AGAIN FOR THIS
OPPORTUNITY TO SHARE SOME
THOUGHTS WITH YOU ABOUT THE WORK
WE'RE DOING.
I DECIDED IN MY TIME TO REALLY
FOCUS ON UNDERSERVED AREAS,
OPPORTUNITIES, AND SO FORTH THAT
WE COULD FOCUS ON MORE
EFFECTIVELY IF WE'RE SERIOUS
ABOUT SOME GOALS WE'RE ACTUALLY
TRYING TO SET AND SEEK.
IN MY TIME -- OOPS.
I WANT TO TALK ABOUT SOME OF THE
WAYS THAT WE'VE -- BY FOCUSING
ON CERTAIN AREAS THAT WE'VE
NEGLECTED TO REALLY ATTEND TO
OTHERS.
I'M GOING TO TALK ABOUT IT IN
THREE PARTICULAR CONTEXTS, STUDY
OF RACISM, ANTI-RACISM, AND
CONTEXT OF HEALTH EQUITY.
THE SECOND PART IS TO TALK ABOUT
HOW THIS BLIND SPOT OR THIS
FOCUS ON CERTAIN PARTS OF THE
WORK HAVE HINDERED OUR ABILITY
TO MOVE THE WORK FORWARD.
AND CALL ON FOCUSING ON THESE
UNDERSERVED AREAS.
I USE THE ANALOGY HERE OF A COIN
BECAUSE TYPICALLY WHEN YOU HAVE
A COIN YOU HAVE THE MOST
IMPORTANT THING ON THE HEAD SIDE
OF THE COIN.
TYPICALLY WE DON'T PAY THAT MUCH
ATTENTION TO THE TAILS,
CERTAINLY NOT TO THE SIDE.
THE SIDE IS SOMETHING WE TEND TO
THROW AWAY AND NOT THINK OF AS A
RELEVANT OR IMPORTANT POINT OR
COMPONENT OF THE COIN.
IT'S OFTEN THE GLUE, THE OTHER
PART TO WHAT IS THE HEAD AND
TAIL, THE THINGS WE SEE AS THE
MOST VISIBLE, AND IT'S USEFUL TO
THINK ABOUT THAT PARTICULAR
CONTEXT.
SO, IN THE CONTEXT OF STUDYING
RACISM, CLEARLY THE HEADS HAVE
BEEN THE FOCUS ON RACISM
PARTICULARLY MEASURING RACISM.
AS YOU'VE SEEN IN THIS, MOST
EVEN THE KEYNOTES HAVE BEEN ON
MEASURING RACISM, NOT
NECESSARILY ON INTERVENTIONS AND
SO FORTH, CLEARLY HAD PANELS,
LIKE THE GREAT ONE THAT JUST
HAPPENED, BUT MOST OF THE FOCUS
HAS BEEN ON MEASUREMENT, MUCH
MORE THAN FIGURING OUT HOW WE'RE
GOING TO INTERVENE AND HOW WE'RE
GOING TO ADDRESS IT.
ONE OF THE MISSING PARTS TENDS
TO BE ALSO WHITENESS.
AND RECOGNIZING JUST AS DR.
MORSE WAS SAYING THERE ARE
EFFORTS TO UNDERMINE, REDO,
REDEFINE WHAT WE'RE TALKING
ABOUT WHEN WE SAY RACISM, AND TO
FOCUS ON OTHER ASPECTS OF THINGS
THAT PEOPLE WHO ARE ADVANTAGED
IN THESE PARTICULAR SOCIETIES
CONTEXT AND AREAS THAT THEIR
EFFORTS ARE NOT NECESSARILY
BEING CONSIDERED AND THEY HAVE A
VESTED INTEREST AND OFTEN ARE
TAKEN SERIOUSLY VESTED INTEREST
IN NOT NECESSARILY MOVING THE
AGENDA FORWARD, WHERE THE MOST
OF US WHO ARE INTERESTED IN
HEALTH EQUITY, WHO ARE
INTERESTED IN JUSTICE, CERTAINLY
DON'T DEFINE THOSE TERMS, THOSE
CONCEPTS, IN THE SAME WAY.
AND SO IT'S IMPORTANT THAT WE
THINK THROUGH THOSE PARTS.
AND THEN THE THIRD SIDE IS
POWER, WHICH IS REALLY THE GLUE,
UNDERLYING FACTOR FOR RACISM AND
WHITENESS.
WE'VE HAD MULTIPLE DEFINITIONS
OF RACISM, SO I'M NOT GOING TO
SPEND REALLY ANY TIME ON THIS.
BUT OBVIOUSLY WE'RE TALKING
ABOUT STRUCTURAL RACISM AND THE
IMPORTANCE OF KEEPING THE FOCUS
ON THE STRUCTURAL ASPECTS OF
THIS, AND DIFFERENTIAL
INDICATION OF RESOURCES THAT ARE
UNDERLYING WHY THIS IS
RELATIONSHIP AND IMPLICATIONS
FOR HEALTH AND WELL-BEING.
WHITENESS IS THE OTHER SIDE OF
THAT COIN, IF YOU WILL.
IT'S A RACIALIZED SYSTEM THAT
OFTEN ADVANTAGES AND REWARDS TWO
GROUPS TYPICALLY OFFERS
ADVANTAGES AND REWARDS TO GROUPS
RACIALIZED AS WHITE.
IT IS THINKING ABOUT HOW DO THE
FACTORS PLAY OUT, WHAT ARE THE
ADVANTAGES, WHAT IS THE BENEFIT
TO FOLKS TO UNDERMINING A SYSTEM
THAT HAS SIGNIFICANT
CONSIDERABLE AND GENERATIONAL
INTERGENERATIONAL BENEFITS TO
THEM.
WE HAVEN'T REALLY DEALT WITH
THAT SIDE OF THE WORK ON RACISM,
TWO BENEFITS FROM THE SYSTEM WE
SAID UP AND WHAT IS THEIR
INCENTIVE TO UNDO THE SYSTEM,
AND IF WE'RE THINKING OF MORE
THAN HALF THE POPULATION THE WAY
WE'RE SORT OF STILL GROUPING
THINGS NOW, EVEN WITH THE OMB
CATEGORY CHANGES, WE HAVE TO
RECOGNIZE THERE ARE FOLKS WHO
BENEFIT FROM THE SYSTEM AS IS,
AND THAT THOSE KIND OF FACTORS
HAVE IMPLICATIONS FOR HOW WE
NEED TO THINK ABOUT THE WAYS WE
APPROACH EFFORTS TO ADDRESS AND
CONCEPTUALIZE RACISM, WHO IS
BENEFITING FROM THE SYSTEM THAT
WE NEED TO PAY ATTENTION.
TO HOW ARE SOMETHING BOTH RACISM
AND WHITENESS OPERATING WITHIN
THE FRAMEWORKS OF, AND IT'S
IMPORTANT BECAUSE IT HELPS US TO
EXPLAIN, UNDERSTAND, AND SEE WHY
SO MUCH ATTENTION IS ON
PARTICULAR ASPECTS OF THE WORK.
IF YOU THINK ABOUT THE MOST
OBVIOUS ASPECT, WE THINK ABOUT
POWER, DECISION MAKINGS.
WHO GETS TO MAKE A CHOICE TO
ACTUALLY VOTE, TO ACTUALLY GET
TO MAKE A DECISION AND SO FORTH.
WHAT IS OFTEN A LITTLE LESS
CLEAR WHO GETS TO PUT THE THINGS
ON THE BALLOT, WHO GETS TO
DECIDE WHAT'S ON THE AGENDA, WHO
GETS TO PUT THOSE THINGS OTHERS
VOTE?
THERE'S A CERTAIN POWER NEVER
GETTING ON THE AGENDA OR NEVER
BEING CONSIDERED EXPLICITLY AND
NOT GETTING THE CHOICE TO HAVE
AN
AN OPEN DISCUSSION OR VOTE TO
SEE IMPLICATION CHOICE OF OPTION
CHOICE OR OPPORTUNITY.
PICKING UP ON WHAT DR. MORSE
SAID, WE HAVE TO REALIZE WHY SO
MUCH ENERGY IS PUT INTO
COUNTERING NARRATIVES,
REDEFINING RACISM, REDEFINING OR
COUNTERING THESE EFFORTS TO
ACTUALLY UNDO THE RACIST EFFECTS
WE'VE SEEN FROM DIFFERENT
POLICIES, PRACTICES, AND NORMS
WE'VE SET IN SOCIETY OVER TIME
THAT YOU'VE SEEN MORE ATTENTION
TO REDEFINING, RENAMING THE
ISSUES AND THE ISSUE FRAMING HAS
BEEN CRITICAL, IS PARTICULARLY
CRITICAL FOR US TO BE ABLE TO
FOCUS ON AND ATTEND TO BECAUSE
IT'S SHAPING HOW PEOPLE
UNDERSTAND AND SHAPING CRITICAL
ASPECTS OF THE WAYS PEOPLE
UNDERSTAND THE IDEOLOGY OF
INFERIORITY THAT IS A KEY
COMPONENT OF THE DEFINITION OF
RACISM THAT MOST OF US USE.
SO IT'S IMPORTANT TO UNDERSTAND
WHY THAT ISSUE FRAMING IS SUCH A
CRITICAL PART OF BOTH
UNDERSTANDING WHO IS BENEFITING
FROM THESE PARTICULAR SYSTEMS
AND HARMED FROM IT AND HOW DO WE
EXPLAIN THAT.
WE ALSO HAVE TO RELATE IT TO
THAT, REMEMBER THAT MOST OF OUR
LEGAL RECOURSE FOR THESE KINDS
OF ISSUES, PARTICULARLY ON A
FEDERAL LEVEL, ARE REALLY ONLY
DESIGNED TO ADDRESS WHEN THERE'S
INTENTIONAL DISCRIMINATION
RACISM, OTHER THINGS THAT ARE
VERY EXPLICITLY NAMED AND WHERE
YOU CAN -- THE PERSON WHO
ACTUALLY MAY HAVE ENGAGED IN A
PARTICULAR BEHAVIOR OR DONE
SOMETHING IS WILLING TO
EXPLICITLY SAY, YES, I DID THIS
FOR THAT REASON.
BUT MOST OF THE WORK THAT WE'RE
DOING ON RACISM, STRUCTURAL
RACISM, AND SO FORTH, DOES NOT
HAVE SOMEBODY STANDING UP AND
SAYING, YES, I'M THE ONE WHO
WANTED TO DO THAT.
YES, THIS WAS MY GOAL IN
CREATING THESE REDLINING
POLICIES, MY GOAL IN STATING
THIS, THAT, WHATEVER.
IT'S NOT SOMETHING -- OUR GOALS
AND FOCUS ARE MISALIGNED WITH
THE POLICIES AND PRACTICES THAT
WE HAVE TO ACTUALLY INTERVENE TO
ADDRESS THESE ISSUES.
WE'VE GOT TO THINK THROUGH WHAT
DOES THAT MEAN FOR STRATEGIES WE
HAVE, EFFECTIVENESS OF THEM.
THE SECOND THREE SIDES THINKING
ABOUT ANTI-RACISM, A CRITICAL
PART OF HOW WE THINK ABOUT WHAT
TO DO TO ADDRESS THESE ISSUES.
MOST OF THE TIME WE THINK ABOUT
GETTING -- HERE THE HEADS ARE
OUTER WORK FOR, EXCUSE ME,
CREATING POLICIES AND PRACTICES
TO MITIGATE OR UNDO THE
FACTORS
DIFFERENTIALLY HARMING A
PARTICULAR GROUP, CREATING
CONDITIONS AND ENVIRONMENT WHERE
THEIR HEALTH IS BEING HARMED,
HEALTH AND WELL-BEING ARE HARMED
CONSISTENTLY.
AND SO MOST OF OUR WORK IS ON
THAT.
HOWEVER, WHAT WE TEND TO FOCUS
LESS ON IS WHAT ARE THE
PRACTICES, THE NORMS, THE WAYS
WE'VE INTERNALIZED THOSE
MESSAGES, THE WAYS WE FRAMED
THEM AS POLICYMAKERS, AS
RESEARCHERS, AS COMMUNITY
MEMBERS, AS COMMUNITY PARTNERS,
COMMUNITY RESEARCHERS, HOW DO WE
UNDERSTAND THE FACTORS AND WHAT
DO WE NEED TO LEARN, UNLEARN,
CO-LEARN, WORK WITH OUR
COMMUNITY PARTNERS TO LEARN HOW
DO WE UNDERSTAND THEIR
EXPERIENCE, HOW DO WE UNDERSTAND
WHAT THOSE LIVED EXPERIENCES
ARE, MECHANISMS FROM THEIR
STANDPOINT AFFECTING THEIR
HEALTH AND WELL-BEING.
POLITICAL WILL IS SOMETHING THAT
MANY HAVE TALKED ABOUT FOR MANY
YEARS.
JAMES JACKSON WAS A MENTOR.
I REMEMBER A TALK HE DID AT NIH
ALMOST TWO DECADES AGO WHERE HE
WAS TALKING ABOUT THE IMPORTANCE
OF POLITICAL WILL, WE KNOW OFTEN
SO MANY THINGS WE CAN DO TO
ADDRESS THESE ISSUES ABOUT
RACISM OR SOCIAL DETERMINANTS OF
HEALTH, YET WE CHOOSE NOT TO DO
THEM OR FUND THEM
WHAT IS THE POLITICAL WILL WE
HAVE TO IMPLEMENT WHAT WE KNOW,
TO FIGURE OUT WHAT ARE THE NEW
THINGS WE NEED TO KNOW?
AND SO WE'VE TAKEN THESE
PRINCIPLES OF ANTI-RACISM AND
APPLIED THEM IN DIFFERENT
CONTEXT, ONE IS IMPLEMENT
SCIENCE, HOW WE NEED TO HELP
FOCUS NOT JUST ON THE WORK, HOW
DOES IMPLEMENTATION SCIENCE --
HOW DOES ANTI-RACISM AFFECT
IMPLEMENTATION SCIENCE, ALSO
WHAT ARE THE COMPONENTS OF THE
RESEARCH, WHAT IS THE RESEARCHER
BRINGING TO THE TABLE THAT
AFFECTS THE WORK WE'RE ACTUALLY
DOING.
WE USE THIS IDEA OF ANTI-RACISM
BEING A LENS.
SOME PEOPLE BALKED AT THE IDEA
WE CALL IT A LENS, BECAUSE A
LENS IS A CHOICE.
YOU PUT ON YOUR GLASSES OR
DON'T.
USE THE LENS TO DECIDE WHAT
YOU'RE GOING TO DO.
IT IS A CHOICE TO LOOK AT THESE
THINGS THROUGH THIS LENS.
IT IS A CHOICE TO DECIDE YOU
WANT TO -- YOU'RE WILLING TO BE
INTROSPECTIVE AND HELD
ACCOUNTABLE, TO DO THESE THINGS
IMPORTANT IN THE WORK AND NOT
JUST FOCUS ON WHAT OTHERS ARE
DOING AND SO FORTH.
THAT'S A CRITICAL PART OF THE
WORK, THAT INNER WORK IS
SOMETHING THAT WE'VE TENDED TO
IGNORE, WHAT ARE THE BIASES,
WHETHER IN REVIEWERS, IN
RESEARCHERS, POLICYMAKERS,
WHOEVER THEY MAY BE, INFLUENCING
CHOICES ABOUT WHAT TO FUND, WHAT
TO PASS, WHAT TO STUDY, HOW TO
STUDY, HOW TO FRAME IT, AND SO
FORTH.
THE OTHER BIG PART OF THIS WORK
IN TERMS OF ANTI-RACISM IS THAT
THE STRATEGY -- RACISM,
ANTI-RACISM, WE TRIED TO HAVE A
A
ONE-SIZE-FITS-ALL APPROACH TO
THE WORK.
WHAT I'M ARGUING HERE IS THAT
PERHAPS WE NEED TO THINK ABOUT
THIS A BIT DIFFERENTLY.
AS OPPOSED TO SAYING THAT WE
NEED TO PUT ALL OF OUR -- WE'VE
KIND OF IN THE COURSE OF THE TWO
DAYS ALLUDED TO THIS BUT
THINKING ABOUT, YES, MEASUREMENT
IS IMPORTANT BUT IT'S NOT THE
ONLY THING.
YES, COMMUNITY-BASED STRATEGIES
ARE IMPORTANT BUT THEY ARE NOT
THE ONLY THING.
YES, CHANGING POLICY LONG-TERM
POLICIES AND FEDERAL POLICIES
ARE CRITICAL, EVEN LOCAL AND
STATE POLICIES ARE CRITICAL BUT
NOT THE ONLY THING.
AND WHAT ARE CONDITIONS, OTHER
PART MOST OFTEN IGNORED IN THIS
CONTEXT, IS EVEN IF YOU ADDRESS
THOSE THINGS ALL THE NEGATIVE
THINGS, ALL THE HARMFUL THINGS
IN THE ENVIRONMENT THOSE ARE NOT
THE ONLY CONDITIONS THAT HELP
PEOPLE LIVE LONG HEALTHY LIVES
AND BE WELL.
SO WHAT ARE THE POSITIVES WE
NEED TO ACCENTUATE, BUILD, THAT
GIVE PEOPLE'S LIVES MEANING AND
PURPOSE?
HOW ARE WE GOING TO CREATE
THINGS, CONDITIONS FOR LOVE AND
CARING AND RELATIONSHIP, HOW DO
WE CREATE POSITIVES IN OUR
ENVIRONMENT AND BUILD ON THOSE
AS STRENGTHS AND ASSETS, NOT
JUST FOCUSING ON THE NEGATIVE
PARTS OF WHAT WE'RE TRYING TO
FIX BY ADDRESSING RACISM.
THE LAST PART IS IN THE CONTEXT
OF HEALTH EQUITY, AGAIN MOST OF
OUR WORK IMPLICITLY TODAY HAS
BEEN FOCUSED ON RACIAL -- TODAY
AND YESTERDAY, FOCUS LARGELY ON
RACIAL AND ETHNIC INEQUITIES.
WHAT I WOULD SAY IS THERE'S BEEN
SOME ATTENTION MOSTLY TO WOMEN'S
HEALTH, AND LGBTQ+ HEALTH, BUT
-- AND A SECONDARY FASHION, BUT
OFTEN THOSE ARE NOT NECESSARILY
INTEGRATED WITH THE WORKS ON
RACIAL AND ETHNIC EQUITY, NOT
CONSISTENTLY DONE SO.
THE SIDE MOST IGNORED IS
INTERSECTIONALITY AS RELATES TO
POLICY, AS RELATINGS TO THE WAY
DATA ARE PRESENTED, CRITICAL
BECAUSE IT DECIDE HOW OR WHAT
THINGS WE FOCUS ON,
DEMONSTRATING THIS IS WHERE
ATTENTION IS NEEDED MEN'S HEALTH
IS MOST IGNORED.
THESE ARE DATA FROM ABOUT 121
YEARS, FROM CDC DATA, NATIONAL
VITAL STATISTICS REPORTS, LIFE
EXPECTANCY BY RACE AND BIRTHS.
YOU'LL SEE FOR BASICALLY
EVERYBODY IS LIVING BETTER,
LIVING LONGER, EVERYBODY IS
THEREFORE -- THIS IS A PROXY FOR
HEALTH.
LIFE EXPECT ANCY WE TREAT AS
PROXY FOR HEALTH, EVERYBODY IS
LIVING DRAMATICALLY LONGER
LIVES, OR WERE, PRE-PANDEMIC.
WE SAW A DIP IMMEDIATELY PRIOR
TO THE PANDEMIC, EXACERBATED
FURTHER DURING THE PANDEMIC.
BACKUP THE POINT HERE IS THERE
WAS A SMALLER GAP, RACIAL
DIFFERENCES WE'VE ACTUALLY SEEN
JUST IF YOU LOOK AT THESE AND
EYEBALL THEM YOU'LL SEE RACIAL
GAPS DECREASED A LITTLE BIT.
YOU SEE SEX DIFFERENCES, MALES
AND FEMALES IN A PARTICULAR
GROUP HAVE INCREASED.
SO, WHEN WE LOOK AT SEX
DIFFERENCES JUST WITHIN THE U.S.
OVERALL WE SEE SLIGHT INCREASE
IN GAP BETWEEN MEN AND WOMEN,
LIFE EXPECTANCY, MALES AND
FEMALES IN LIFE EXPECTANCY.
WE DON'T ACTUALLY HAVE DATA ON
MEMBER AND WOMEN IN THE WAY
PEOPLE MAY IDENTIFY THEMSELVES.
WE STILL HAVE TO USE SEX
CATEGORY, YOU HEAR ME SLIPPING
BACK AND FORTH BETWEEN THE TWO.
WHAT YOU SEE IS, AGAIN, RACIAL
DIFFERENCE IS IMPROVED, AGAIN
NOT ANYWHERE NEAR WHAT WE NEED
TO DO BUT HALF OF WHAT IT WAS
121 YEARS AGO.
THE POINT I'M MAKING IS THAT THE
SEX DIFFERENCE BETWEEN MEN AND
WOMEN HAS GROWN DRAMATICALLY.
AND THE EIGHT-FOLD INCREASE
BETWEEN BLACK FEMALES AND BLACK
FEMALES IS SOMETHING WE DON'T
PRIORITIZE IN FUNDING.
WE DON'T PRIORITIZE IN HEALTH.
WE DON'T PRIORITIZE IN ANY OF
THE WORK WE'RE DOING, AND THERE
AREN'T MECHANISMS IN
INFRASTRUCTURE AROUND ADDRESSING
THOSE PARTICULAR ISSUES ANYWHERE
WITHIN THE FEDERAL GOVERNMENT.
AND SO THE IDEA FOCUSING ON RACE
OR MEN, AND PARTICULARLY THE
INTERSECTION OF THE TWO ARE NOT
THINGS WE HAVE INFRASTRUCTURE TO
ADDRESS WHICH IS WHY WE TEND TO
SEE MEN'S HEALTH CONTINUING TO
FALL BEHIND WOMEN AND SAME
RACIAL AND ETHNIC GROUPS IN THE
CONTEXT OF THE COUNTRY.
QUICKLY, WE TENDED TO FOCUS THIS
CONVERSATION ON RACE AND
ETHNICITY.
TAKING THE CONTEXT OF WHAT
KIMBERLE CRENSHAW WAS SAYING,
HOW SHE THOUGHT ABOUT
INTERSECTIONALITY, ONE KEY
QUESTION SHE ASKED, WHERE IS TE
RACISM WHEN LOOKING AT GENDER
FACTORS OF WOMEN'S -- EXPERIENCE
AND EXPOSURE OF EMPLOYMENT
DISCRIMINATION THAT SHE COULDN'T
SEE WHEN LOOKING AT SEX, WHEN
YOU'RE LOOKING AT RACE, YOU HAD
TO LOOK AT INTERSECTION OF THE
TWO.
WHAT I'M SUGGESTING WE HAVE TO
LOOK AT THESE ISSUES OF RACE AND
SAY WHERE IS THE GENDER IN THIS
AND FOCUS ON THE DATA THAT
ACTUALLY SUGGESTS USING
EPIDEMIOLOGY, NOT JUST OTHER
DATA TO ACTUALLY SAY, OKAY, IF
THE GROUP IS DOING WORSE HOW DO
WE NEED TO ADDRESS THOSE ISSUES.
SO JUST IN CLOSING QUICKLY WE
HAVE ADDRESSED SOME OF THESE
ISSUES, TRIED TO TALK ABOUT SOME
OF THESE THINGS IN THE WORKS
WE'RE DOING WITH CHANDA FORD,
SECOND EDITION WILL BE OUT IN
OCTOBER.
I LOOK FORWARD TO -- HOPEFULLY
THIS WILL BE VALUABLE TO YOU.
FIRST EDITION WAS USEFUL IN
THINKING ABOUT THE SCIENCE AS
WELL AS THE TOOLS, THAT PUBLIC
HEALTH PROFESSIONALS AND OTHER
PROFESSIONALS IN THE HEALTH
SCIENCES NEED TO ADDRESS THESE
ISSUES.
THANK YOU.
>> THANK YOU FOR THE EXCELLENT
PRESENTATION, DR. GRIFFITH.
NEXT UP IS DR. RUTH SHIM.
>> IT'S GREAT TO BE HERE WITH
ALL OF YOU.
I'M REALLY ENERGIZED BY THIS
PANEL AND BY ALL OF THE
PRESENTATIONS THAT I WAS ABLE TO
SEE.
ONE OF THE CHALLENGES OF COMING
AT THE END OF A REALLY ENGAGING
AND WONDERFUL TWO DAYS OF
CONFERENCE IS I'M PRETTY SURE
I'M NOT GOING TO SAY THAT MUCH
THAT HASN'T ALREADY BEEN SAID OR
COVERED AGAIN BUT THE REPETITION
IS REALLY HELPFUL.
SO I'M GOING TO TRY TO SPEND MY
BRIEF TIME HIGHLIGHTING SOME
THINGS THAT I FEEL ARE IMPORTANT
TO'D ADD AND BUILD ON WHAT'S
SAID.
DR. GRIFFITH WAS TALKING ABOUT
OPPORTUNITIES AND DIRECTIONS,
I'M HERE TO TALK ABOUT A
NEGATIVE GRAHAM, -- NEGATIVE
FRAME OF GAPS.
WE'LL TALK ABOUT SOME HISTORY,
AGAIN ALSO TALKED ABOUT IN THIS
CONFERENCE, A LOT, HOW HISTORY
IS SO IMPORTANT, A FUNDAMENTAL
CAUSE OF STRUCTURAL RACISM AND
CAUSE OF ILLNESS AND DISEASE.
WE'RE GOING TO TALK ABOUT SOME
INACCURATE PERSPECTIVES AND HOW
THEY HAVE IMPACTED RESEARCH ON
STRUCTURAL RACISM, AND WE'RE
GOING TO TALK ABOUT NEW
PERSPECTIVES.
SO MY FAVORITE QUOTE ABOUT
HISTORY COMES FROM MAY MAYA AN,
HISTORY DESPITE WRENCHING PAIN
CANNOT BE UNLIVED BUT IF FACED
WITH COURAGE NEED NOT BE LIVED
AGAIN.
I WAS RECENTLY IN MONTGOMERY,
ALABAMA, AT THE EQUAL JUSTICE
INITIATIVE WORK, AND THIS QUOTE
WAS ON THE WALL OF THE ORIGINAL
BUILDING OF THE EQUAL JUSTICE
INITIATIVE.
THESE PEOPLE SHOULD LOOK
FAMILIAR TO SOME OF US, I HOPE
AT LEAST DEFINITELY THE FOLKS IN
THE MORE RECENT HISTORY.
BUT THESE ARE ALL OF THE
DIRECTORS OF THE NIH, HEADS OF
THE NIH, UP UNTIL -- FROM 19515
TO THE PRESENT.
WHAT YOU SEE HERE IS A
SIGNIFICANT NUMBER OF MEN.
A FEW WOMEN DOTTED IN THERE.
BUT ALL OF THESE MEN, YOU KNOW,
IT'S REALLY HARD AS WE'VE TALKED
ABOUT TODAY TO IDENTIFY PEOPLE'S
RACE OR ETHNIC BACKGROUND BY
LOOKING AT THEM BUT WE CAN MAKE
SOME INFERENCES.
DR. GRIFFET WAS TALKING ABOUT
THE IMPORTANCE OF POWER, WE'RE
THINKING ABOUT HISTORY AND
POWER, WHO SETS AGENDAS AND
DECIDES WHAT RESEARCH IS
IMPORTANT, WHAT AREAS TO FOCUS
ON, WHERE THE IMPORTANT
DECISIONS ABOUT WHAT GETS FUNDED
AND WHAT MONEY GOES IN IS
CRITICAL TO THE CONVERSATION.
WE HAVE TO BRING IN A
CONVERSATION ABOUT OPPRESSION
WHEN THINKING ABOUT DECISIONS,
WHAT GETS FUNDED, WHAT GETS
ADDRESSED, AND WHAT GETS
ATTENTION.
AND SO I ALSO APPRECIATE DR.
MORSE BRINGING UP THE ENDING
UNEQUAL TREATMENT REPORT,
UPDATED REPORT FROM 20 YEARS AGO
FROM THE ORIGINAL REPORT.
I HAD THE GREAT HONOR TO SERVE
ON THAT COMMITTEE IN DEVELOPING
THAT UPDATED REPORT.
AND IN IN THAT REPORT WE TOUCHN
OPPRESSION, WORK BY IRIS MARIAN
YOUNG, THE FIVE FACES,
EXPLOITATION, UNEQUAL EXCHANGES
OF ONE GROUP'S LABOR AND
ENERGIES FOR ANOTHER GROUP'S
ADVANCEMENT.
SHE TALKS ABOUT POWERLESSNESS,
OPPRESSED GROUPS' LACK OF POWER,
BEING BLOCKED, MARGINALIZATION
WHERE WE EXPEL SPECIFIC GROUPS
FROM MEANINGFUL PARTICIPATION IN
SOCIETY, AND VIOLENCE OR THREATS
AND EXPERIENCES OF PHYSICAL AND
STRUCTURAL VIOLENCE, ALL TYPES
HAVE IMPORTANT BUT BECAUSE I
HAVE LIMITED TIME I WANT TO
FOCUS ON CULTURAL IMPERIALISM
WHICH WE CAN TALK A LITTLE BIT
AND REFER TO AS COLONIALISM,
COLONIZATION, CULTURAL
IMPERIALISM IS DEFINED AS
ESTABLISHING THE RULING CLASS
CULTURE AS THE NORM, OTHERING
ALL THE OTHER GROUPS.
THE PEOPLE THAT HAVE POWER,
PEOPLE WHO DOMINANT CULTURE,
THEIR IDEAS, PERSPECTIVES, THEIR
VALUES HAVE GREATER WEIGHT, AND
GREATER VALIDITY THAN THOSE
PEOPLE THAT ARE NOT PART OF THAT
DOMINANT CULTURE.
I WANT TO TALK AGAIN, KEEPING
THIS FRAME ON RESEARCH, HOW WE
THOUGHT ABOUT RESEARCH AND
RESEARCH AROUND STRUCTURAL
RACISM AND HOW THAT RELATES TO
THIS WORK.
I SO APPRECIATE DR. HARDEMAN'S
KEYNOTE THIS MORNING AND REALLY
THINKING THROUGH THE PROGRESS
THAT WE'VE MADE SAND HER
REFERENCES TO WHERE PEOPLE HAVE
COME FROM BECAUSE I THINK
BUILDING ON THE WORK THAT HAS
BEEN DONE FOR A REALLY LONG
PERIOD OF TIME WE CAN START TO
THINK ABOUT, ONE, WHAT PROGRESS
WE'VE MADE, BUT ALSO HOW MUCH
MORE WORK WE NEED TO ACCOMPLISH.
AND SO AS WE'RE THINKING ABOUT
CULTURAL, THE VALUES OF WHITE
SUPREMACY CULTURE THAT INFECT
OUR SOCIETY, SOME PARTICULAR
VALUES ARE MOST IMPORTANT WHEN
TALKING ABOUT MEDICAL RESEARCH.
SO, ONE OF THE THINGS SHE SAYS
IS -- I APOLOGIZE TYPOS, I
ALREADY NOTICED TWO, BUT ANYWAY,
SO ONE OF THE THINGS SHE SAYS,
WORSHIP OF THE WRITTEN WORD.
AND SO SHE TALKS ABOUT THIS AS
LIMITED ACTING OR VALUE OF OTHER
WAYS THAT INFORMATION GETS
SHARED.
THE BELIEF THERE'S ONLY ONE
RIGHT WAY TO DO THINGS.
I THINK AGAIN WHEN WE THINK
ABOUT RESEARCH, IN PARTICULAR,
THIS COMES THROUGH PRETTY
STRONGLY IN THE WAY THAT WE
THINK ABOUT RESEARCH AS THIS
GOLD STANDARD BEING RANDOMIZED
CLINICAL CONTROLS TRIAL AND THIS
IDEA IF YOU'RE TRYING TO PROVE
SOMETHING THE ONLY WAY YOU CAN
PROVE IT IS WITH A RANDOMIZEED
CLINICAL TRIAL, THAT HAS TO BE
DOCUMENTED EFFECTIVELY IN OUR
SCIENTIFIC PUBLICATIONS, AND
THAT HAS TO ABLE -- TO BE -- A
MENTOR TOLD ME IF YOU DIDN'T
PUBLISH IT, IT DIDN'T HAPPEN,
THIS WORSHIP OF THE WRITTEN WORD
IS THIS WHITE SUPREMACY CULTURE
BELIEF AND IT NEGATES SO MANY
OTHER WAYS AND OTHER CULTURAL
VALUES, INCLUDING THE SPOKEN
WORD, AND THE WAY THAT CERTAIN
CULTURES AND TRADITIONS HAVE
PASSED ON KNOWLEDGE AND HAVE
PASSED ON RESEARCH EXPERTISE
THROUGH STORIES, THROUGH VERBAL
ENCOUNTERS, THROUGH CULTURAL
LEARNING THAT IS SHARED WITHIN
THE COMMUNITY AND IS NOT
SPECIFIC TO THE WRITTEN WORD.
ANOTHER EXAMPLE OF WHAT HAPPENS
WHEN WE DON'T THINK ABOUT HOW
WHITE SUPREMACY CULTURE INFECTS
OUR RESEARCH IS PATERNALISM.
AND THAT IS WHEN THE DECISION
MAKING IS CLEAR TO THOSE WITH
POWER, UNCLEAR TO THOSE THAT DO
NOT HAVE POWER.
AND THAT THOSE WITH POWER THINK
THEY ARE CAPABLE OF MAKING
DECISIONS FOR AND IN THE
INTEREST OF THOSE WITHOUT POWER.
THE PREVIOUSLY PANEL HIGHLIGHTED
THIS IDEA OF HOW SO MANY YEARS
COMMUNITY HAS NOT BEEN AT THE
CENTER OF OUR DECISIONS, OF OUR
RESEARCH.
WE'VE NOT ENGAGED COMMUNITY.
WE'VE NOT SEEN OURSELVES AS PART
OF THE COMMUNITY.
THE ACADEMIC RESEARCH COMMUNITY
HAS BEEN SEPARATE, AND AWAY.
AND HAD THIS VERY PATERNALISTIC
VIEW THAT THOSE IN THE ACADEMIC
SPACES KNEW FAR BETTER ABOUT THE
COMMUNITY AND THE NEEDS OF THE
COMMUNITY THAN THOSE WITHIN THE
COMMUNITY.
SO I'M NOT PROVIDING EXPERTISE,
NOT RECOGNIZING THE EXPERTISE OF
COMMUNITY MEMBERS, NOT VALUING
THAT EXPERTISE BY COMPENSATING
PEOPLE IN RESEARCH IN THE
COMMUNITY, ALL OF THOSE THINGS
ARE EXAMPLES OF WHAT WE SEE WITH
PATERNALISM.
QUANTITY OVER QUALITY, SO ALL
RESOURCES OF AN ORGANIZATION ARE
DIRECTED TOWARDS PRODUCING
MEASURABLE GOALS.
AND THESE THINGS THAT CAN BE
MEASURED ARE MORE VALUED THAN
THINGS THAT CANNOT BE MEASURED.
AND THIS GETS BACK TO DR.
HARDEMAN TALKED ABOUT IT, AND
DR. ADKINS JACKSON YESTERDAY
MENTIONED THE IMPORTANCE OF
QUALITATIVE RESEARCH.
AGAIN, HOW WE HAVE FELT THAT WE
HAVE THIS VALUE THAT
QUANTITATIVE RESEARCH IS
ALL-KNOWING WHEN QUALITATIVE
RESEARCH HAS SIGNIFICANT VALUE
ESPECIALLY WHEN STUDYING
STRUCTURAL RACISM.
IF WE'RE NOT THINKING ABOUT
IMPORTANCE -- NOT VALUING
QUALITATIVE RESEARCH, PUTTING
FUNDING INVESTMENT IN, WE
MISSING A HUGE PIECE OF HOW WE
SHOULD BE STUDYING STRUCTURAL
RACISM.
THE IDEA THAT IT IS SO COMPLEX
TO THINK ABOUT ALL OF THE THINGS
THAT GO INTO DEVELOPMENT OF
STRUCTURAL RACISM, WE'VE HAD
EXPERTISE UNPACKING HOW THESE
THINGS WORK TOGETHER, IN THIS
COMPLICATED WAY, AND HOW TRYING
TO TEASE OUT THINGS WITH
SPECIFIC MEASURES BECOME SO
COMPLICATED, AND THAT RELATES TO
THE COMPLEXITY OF THIS WORK, HOW
QUALITY REALLY SHOULD BE VALUED
FAR MORE THAN QUANTITY.
AND FINALLY, THIS IS REALLY
IMPORTANT POINT, THIS IDEA OF
OBJECTIVITY, RIGHT?
THE BELIEF THERE'S SUCH A THING
AS BEING OBJECTIVE.
AND THAT THERE'S IMPATIENCE WITH
THINKING THAT DOES NOT APPEAR
LOGICAL TO PEOPLE WITH POWER.
BREAKING DOWN OBJECTIVITY PIECE
MORE, TALKING ABOUT FEMINIST
STANDPOINT THEORY THAT OPPRESSED
PEOPLE GENERATE KNOWLEDGE THAT
OFFERS INSIGHTS THAT DIFFER FROM
MAINSTREAM PER PERSPECTIVES, AE
DOMINANT CULTURE PRODUCED
KNOWLEDGE WITHIN HISTORICAL
CONTEXT THAT BOLSTERED ELITE
SOCIAL MONTHS AS SCIENTISTS.
AND THEREFORE THE OBJECTIVITY
THAT THESE THINKERS IN DOMINANT
CULTURE CLAIM TO POSSESS FAILS
TO SHAPE SCIENCE, CULTURE, AND
POLITICS IN A NEUTRAL WAY.
WE THINK OF THIS OBJECTIVITY AND
NEUTRALITY BUT IN FACT THOSE
FOLKS IN DOMINANT CULTURE
SHAPING THEIR BELIEFS ARE DOING
SO IN THIS INCREDIBLY BIASED
PROBLEMATIC WAY.
SO WHEN WE THINK ABOUT STRONG
OBJECTIVITY, WHICH IS WORK BY
PATRICIA HILL COLLINS, THE IDEA
OH PROSED GROUPS -- OPPRESSED
GROUPS MAY HAVE GREATER
OBJECTIVITY, FORCED TO
UNDERSTAND VIEWS AND
PERSPECTIVES OF THOSE PEOPLE IN
POSITIONS OF POWER.
AND THOSE PEOPLE IN POWER MAY
HAVE LESS OBJECTIVITY BECAUSE
THE REALITIES OF OPPRESSION ARE
OFTEN INVISIBLE TO THOSE NOT IN
THE DOMINANT GROUPS.
WE'VE TALKED ABOUT POWER.
THE WORLD WORLD HEALTH ORGANIZS
THINKING ABOUT POWER.
WE OPERATE IN A MODEL, A FEW
INDIVIDUALS HAVE POWER AND
COERCION OVER OTHERS.
WE THINK ABOUT GIVING POWER TO
ONE OR TWO INDIVIDUALS, BUT
REALLY WE NEED TO SHIFT TO
THINKING ABOUT POWER WITH, WITH
THE COLLECTIVE POWER COMMUNITY
AND ORGANIZATIONS, AND POWER
WITHIN HELPING PEOPLE WITH
INDIVIDUAL CAPACITY TO EXERCISE
POWER.
I WANT TO CALL ATTENTION BACK TO
THIS WONDERFUL STUDY THAT MANY
FOLKS HERE PARTICIPATED IN,
AROUND THE FUNDING DISPARITIES
THAT THE NIH HAS.
AND HOW IT RELATES TO THINKING
AND HOW IT IMPEDES INNOVATION
AND CREATIVITY, MUCH BECAUSE OF
THESE ISSUES AROUND FEMINIST
STANDPOINT THEORY AND STRONG
OBJECTIVITY.
SO ONE OF THE WAYS, I HAVE JUST
A FEW SECONDS, MINUTES LEFT, I
WANT TO SPEND A BRIEF PERIOD OF
TIME TALKING ABOUT THE
IMPORTANCE OF COMMUNITY-BASED
PARTICIPATORY RESEARCH BECAUSE
IT IS A WAY, A PRINCIPLE THAT I
KNOW THE NIH HAS BEEN REALLY
ACTIVELY WORKING ON TO FULLY,
FULLY WORK WITH COMMUNITIES AS
EQUAL PARTNERS IN THE WORK WE
DO.
AND THE PRINCIPLES OF
COMMUNITY-BASED RESEARCH
ACKNOWLEDGE COMMUNITIES AS
UNITIES OF IDENTITY, BUILDS ON
EXISTING STRENGTHS, FACILITATES
PARTNERSHIPS, ADDRESS SOCIAL
INEQUALITIES, COMMIT TO
CO-LEARNING AND CAPACITY
BUILDING, BALANCES KNOWLEDGE
GENERATION AND INTERVENTION TO
ENSURE MUTUAL BENEFITS FOR
PARTNERS, FOCUSES ON LOCAL
ISSUES, DELIVERS RESULTS AND
KNOWLEDGE TO ALL PARTNERS, AND
ESTABLISHES SUSTAINABLE
LONG-TERM PARTNERSHIP WAS
COMMUNITIES.
THAT THESE IS CRITICAL.
PARTNERSHIPS NEED TO BE
SUSTAINABLE, LONG-TERM, NOT THIS
LIKE EXTRACTION COMING INTO
SOCIETIES ALREADY DISCUSSED.
SO JUST TO WRAP UP, HOW DO WE
PROMOTE THOSE MARGINALIZED IZED
OPPRESSED ARE?
SOME AREAS TO SHIFT OUR WORK,
AGAIN I'M NOT SAYING ANYTHING
THAT HASN'T ALREADY BEEN SAID
BUT I THINK WE NEED TO EXPAND
AND BUILD ON COMMUNITY-BASED
PARTICIPATORY RESEARCH,
REEVALUATE RISKS FROM DIFFERENT
PERSPECTIVE THAT CONSIDERS
POSITIONALITY, SO I THINK A LOT
OF FUNDERS ARE AFRAID TO GIVE
MONEY TO CERTAIN GROUPS WHICH
THEY SAY, OH, THEY DON'T HAVE A
TRACK RECORD, THEY HAVEN'T
DEMONSTRATED THEY CONDUCT
RESEARCH IN THE WAYS THAT WE
WANT THEM TO CONDUCT RESEARCH,
THEY ARE TOO RISKY TO GIVE THIS
MONEY TO BECAUSE THEY WON'T USE
IT APPROPRIATELY.
WE HAVE TO THINK ABOUT WHERE IS
OUR -- LIKE WHERE IS THAT
PERSPECTIVE COMING FROM AND HOW
IS IT WRAPPED UP IN SYSTEMS OF
OPPRESSION AND WHITE SUPREMACY
CULTURE.
WE NEED TO RETHINK RESEARCH
MODELS AND GOLD STANDARDS,
PRIORITIZING THE WAY KNOWLEDGE
IS GLEANED FROM MARGINS,
INCLUDING QUALITATIVE RESEARCH.
WE NEED TO CENTER EXPERTISE OF
OPPRESSED PEOPLE ESPECIALLY
MINORITIZED PEOPLE LIVED
EXPERIENCE AND REDRESS THE
HARMS.
I'LL END WITH THIS QUOTE FROM
BELL HOOKS.
THIS IS AN INTERVENTION.
A MESSAGE FROM THAT SPACE IN THE
MARGIN THAT IS A SITE OF
CREATIVITY AND POWER, THAT
INCLUSIVE SPACE WHERE WE RECOVER
OURSELVES, WHERE WE MOVE IN
SOLIDARITY TO ERASE THE CATEGORY
COLONIZED/COLONIZER.
MARGIN AT AS A SITE OF
RESISTANCE.
ENTER THAT SPACE.
LET US MEET THERE.
ENTER THAT SPACE.
WE GREET YOU AS LIBERATORS.
THANK YOU.
>> THANK YOU, DR. SHIM, FOR YOUR
EXCELLENT PRESENTATION.
NEXT WE HAVE ADDIE ROLNICK.
SO.
GOOD MORNING/AFTERNOON,
EVERYONE.
I'M EXCITED TO BE HERE.
I'M NOT A HEALTH RESEARCH, I'M
ALSO NOT NATIVE.
I'M GOING TO TALK ABOUT
INDIGENOUS HEALTH INEQUALITY SO
WHAT AM I DOING HERE?
FIRST OF ALL, THANKS FOR
INCLUDING ME.
I'VE LEARNED A LOT FROM
LISTENING, I ALWAYS LEARN A LOT
LISTENING TO THOSE WHO FOCUS ON
HEALTH RESEARCH.
MY WORK IS JUSTICE SYSTEMS.
HEALTH INEQUALITIES AND JUSTICE
SYSTEM OUTCOMES ARE LINKED, SO
HEALTH INEQUALITIES CAN LEAD TO
LEGAL SYSTEM ENTANGLEMENT, WHICH
CAN LEAD TO WORSE INDIVIDUAL
COMMUNITY AND INDIVIDUAL HEALTH
OUTCOMES.
SO WHAT I WANT TO DO TODAY IS
ACTUALLY TRY TO GET SPECIFIC,
AND TALK ABOUT SOME OF THE
INNOVATIONS THAT EMERGED FROM
TRIBAL JUSTICE SYSTEMS AND
CONTEXT IN WHICH THEY EMERGED
FOR ADDRESSING WHAT WE THINK OF
AS HEALTH ISSUES AND BARRIERS,
PARTICULARLY IN THE JUSTICE
FIELD, FOR DOING THIS WORK.
MOST OF MY WORK HAS BEEN ON
NATIVE CHILDREN, BUT MANY POINTS
APPLY TO ADULTS AS WELL.
SO BRIEFLY FIRST I WANT TO
SKETCH OUT WHAT WE'VE BEEN
TALKING ABOUT, FOR MOST OF THE
WORKSHOPS, THIS IDEA STRUCTURAL
RACISM CAN FEED HEALTH
ENEQUITIES AND FEED INVOLVEMENT
IN VARIOUS STATE SYSTEMS
INCLUDING JUVENILE AND CRIMINAL
SYSTEMS.
AND I WANT TO MAKE THE CASE THAT
TRIBAL DELINQUENCY AND CRIMINAL
SYSTEMS AND TRIBAL JUSTICE
SYSTEMS MORE BROADLY ARE
IMPORTANT SITES FOR THE KINDS OF
INNOVATIONS THAT PRIORITIZE
HEALING AND TREATMENT THAT WE'VE
TALKED ABOUT HERE, AND THAT ALSO
IS TALKED ABOUT IN THE CONTEXT
OF CRIMINAL JUSTICE REFORM.
AND THEN THIRD, I'LL TALK ABOUT
THE HARD PARTS, BARRIERS AND
PROBLEMS.
WHAT ARE THE RESEARCH AND
FUNDING BARRIERS THAT HAVE
THREATENED THE DEVELOPMENT AND
SUSTAINABILITY OF THESE
PROGRAMS?
SOR FIRST, WHAT IS THE
CONNECTION HERE?
SO, WE TALK ABOUT SOCIAL
DETERMINANTS OF HEALTH, MEANING
THAT THERE ARE -- THE CONTEXT TO
WHICH INDIVIDUAL PEOPLE ARE BORN
CAN IMPACT HEALTH.
SOCIAL DETERMINANTS MIGHT
INCLUDE THE EXPERIENCES, ADVERSE
CHILDHOOD EXPERIENCES, ACEs,
NEGATIVE THINGS IN CHILDHOOD,
POVERTY, LACK OF ACCESS TO
RESOURCES, EDUCATIONAL
ATTAINMENT, PHYSICAL
ENVIRONMENT, AND THEN PERSONAL
AND COMMUNITY VIOLENCE, AND I'VE
ADDED HISTORICAL TRAUMA WHICH
I'LL MENTION IN A MINUTE.
ON THESE SOCIAL DETERMINANTS,
THE TAKEAWAY IS NATIVE PEOPLE
FARE AT THE BOTTOM OF ALL OF
THEM CONSISTENTLY.
SO WHY DON'T I HAVE A SLIDE
GIVING YOU SPECIFIC STATISTICS?
BECAUSE I'M TIRED OF DOING THAT,
TIRED OF OPENING EVERY TALK
ABOUT NATIVE CHILDREN TALKING
ABOUT HOW TERRIBLE THEIR
CIRCUMSTANCES ARE.
THERE'S A FEW LINKS IN THIS
SLIDE TO MORE DETAILED
INFORMATION BUT BASICALLY THEY
TEND TO BE POORER, LIVE IN
COMMUNITIES WITH FEWER SOCIAL
SAFETY NET SERVICES, GREATER
ENVIRONMENTAL DANGER, MORE
LIKELY TO DROP OUT, LESS LIKELY
TO GET ADVANCED DEGREE, MORE
LIKELY TO EXPOSED TO BOTH
PERSONAL ABUSE AND COMMUNITY
VIOLENCE, COMPARED TO -- WHEN WE
TALK TO DISPARITIES COMPARED TO
NON-HISPANIC WHITES BUT ON A LOT
OF MEASURES IT'S IMPORTANT TO
NOTE NATIVE PEOPLE ARE LEFT OUT
OF THE CONVERSATION, SCORING
WORST OR SECOND TO THE WORSE,
OFTEN LEFT OUT BECAUSE OF SMALL
NUMBERS FROM OVERALL
DISCUSSIONS, THESE ARE REALLY
NOT DOING WELL IN THESE AREAS.
SO OF COURSE AS WE'VE TALKED
ABOUT HERE, STRUCTURAL
DETERMINANTS INFLUENCE
STRUCTURES, WHAT WE CREATES BAD
OUTCOMES, LEGAL RULES, RACISM,
COLONIZATION, ALL OF THESE ARE
STRUCTURAL FACTORS THAT PRODUCE
SOCIAL DETERMINANTS.
SO, THIS LEADS TO HEALTH
INEQUITIES.
AGAIN, HERE ON A LOT OF MEASURES
WE THAT YOU CAN ABOUT WITH
HEALTH INEQUITIES I'VE GIVEN YOU
SOME HERE, NATIVE PEOPLE HAVE
SHORTER LIFE EXPECTANCIES THAN
NON-HISPANIC WHITES, HIGHER
RATES OF DIABETES, TUBERCULOSIS,
STIS, OTHER HEALTH PROBLEMS AS
WELL.
REALLY HIGH RATES OF SUICIDE,
INCLUDING NOTABLE YOUTH SUICIDE
CLUSTERS IN MANY COMMUNITIES,
HIGH RATES OF ALCOHOL USE,
SUBSTANCE USE AND ABUSE, HIGH
RATES OF SUICIDE, DEPRESSION,
OTHER MENTAL HEALTH PROBLEMS.
AGAIN, WE SEE CONSISTENTLY HERE
NATIVE CHILDREN AND NATIVE
PEOPLE IN GENERAL SCORING AT THE
BOTTOM OF HEALTH EQUITY
MEASURES.
I DO WANT TO SAY HERE THAT I
THINK RACE IS A REALLY IMPORTANT
MODEL FOR ANALYZING NATIVE
PEOPLE AS A COMMUNITY BUT ALSO A
LIMITED ONE.
SO THERE ARE VARYING DEFINITION
OFS OF HOW NATIVE PEOPLE ARE
DEFINED AS A GROUP, A LOT OF
TIMES LOOKING AT RACIAL CATEGORY
ON CENSUS, SOMETIMES WHAT WE'RE
THINKING ABOUT IS THE LEGAL
CATEGORY OF INDIAN PEOPLE,
USUALLY CALLED AMERICAN INDIAN
AND ALASKA NATIVE THAT DOESN'T
CORRESPOND TO RACIAL CATEGORY.
THERE'S CONFUSION.
ONE RESULT, EVEN THOUGH WE SEE
CONSISTENT STATISTICS SHOWING
THAT THEY ARE FARING POORLY ON
THESE MEASURES A LOT OF
STATISTICS ARE PROBABLY
UNRELIABLE BECAUSE MAYBE WE'RE
LOOKING AT A SMALL SUBSET, A
CONFUSING SET OF DEFINITIONS,
I'LL TALK ABOUT THIS FROM
PERSPECTIVE OF RACE BUT
INDIANNESS AND SELF-GOVERNMENT
FOR TRIBES WHICH IS UNIQUE.
SO THEN PERHAPS UNSURPRISINGLY
THESE SORTS OF HEALTH INEQUITIES
CAN LEAD TO AND OFTEN LEAD TO
INVOLVEMENT IN MULTIPLE
DIFFERENT GOVERNMENT SYSTEMS.
SO HEALTH CARE, MENTAL HEALTH, A
SEPARATE SYSTEM, CHILD WELFARE
OR FOSTER CARE, JUVENILE
DELINQUENCY, CRIMINAL NOTICE, I
COULD PUT EDUCATION ON HERE SO
THE POINT HERE IS THAT THERE ARE
MULTIPLE DIFFERENT TYPES OF
GOVERNMENT SYSTEMS THAT MAY BE
NECESSARY TO ADDRESS WHAT WE
THINK OF AS HEALTH INEQUITIES.
MOST OF THE PRESENTERS INVOLVED
IN THIS CONFERENCE HAVE TALKED
ABOUT THE HEALTH CARE AND MENTAL
HEALTH SYSTEMS, I'M GOING TO
FOCUS MOSTLY ON THE DELINQUENCY
AND CRIMINAL SYSTEMS, WHAT WE
THINK OF AS THE PLACE TO ADDRESS
HEALTH DISPARITIES.
SO, TRIBAL JUSTICE SYSTEMS, I
MEAN DELINQUENCY, PRIORITIZING
HEALING AND TREATMENT.
HERE WHEN I FIRST STARTED TO
TALK ABOUT THIS WORK AMONG
HEALTH RESEARCHERS I WAS ASKED
WHAT I THINK IS AN OBVIOUS AND
IMPORTANT QUESTION I FORGOT TO
ADDRESS, WHY ARE YOU TALKING
ABOUT TREATING SOMETHING THAT'S
A HEALTH PROBLEM THROUGH SYSTEMS
THAT ARE DESIGNED TO GET PEOPLE
IN TROUBLE?
SO IF AS I CONTEND WHAT IS
HAPPENING TO NATIVE PEOPLE WHEN
THEY COME INTO THE YOU'VE NIGHT
AND -- JUVENILE AND CRIMINAL
JUSTICE SYSTEM, HILT ENEQUITIES,
EXPERIENCE OF TRAUMA, MENTAL
HEALTH INEQUITIES, CONVERTING
INTO SOMETHING WE CRIMINALIZE
WHY WOULD WE TRY TO ADDRESS
THROUGH SYSTEMS THAT
CRIMINALIZE?
A FEW ANSWERS, IT'S IMPORTANT TO
EXPLAIN THE REALITY OF WHY
JUSTICE SYSTEMS ARE AN AREA WE
SHOULD BE FOCUSING ON.
FIRST OF ALL, CHILD WELFARE AND
DELINQUENCY SYSTEMS BECAUSE OF
FOCUS ON CHILDREN HAS ALWAYS
EMPHASIZED HEALING AND TREATMENT
AS POTENTIAL GOALS.
BUT INCREASINGLY IN RECENT YEARS
THEY HAVE DONE SO SO THERE'S A
LOT OF ENERGY IN CHILD WELFARE
AND DELINQUENCY TO FOCUS ON
HEALING AND TREATMENT.
EVEN MORE RECENTLY, REFORMS OR
SUGGESTED REFORMS TO ADULT
CRIMINAL SILLS ITEM ARE STARTING
TO PRIORITIZE IDEA OF HEALING OR
TREATMENT OVER PUNISHMENT,
INROADS TO TALK ABOUT HEALTH
PROBLEMS AND TREATMENT OF HEALTH
PROBLEMS THROUGH THE JUSTICE
SYSTEM.
EVEN IF THEY THOUGHT IT WAS THE
WRONG WAY TO DO IT, WE SHOULD
NOT BE IN THE SYSTEM AT ALL, THE
REALITY FOR ARE TRIBAL
GOVERNMENTS JUSTICE SYSTEM
FUNDING CAN BE EASIER TO SECURE
THAN HEALTH CARE FUNDING.
THERE'S 85 DETENTION FACILITIES
ON THE RESERVATIONS, 15 OF THEM
SPECIFICALLY THERE TO SERVE
YOUTH, AND LAST TIME I CHECKED
THERE WERE MAYBE FIVE MENTAL
HEALTH, SECURE MENTAL HEALTH
FACILITIES THAT SERVE YOUTH.
TRIBES ARE GETTING HEALTH
FUNDING THROUGH ONE AGENCY,
JUSTICE FINANCING THROUGH
ANOTHER AGENCY, IT'S HARDER TO
BUILD A HEALTH BUILDING THAN
SOMETIMES BUILD A JUSTICE
BUILDING.
WHAT WE SEE ARE TRIBAL JUSTICE
SYSTEMS HAVE INNOVATED IN A LOT
OF AREAS PARTLY OUT OF
NECESSITY.
SO HOW DOES THIS KIND OF
TREATMENT FIT INTO A JUSTICE
SYSTEM?
COURTS, SOMEONE COMES INTO A
COURT BECAUSE THEY GET IN
TROUBLE FOR SOMETHING.
FIRST THEY MIGHT JUST ORDER
TREATMENT AS A CONDITION OF
SUPERVISION OR PLACEMENT ON
PROBATION.
SECOND THEY WILL OFTEN DIVERT AN
INDIVIDUAL OUT OF THE LEGAL
SYSTEM AND INTO TREATMENT.
SO WE CALL THOSE DIVERSION
PROGRAMS, LET'S GET YOU OUT OF
THE SYSTEM AND ON THE CONDITION
YOU COMPLETE SOME SORT OF
TREATMENT.
AND THEY MIGHT INCORPORATE
TREATMENT INTO EXISTING PROGRAMS
OR FACILITIES.
SO WE STILL HAVE A LOT OF
QUESTIONS ABOUT WHAT SORTS OF
TREATMENT WORKS, INTERESTING TO
THINK ABOUT THE WAY IT'S
INCORPORATED.
SO HERE JUST AS BACKGROUND FOR
THOSE WHO DON'T WORK IN INDIAN
COUNTRY, IT'S A COMPLICATED
PLACE TO NAVIGATE.
FOR NATIVE PEOPLE THE GOVERNMENT
SYSTEMS THAT THEY HAVE TO
NAVIGATE AND THE WAY TO GET
SERVICES ARE COMPLICATED EVEN
MORE THAN FOR OTHER PEOPLE
BECAUSE OF JURISDICTIONAL RULES.
SO INDIAN COUNTRY WHICH INCLUDES
RESERVATIONS AND THAT'S WHERE
40% OF NATIVE PEOPLE LIVE
NATIONALLY, PEOPLE WHO NEED
ACCESS TO SERVICES LIKELY HAVE
TO DEAL WITH TWO OR MORE OF THE
GOVERNMENTS LISTED, TRIBAL
GOVERNMENT, STATE GOVERNMENT,
FEDERAL GOVERNMENT.
THE QUESTION OF WHO HAS
JURISDICTION DEPENDS ON WHAT THE
PROBLEM IS AND WHO THE PERSON IS
AND CAN BE VERY COMPLICATED.
AND WHETHER OR NOT THESE
GOVERNMENTS TALK TO EACH OTHER
EFFECTIVELY IS A WHOLE DIFFERENT
QUESTION.
AND THEN TO ACCESS SPECIFIC
SERVICES, LET'S SAY A CHILD GETS
IN TROUBLE AND THAT CHILD
CLEARLY NEEDS, SAY, TREATMENT
FOR AN UNDERLYING EXPERIENCE OF
DEPRESSION, TRYING TO FIND THOSE
SERVICES IS GOING TO OFTEN
REQUIRE NAVIGATING MAYBE ALL
THREE OF THOSE GOVERNMENTS, BUT
ALSO MAYBE LOCAL GOVERNMENTS,
NON-PROFITS, MULTIPLE FEDERAL
AGENCIES, RIGHT, SO DEPARTMENT
OF JUSTICE, HEALTH AND HUMAN
SERVICES, AND SORT OF THE TWO
MAJOR ONES, PERHAPS DEPARTMENT
OF -- BUREAU OF INDIAN EDUCATION
WHICH IS A SEPARATE AGENCY THAT
HANDLES EDUCATION AND OFTEN
PRIVATE PROVIDERS, SORT OF A
MAZE, FOR OTHER GROUPS AS WELL
BUT BECAUSE OF JURISDICTIONAL
RULES IT'S EVEN WORSE IN INDIAN
COUNTRY.
SO, IN THIS CONTEXT, TRIBAL
CONTROL AND INNOVATION IS
CRITICALLY IMPORTANT.
SO, FEDERAL LAW RECOGNIZES
IMPORTANCE OF TRIBAL SOVEREIGNTY
AND SELF-GOVERNANCE,
JURISDICTION OR POWER TO SHAPE A
SYSTEM AND DEFINE RULES.
BY SELF-GOVERNANCE I'M TALKING
ABOUT PROGRAM ADMINISTRATION, SO
ABILITY TO DECIDE BUDGETARY
PRIORITIES AND ADMINISTER
PROGRAM ALSO.
A NUMBER OF LAWS IMPORTANCE IS
REAFFIRMED, EXECUTIVE ORDERS
UNDER EVERY PRESIDENT SINCE
NIXON, ALLOWING TRIBES TO TAKE
OVER ONING THEIR OWN, TRIBAL ON
ORDER ACTS IN RECENT YEARS
EXPANDED TRIBAL JURISDICTION
OVER THINGS IN THE AREA OF
CRIMINAL AND JUVENILE JUSTICE.
SO THIS IS IMPORTANT BECAUSE THE
CONTEXT IS DIFFICULT, SO MANY
OTHER GOVERNMENTS THERE HAVING
TRIBES LEAD THE WAY, SOVEREIGNTY
AND SELF-GOVERNANCE ALLOWING
THAT TO HAPPEN, IT'S ALLOWED
TRIBES TO BE I THINK INTERESTING
SITES OF INNOVATION.
CERTAINLY ANY COMMUNITY COULD
EXPERIENCE THE SAME PROBLEM OF
WE HAVE THE LOCAL COMMUNITY,
WHAT'S PRODUCED BY DOMINANT
CULTURE ISN'T WORKING BUT
BECAUSE TRIBES LEGALLY HAVE THE
RIGHTS TO INCORPORATE TRIBAL
CULTURE INTO LAW AND EXERCISE
THAT, THEN THAT MAKES THEM
STRUCTURALLY AN INTERESTING SIDE
FOR PRODUCING INNOVATIONS, THERE
ARE 574 TRIBAL GOVERNMENTS SO
NOT ONE MODEL EMERGES.
SO, I WANT TO HIGHLIGHT TWO
DIFFERENT WHAT I THINK ARE
INTERESTING INNOVATIONS THAT
EMERGED IN CONTEXT OF TRIBAL
JUVENILE COURTS.
TRAUMA-INFORMED CARE, YOU HAVE
CHILDREN, SAY, FACING
SIGNIFICANT HEALTH, MENTAL
HEALTH INEQUITIES, DOCUMENTED
EXPERIENCES OF TRAUMA, COME INTO
A SYSTEM, LOTS OF DELINQUENCY
SYSTEMS ARE TRYING TO DO TRAUMA
INFORMED CARE BUT THE MODEL IS
NOT THE SAME MODEL, AS WHAT HAS
EMERGED FROM WESTERN CRITICAL
RESEARCH ON TRAUMA.
SO WHAT'S DIFFERENT ABOUT IT,
DEFINITION OF TRAUMA TENDS TO
INCLUDE HISTORICAL AND GROUP
TRAUMA, STRUCTURAL INEQUITY IN A
WAY WESTERN MODEL DOESN'T DO,
RECOLLECT FLIESES -- RECOGNIZES
GROUP KINSHIP, THESE THINGS LINK
INDIVIDUAL WELL-BEING TO
COMMUNITY WELL-BEING IN A WAY
WESTERN MODELS DON'T DO,
INCORPORATE TRADITIONAL CULTURAL
ACTIVITIES, ADAPT THERAPEUTIC
APPROACH ALSO, SO DEVELOPMENT OF
COMMUNITY-SPECIFIC MODELS WHICH
AGAIN HAS BEEN AN ISSUE THAT
MANY OTHER SMALLER COMMUNITIES
CONFRONT.
ONE WAY IN WHICH WE SEE THIS
HAPPENING, ONE AREA IS TRIBAL
HEALING TO WELLNESS COURTS.
SO THESE ARE JUST IN A WAY
MODELED OFF OF DIVERSIONARY DRUG
COURTS, BUT OVER SEVERAL DECADES
NATIVE RESEARCHERS AND TRIBES
HAVE REPRODUCED AND REFINE THE
MODEL TO MAKE IT SPECIFICALLY
SERVE NATIVE PEOPLE, IT'S BASED
LOOSELY ON THE DRUG COURT MODEL
BUT LOOKS DIFFERENT.
NON-ADVERSARIAL, INDIVIDUALIZED,
INCLUDES COMMUNITY INVOLVEMENT,
INTEGRATES TREATMENT INTO THE
CRIMINAL OR JUVENILE SYSTEM.
WHAT'S NOTABLE IT'S NOT JUST
LET'S BRING IN TREATMENT AND ASK
PEOPLE INVOLVED IN THE JUSTICE
SYSTEM TO GET SOME TREATMENT FOR
HEALTH ISSUES, BUT IT ACTUALLY
CHANGES AND REDEFINES THE
STRUCTURE AND APPROACH OF HOW
THE, SAY, DELINQUENCY OR
CRIMINAL SYSTEM WILL OPERATE
CHANGING RULES TO PRIORITIZE
HEALING AND HEALTH.
ONE LAST NOTE HERE, THIS IS
GREAT, RIGHT.
WE'VE GOT GREAT INNOVATIONS,
TRIBES DOING THINGS OF INTEREST
TO OTHER COMMUNITIES BUT WHY
DON'T WE TALK ABOUT THEM?
RESEARCH AND FUNDING BARRIERS
THREATEN ABILITY TO DEVELOP
THESE PROGRAMS AND SUSTAIN THEM.
SO, JUST SORT OF REFERRING BACK
TO WHAT DR. SHIM NOTED, THE GOAL
STANDARD FOR VALIDATING A
PROGRAM THAT WORKS, IN
PARTICULAR IN THE JUSTICE
CONTEXT, IN ORDER TO GET MONEY
FOR AN INTERVENTION THAT'S
SUPPOSED TO REDUCE INEQUALITY IN
THE JUSTICE SYSTEM OR HELP
PEOPLE IN THE JUSTICE SYSTEM,
YOU NEED TO HAVE AN
EVIDENCE-BASED PROGRAM, AND
THAT'S USUALLY VALIDATED BY
RANDOMIZED CONTROLLED TRIALS.
SO, GOVERNMENT AND PRIVATE
FUNDING STRONGLY FAVORS THOSE
KINDS OF PROGRAMS, IT'S USUALLY
MEASURED IN A PARTICULAR WAY.
SO RCTs RARELY INCLUDE NATIVE
PARTICIPANTS, BECAUSE OF THE
SIZE OF THE SAMPLE AND LENGTH OF
THE PROGRAM IN PLACE IT'S
DIFFICULT TO VALIDATE EXISTING
PROGRAMS USING STANDARD RCT
STUDY DESIGN.
WELLNESS COURTS ARE NOT A
VALIDATED PRIVATE FUNDING AND
FEDERAL FUNDING DOESN'T ACCOUNT
FOR INDIGENOUS RESEARCH
METHODOLOGIES OR REALITIES OF
TRIBAL COMMUNITIES SO WE ARE AT
THIS PLACE IT'S VERY DIFFICULT
TO VALIDATE PROMISING APPROACHES
WHICH MEANS WE CAN NEVER PUT
THEM IN PUBLICATION THAT
RECOMMENDS AN APPROACH OTHER
COMMUNITIES SHOULD TAKE AND CAN
NEVER REFINE AND DEVELOP THEM
EFFECTIVELY.
SO WHAT TO DO?
SO HERE I WANT TO FOCUS ON
IMPROVING RESEARCH AND PROGRAM
SUPPORT.
IN TERMS OF RESEARCH ON THE LEFT
SIDE OF THE SLIDE RECOGNIZING
INDIGENOUS KNOWLEDGE, A 2022
BIDEN ADMINISTRATION SET OF
GUIDANCE THAT REQUIRES THE
FEDERAL GOVERNMENT ACROSS
AGENCIES TO INCORPORATE
INDIGENOUS KNOWLEDGE BUT THIS IS
RELATED TO DR. SHIM'S POINT,
COMMUNITIES PRODUCE KNOWLEDGE IN
DIFFERENT WAYS, IT'S IMPORTANT
TO RECOGNIZE THOSE DIFFERENT
WAYS.
ENSURE TRIBAL GOVERNMENTS HAVE
FULL ACCESS TO DATA BUT ALSO
RESPECT TRIBAL CONTROL OVER AND
CONCERNS ABOUT HEALTH AND
JUSTICE SYSTEM DATA THAT OTHER
GOVERNMENTS OR OTHER RESEARCHERS
MIGHT HAVE ACCESS TO.
INCORPORATE INDIGENOUS RESEARCH
METHODOLOGIES AND PROTOCOLS,
THIS IS LIKE QUALITATIVE
RESEARCH IS HELPFUL HERE AND
COMMUNITY-BASED RESEARCH, BUT
ALSO BE WILLING TO ASK DIFFERENT
QUESTIONS, TO REDEFINE WHAT IT
MEANS FOR PROGRAM TO BE
SUCCESSFUL, BY WORKING DIRECTLY
WITH THE COMMUNITIES OR HAVING
RESEARCHERS DIRECTLY FROM THE
COMMUNITIES.
AND THEN SUPPORT INDIGENOUS
RESEARCHERS WHO ARE DOING THIS
WORK.
ON THE OTHER SIDE OF THE SLIDE
IT'S EQUALLY IMPORTANT TO THINK
ABOUT THIS IN TERMS OF
PROGRAMMING AND FUNDING FOR
PROGRAMS.
SO RECOGNIZING THE ROLE OF
CULTURE AND TRADITION IN HEALTH
INTERVENTIONS, SO WHAT TRIBES
HAVE FOUND IS THAT JUST
CONNECTING PEOPLE WITH CULTURAL
ACTIVITIES OR TRADITIONAL
ACTIVITIES CAN BE A PROTECTIVE
FACTOR AND CAN LEAD TO BETTER
HEALTH OUTCOMES, RECOGNIZING
THAT ALONE IS IMPORTANT.
AND DEVELOPING OR ADAPTING
TREATMENT MODELS TO SEE HOW THEY
CAN SERVE NATIVE PEOPLE AND WORK
IN THE CONTEXT OF TRIBAL
COMMUNITIES, AND WHAT THIS MEANS
IS FUNDING HAS TO BE FLEXIBLE TO
PERMIT CROSS-SYSTEM INNOVATION
IT'S REALLY HARD TO THINK ABOUT
ADDRESSING THE HEALTH PROBLEMS
THAT LEAD TO JUSTICE SYSTEM
INVOLVEMENT.
AND ENSURE CONTINUED SUSTAINABLE
FUNDING BECAUSE IT'S NOT
POSSIBLE TO EVALUATE AND REFINE
A PROGRAM IF IT'S ONLY FUNDED
FOR THREE YEARS AND IT GOES
AWAY.
I'M THE LAST PRESENTER, JUSTICE
SYSTEMS CAN BE CRITICAL SITES
FOR INTERVENTION RELATED TO
HEALTH DISPARITIES AND THIS IS
INTERESTING BECAUSE FOR CRIMINL
JUSTICE REFORM MADE THIS
POSSIBLE.
TRIBAL GOVERNMENTS HAVE BEEN
LEADERS IN COMMUNITY-SPECIFIC
APPROACHES FOR MANY YEARS,
OVERALL INVISIBILITY AND
DISCONNECT BETWEEN RESEARCH
METHODS AND FUNDING AND
COMMUNITY NEEDS HAMPERED ABILITY
TO IMPLEMENT AND REFINE THESE
PROGRAMS, CREATE TRANSFERABLE
MODELS OTHER TRIBES AND
NON-TRIBAL COMMUNITIES CAN USE.
>> THANKS YOU FOR YOUR EXCELLENT
PRESENTATION.
I'D LIKE TO WELCOME BACK
EVERYONE, THANKS AGAIN FOR ALL
ON YOUR INFORMATIVE
PRESENTATIONS, AND I'D LIKE TO
START OUR DISCUSSION Q&A, JUST
TO REMIND OUR AUDIENCE PLEASE
ADD ANY QUESTIONS TO SLIDO.
AND WE'LL START WITH, LET'S SEE,
FIRST QUESTION FOR DR. GRIFFITH.
CAN YOU PLEASE POINT OUT WHO
BENEFITS FROM RACISM?
ARE THERE EXAMPLES OF EFFORTS TO
MEASURE AND EXAMINE THE
RELATIONSHIP BETWEEN VARIOUS
ASPECTS OF STRUCTURAL RACISM AND
ADVANTAGE PRODUCED BY THOSE
ASPECTS?
MEASURING ADVANTAGE EXPERIENCED
BY PEOPLE WHO ARE WHITE.
>> THIS WAS FOR ME?
>> UH-HUH.
>> SURE.
I MEAN I THINK IT'S, AGAIN, IF
YOU LOOK AT THE DEFINITION OF
RACISM, THREE PARTS, IT TALKS
ABOUT THE STRUCTURAL FACTORS,
IDEOLOGY OF INFERIORITY, AND
THEN THE DIFFERENTIAL BENEFIT OR
DISTRIBUTION OF RESOURCES AND
OPPORTUNITIES.
SO, THE ANSWER IS IN WHO
BENEFITS AND WHO HAS
DIFFERENTIAL OPPORTUNITIES TO BE
HEALTHY, TO BE WELL, WHETHER
IT'S ACCESS TO HEALTH CARE,
WHETHER IT'S RETURN ON
EDUCATION, SO THAT THE ECONOMIC
DIFFERENCE BETWEEN RACIAL GROUPS
DOING THE SAME JOB IN THE SAME
LEVEL OF EDUCATION, UNEMPLOYMENT
STATISTICS, I MEAN, WE COULD GO
ON.
I THINK IT'S JUST, YEAH, THERE
ARE MANY EXAMPLES OF WHERE WHITE
PEOPLE BASICALLY REGARDLESS OF
INCOME LEVEL AND OPPORTUNITY DO
BENEFIT IN OUR SOCIETY.
YES, IT IS NOT -- THERE ARE
CONTEXTS POTENTIALLY WHERE IT'S
NOT AS OBVIOUS OR POTENTIALLY AS
UNIVERSAL BUT IF YOU LOOK AT A
POPULATION LEVEL THAT IT IS
SOMETHING THAT IS CRITICAL TO
RECOGNIZE AND CONSIDER.
THE EDICT STUDY THAT WAS DONE IN
BALTIMORE, SOUTHWEST BALTIMORE,
LOW INCOME, PARTICULARLY BLACK
AND WHITE GROUPS SOME YEARS AGO
NOW, DOES SHOW THAT IT'S REALLY
ABOUT SEGREGATION, AT A NATIONAL
LEVEL, MANY OF THE DIFFERENCES
WE SEE ARE DRIVEN BY RACE-BASED
RESIDENTIAL SEGREGATION.
WHEN YOU CONTROL FOR
DIFFERENTIAL ACCESS TO
EDUCATION, DIFFERENTIAL RATES OF
PEOPLE LIVING IN THE SAME
COMMUNITY, AND DIFFERENTIAL
INCOME, THAT SOME OF THE
DIFFERENCES DO GO AWAY BUT MANY
OF THEM ACTUALLY PERSIST.
SO IT IS NOT SOMETHING THAT WE
CAN JUST SAY THAT IS NOT A REAL
FACTOR, IT'S SOMETHING THAT'S
CONSISTENT THAT WE'RE SEEING
ACROSS TIME.
>> I WANT TO QUICKLY ADD TO
THAT.
AND JUST SAY I LOVE THAT
QUESTION ABOUT, LIKE, WHO
BENEFITS, RIGHT?
BECAUSE IT SEEMS PRETTY OBVIOUS
WHITE PEOPLE BENEFIT FROM
STRUCTURAL RACISM.
I ALSO WANT TO POINT OUT HEATHER
McGEE'S WORK WOULD SAY THAT
EVEN THOUGH THERE ARE SOME WHITE
PEOPLE THAT BENEFIT FROM RACISM,
THERE'S A SIGNIFICANT NUMBER OF
WHITE PEOPLE THAT ARE HARMED BY
STRUCTURAL RACISM AS WELL.
AND SO THIS KIND OF IDEA, THERE
ARE A SMALL NUMBER OF WHITE
PEOPLE THAT BENEFIT FROM
STRUCTURAL RACISM, AND THEN MOST
EVERYBODY ELSE INCLUDING THAT
SMALL NUMBER OF WHITE PEOPLE
THAT ARE GETTING ADVANTAGES ARE
STILL COLLECTIVELY AS A SOCIETY
ALL SUFFERING BECAUSE OF THE
STRUCTURAL RACISM THAT EXISTS.
>> OKAY.
LET'S SEE.
WE RECEIVED A LOT OF COMMENTS.
THANK YOU, DR. SHIM.
YOUR WORK IS MAKING ME
REEVALUATE THE HEALTH RESEARCH.
IMPLEMENTATION PRACTICES THAT
I'VE ALWAYS THOUGHT WERE UNEQUAL
AND BIASED BUT COULDN'T
ARTICULATE WHY.
FROM ANOTHER, GREAT COMMENT, I'D
LIKE TO GIVE CUE KUDOS TO THE
PRESENTERS TODAY, ONE OF THE
BEST WORKSHOPS I'VE ATTENDED.
LET'S SEE.
ANOTHER COMMENT, LET'S SEE.
IT'S IMPORTANT TO POINT OUT
WELL-FUNDED AND SENIOR
SCIENTISTS HAVE THE POWER TO SET
AGENDA IN RESEARCH IN U.S.
WE NEED TO BE LESS BIASED, AND
MORE JUST.
FUNDING DISPARITIES BETWEEN
NEVER FUND AND FUNDING MULTIPLE
TIMES, HUGE DISPARITIES.
ANY COMMENTS?
>> I HAVE A LOT OF COMMENTS.
I WANT TO DEFER TO OTHERS.
OKAY.
SO I HAVE A LOT OF COMMENTS BUT
I WILL TELL YOU, I ALWAYS HAVE A
FAIR AMOUNT OF IMPOSTOR SYNDROME
INVITED IN SPACES LIKE THIS
BECAUSE I'M NOT AN NIH-FUNDED
RESEARCHER.
AND ONE OF THE REASONS THAT I'M
NOT AN NIH-FUNDED RESEARCHER IS
BECAUSE EARLY IN MY ACADEMIC
CAREER, I ATTEMPTED OVER AND
OVER TO GET NIH FUNDING AND
THOUGHT I HAD THE SKILLS, I
THOUGHT I HAD THE ABILITIES, I
HAD ALL THE BEST MENTORS, AND
THESE WERE MOSTLY WHITE PEOPLE
THAT WERE REALLY SKILLED
RESEARCHERS, AND TIME AND TIME
AGAIN I WAS DENIED EVEN LIKE
READ, LIKE MY GRANT PROPOSALS
WERE NEVER SCORED, NOT A SINGLE
ONE OF MY GRANT PROPOSALS I EVER
PUT IN AT THE NIH WAS EVER
SCORED.
AND AFTER A WHILE I GAVE UP.
BECAUSE I DECIDED THAT LIKE IT
WASN'T WORTH THE MENTAL AND
PHYSICAL STRAIN THAT IT REQUIRED
TO TRY TO RECEIVE THAT FUNDING.
AND I THINK MY EXPERIENCE,
SOMEHOW I MANAGED TO BE
RELATIVELY IN ACADEMIA WITHOUT
NIH FUNDING, I'LL TAKE IT AS A
GIFT.
I'M SURE I'M NOT ALONE.
I'M QUITE SURE THERE ARE SO MANY
POTENTIALLY TALENTED RESEARCHERS
OUT THERE THAT DECIDED EARLY ON
IN THEIR CAREERS THIS WAS NOT
THE PATH FOR THEM BECAUSE OF THE
BIAS OF PEOPLE WORKING IN THESE
SPACES THAT HAVE A CERTAIN TYPE
OF OBJECTIVITY, THAT THEY FELT
WAS JUST NOT FOR THEM.
SO I HOPE THAT WE CAN THINK AND
DO BETTER.
THERE'S WORK HAPPENING THAT IS
DOING BETTER BUT THERE IS A LOT
MORE WORK THAT NEEDS TO BE DONE.
WE TALKED SO MUCH ABOUT
PATHWAYS, IMPROVING THE
PIPELINE, THERE'S SO MANY WAYS
PEOPLE GET SORTED OUT AND
EXCLUDED FROM THIS WORK.
I THINK WE NEED TO THINK
DIFFERENTLY ABOUT IT.
>> NOT TO PILE ON BUT JUST TO
BUILD ON WHAT DR. SHIM SAID, I
HAVEN'T HAD VERY MUCH FUNDING.
I'VE HAD A VERY SIMILAR
TRAJECTORY AND PATH.
I THINK IT WOULD BE INTERESTING
AS A THOUGHT EXERCISE TO LOOK AT
THE FOLKS INVITED TO SPEAK AND
LOOK AT FUNDING PORTFOLIOS .
IF THAT'S NOT A STRONG
CORRELATION, IF YOU WILL, WHAT
DOES THAT SUGGEST ABOUT WHAT
WE'RE DOING AND WHO WE'RE
FUNDING.
>> THANK YOU FOR YOUR COMMENTS.
SO I WANT TO THANK EVERYONE FOR
PARTICIPATING IN THIS SESSION.
AND OUR NEXT SESSION IS NOW THE
BREAKOUTS.
WELL, THANK YOU.
WELCOME BACK FROM THE BREAKOUT
DISCUSSIONS.
OUR ROOM WENT TERRIFIC.
I HOPE EVERYBODY HAD AN ENGAGING
AND INTERACTIVE DISCUSSION.
WE'RE INTERESTED TO HEAR THE
HIGHLIGHTS FROM THE ROOMS.
THERE WERE NINE DIFFERENT ROOMS,
COVERING A TOTAL OF FOUR TOPICS,
BUT ALL WITH SIMILAR QUESTIONS
IN TERMS OF WHERE ARE WE NOW,
WHAT ARE SOME BARRIERS, AND
WHERE ARE WE LOOKING INTO THE
FUTURE, RECOMMENDATIONS FOR
PROGRESS.
SO, I KNOW EVERYONE TOOK A
DIFFERENT FORMAT ON THIS, AND
THAT'S GREAT.
THIS SHOULD BE A VERY INFORMAL
REPORT-OUT BUT WE'RE GOING TO
GIVE ABOUT FIVE MINUTES TO EACH
VIRTUAL ROOM.
I BELIEVE EVERYONE HAS A
VOLUNTEER THAT'S GOING TO BE
REPORTING OUT.
SO YOU HAVE FIVE MINUTES, AND WE
WOULD LOVE TO HEAR SOME OF WHAT
WAS DISCUSSED IN YOUR ROOM.
SO, CAN I SEE WHO IS GOING TO BE
REPORTING OUT FOR ROOM 1?
I BELIEVE THE TOPIC OF ROOM 1
WAS ON METHODS AND METHODOLOGY.
>> CAN YOU HEAR ME OKAY?
>> YEAH.
>> SO WE ALSO HAD A VERY
INTERESTING DISCUSSION IN OUR
GROUP.
OUR TEAM CAME UP WITH THESE
REPORTING OUT HIGHLIGHTS.
FIRST, WE THOUGHT THERE WAS LACK
OF CONSENSUS IN HOW WE MEASURE
STRUCTURAL RACISM AND DIFFERENT
TYPES.
RACISM, INCLUDING INTERPERSONAL,
CULTURAL, INSTITUTIONAL RACISM,
AND THIS CAN ALSO IMPACT PEER
REVIEW IN GRANTS AT NIH FUNDING,
AND THAT THERE IS NO SINGULAR
MEASURE FOR STRUCTURAL RACISM,
AND IT REALLY DEPENDS ON THE
CONTEXT, THE PROBLEM, THE
POPULATION, AND A LOT MORE.
IT'S IMPORTANT TO HIGHLIGHT HOW
TO MEASURE COLORISM.
THERE WAS AN EXAMPLE FROM PUERTO
RICO.
AND THIS CAN HAVE EXPERIENCES
WITH STRUCTURAL RACISM AND CAN
IMPACT HEALTH OUTCOMES.
IN TERMS OF GRANTS, NIH, GRANT
REVIEWS, THERE'S A LOT OF
IMPLICIT AND EXPLICIT BIASES
THAT GOES INTO THE PEER REVIEW,
A LOT OF BARRIERS PLACED, AND
THE FOCUS NEEDS TO BE PLACED ON
NOT THE REPUTATION BUT THE
SCIENCE, AND THERE NEEDS TO BE
LESS POLICIES THAT PERPETUATE
THESE DISPARITIES TO FAVOR
CERTAIN TYPES OF APPLICANTS OVER
OTHERS.
SO, THIS REALLY NEEDS TO FOCUS
AGAIN ON INNOVATION, CREATIVITY,
AS OPPOSED TO THE MANY TYPES OF
FACTORS SUCH AS CANDIDATE TITLE
OR THE INSTITUTIONAL NAMES OR
MENTOR NAME OR MENTOR
REPUTATION.
THIS IS THE CAREER AWARD.
THERE NEEDS TO BE EFFORTS TO
DIVERSITY THE SCIENTIFIC
WORKFORCE THAT ARE TRULY
INTERESTED AND ARE DOING THIS
WORK, AT MANY TIMES WITHOUT
FUNDING, AND THERE NEEDS TO BE
WAYS THAT RESEARCHERS AND
SCHOLARS CAN BE INVOLVED AND
FUNDED, INCLUDING OUR NEXT
GENERATION OF RESEARCHERS, IT'S
UNDERGRADUATES, BRINGING THEM
EARLY ON IN THE PIPELINE TO
EDUCATE THEM ABOUT THESE
DIFFERENT AND COMPLEX TOPICS.
ARE CONCERNS ARE THERE'S ALSO,
BECAUSE OF OUR CHANGING
POLITICAL CLIMATE, THAT WE NEED
TO BE MINDFUL ABOUT IMPLICATIONS
THAT THIS CAN HAVE ON THE
SCHOLARS WHO ARE DOING THIS
WORK.
AND HOW WE PROTECT THEM AND IN
CERTAIN STATES AND INSTITUTIONS
DEPENDING WHERE YOU WORK THIS
TYPE OF TOPIC IS NOT TO BE
DISCUSSED IN EDUCATION
CURRICULUM.
AND SO IN TERMS OF TEACHING AND
RESEARCH, HOW DO WE MAKE THIS A
MORE SAFE CLIMATE FOR ALL DOING
THIS KIND OF WORK.
THANK YOU.
>> THANK YOU.
THAT WAS A WONDERFUL REVIEW.
SO, NOW WE ARE ON ROOM 2, WHICH
ALSO WAS ON THE SIMILAR TOPIC, I
BELIEVE, METHODS AND
METHODOLOGY, SIMILAR QUESTIONS
WERE DISCUSSED.
WHO IS GOING TO BE DOING THE
REPORT-OUT FOR ROOM 2?
IS THERE -- NOT EVERYONE WILL
HAVE A SLIDE I UNDERSTAND.
>> YEAH, I WILL BE THE REPORTER
FOR ROOM 2.
I DON'T THINK WE HAVE A SLIDE.
DO WE HAVE A SLIDE?
>> LOOKS LIKE YOU MAY.
THERE'S SOMETHING BEING SHARED.
HOWEVER YOU WANT TO DO IT.
WE LOOK FORWARD TO HEARING FROM
YOU.
FIVE MINUTES OR SO.
>> WE HAD A LOT OF GREAT
DISCUSSIONS BUT FOCUSED ON FOUR
THINGS HERE.
AT THE BEGINNING WE WANT TO
THANK THE ORGANIZERS TO HAVE
THIS KIND OF DISCUSSION.
WE FELT IT'S A VERY LONG-NEEDED
DISCUSSION, EVEN BY HAVING THIS
WORKSHOP TO GET PEOPLE TOGETHER
THAT'S A GREAT SUCCESS.
SO WE CAN COME TOGETHER TO LEARN
AND ALSO TO DISCUSS.
SO WE FOCUSED ON THE BARRIERS
FOR THE MEASUREMENT AND RESEARCH
ON THE STRUCTURAL RACISM,
THINKING ABOUT WHAT SOLUTIONS,
INTERESTINGLY, THE FIRST THING,
SIMILAR FOR THE GROUP 1, WE
DISCUSSED A LOT OF THE SYSTEMS,
OUR SYSTEMS AS A BARRIER
THEMSELVES.
FOR EXAMPLE, FUNDING SYSTEM
FOCUSES MORE ON THE QUANTITY OF
RESEARCH, MORE ON THE PAST
EXPERIENCE, AND SO THAT COULD --
ALSO ACADEMIC BARRIERS, CERTAIN
INFORMATION WAS NOT INCLUDED
INTO THE CURRICULUM, AND SO, FOR
EXAMPLE, THE RESEARCHERS HAVE
CERTAIN TRAINED TO DO CERTAIN
TYPE OF RESEARCH, SO THOSE ARE
SOME BARRIERS PER PETTING
STRUCTURAL RACISM.
ONE IMPORTANT STEP FOR US IS
REALLY CONVINCE STAKEHOLDERS TO
DISCUSS THOSE ISSUES, HOW WE CAN
CHANGE OUR SYSTEM AND THINK OUT
OF THE BOX.
SO WE CAN SUPPORT THE RESEARCH
ON THE STRUCTURAL RACISM.
AND THE SECOND THING WE TALK
ABOUT IS TO SUPPORT
MULTI-DISCIPLINARY RESEARCH.
TRADITIONALLY WE TALK ABOUT
HEALTH-RELATED RESEARCH, WE TALK
ABOUT MEDICAL DOCTORS, PUBLIC
HEALTH, DISCIPLINES.
WE NEED MORE, OTHER DISCIPLINES,
FOR EXAMPLE SOCIOLOGISTS,
HISTORIANS, ANTHROPOLOGY IS,
PHILOSOPHERS, COMMUNITY MEMBERS
WITH LIVED EXPERIENCE.
IT'S HARD TO HAVE A REAL
INTERDISCIPLINARY TEAM BECAUSE
THEY MAY NOT SPEAK THE SAME
LANGUAGE.
MAY TAKE LONGER TIME FOR THE
INTERDISCIPLINARY TEAM TO GET
OFF THE GROUND FOR THE PROJECT
GOING, SO THAT SOMETIMES MAY NOT
ALIGN WITH THE FUNDERS'
TIMELINE.
SO THE SECOND AREA WE DISCUSSED
A LOT IS SUPPORTING MIXED
METHODS, TO SUPPORT THE
QUALITATIVE RESEARCH, WE TALK
ABOUT QUANTITATIVE RESEARCH IS
REALLY IMPORTANT FOR THE
STRUCTURAL RACISM RESEARCH, AND
EXPLORE WAYS FUNDERS LIKE NIH
COULD FUND.
CURRENTLY MAY NOT CALL OUT
EXPLICITLY FOR QUANTITATIVE
RESEARCH, USUALLY EMBEDDED INTO
THE METHODOLOGY, INTO THE MIXED
METHODOLOGY, SO WE ENCOURAGED BY
OUR LEADERS OF THE BREAKOUT
SESSIONS TO TALK WITH PROJECT
OFFICERS TO EXPLAIN MORE
IMPORTANCE OF THE RESEARCH,
WHETHER THERE ARE WAYS TO FUND
IT.
AND THE LAST ONE WE WANT TO TALK
ABOUT IS TO ENCOURAGE STRUCTURAL
RACISM IN GRADUATE AND
UNDERGRADUATE LEVEL COURSE,
SYSTEM BARRIERS, THE FIRST ONE,
IDENTICAL BARRIERS, SINGLE OUT
BECAUSE WE THINK THIS IS REALLY
IMPORTANT TO INCORPORATE THOSE
TRAINING INTO THE EDUCATION SO
WE CAN BUILD THE NEXT GENERATION
OF RESEARCHERS WHO REALLY
UNDERSTAND THE STRUCTURAL
RACISM.
AND LET ME KNOW IF YOU NEED TO
ADD ANYTHING.
>> I THOUGHT THAT WAS A GREAT
SUMMARY.
>> EXCELLENT.
THANK YOU.
>> THANK YOU SO MUCH.
SO WE'RE MOVING TO ROOM 3, AND
IF I'M NOT MISTAKEN IT'S THE
SAME TOPIC, METHODS AND
METHODOLOGY.
OKAY.
WHOEVER IS REPORTING OUT PLEASE
FEEL FREE TO GO AHEAD.
THANK YOU.
>> THANKS, TIFFANY.
ON BEHALF OF ROOM 3, I'M GOING
TO TRY AND PROVIDE A BRIEF
SUMMARY OF THE MAIN POINTS THAT
WERE BROUGHT UP.
SO, WE SPENT QUITE A BIT OF TIME
DISCUSSING SOME OF THE BARRIERS
TO MAKING PROGRESS IN THIS
CONTEXT.
AND ONE OF WHICH WAS THE LACK OF
COMMON DEFINITIONS, SO THIS IS
CREATING SOME HURDLES, ARRIVING
AT COMMON METRICS,
UNDERSTANDING, AND ALSO
CONVEYING INFORMATION TO BROADER
COMMUNITIES.
THERE WERE MULTIPLE
RECOMMENDATIONS THAT CAME UP
OVER THE COURSE OF THE
CONVERSATION, SOME OF WHICH
RELATES BACK TO PREVIOUS POINTS
BROUGHT UP AS WELL.
I THINK ONE OF THE ASPECTS KEPT
COMING UP REPEATEDLY WAS THE
NEED FOR A CENTRAL REPOSITORY
FOR METHODS, FOR METRICS, ALONG
WITH GUIDANCE ON USAGE, BEST
PRACTICES, ALLOWING PEOPLE FROM
BROADER RESEARCH COMMUNITY TO
BENEFIT FROM THE KNOWLEDGE OF
EXPERTS IN THE FIELD.
WHICH WOULD ALLOW FOR BROADER
ADOPTION OF THE METHODS AS WELL.
ALONG THOSE LINES THERE WAS
DISCUSSION ABOUT NEED FOR MORE
NUANCED APPROACH IN
CONSIDERATION OF METRICS
THEMSELVES, ALSO A POINT RAISED
ABOUT THE NEED FOR CLEAR
DOCUMENTATION, TRANSPARENCY, TO
ENSURE THAT THESE METRICS ARE,
AGAIN, BEING USED BROADLY, AND
THEIR VALUE IS MADE CLEAR AS
WELL.
THE OTHER POINT THAT CAME UP
REPEATEDLY, AND THE PREVIOUS
ROOM DESCRIBED IT AS WELL, WAS
THE NEED FOR SUPPORTING
QUALITATIVE RESEARCH AND
METHODOLOGIES IN SUPPORT OF
THAT.
THE LAST ASPECT BROUGHT UP HERE
WAS THE NEED FOR DEVELOPING
NATIONAL AND BROADER USE METRICS
AND MEASURES, TRYING TO PUT
THESE METRICS IN A BROADER
CONTEXT THAT WOULD SPEAK TO
COMMUNITIES IN GENERAL.
AND I THINK THAT TOUCHES UPON
ALL OF THE MAIN POINTS, BUT
OTHERS FROM ROOM 3 FEEL FREE TO
JUMP IN IF I LEFT OUT SOMETHING
IMPORTANT.
>> NO, THERE WAS A CLEAR
RECOMMENDATION MEASURES HAVE
BEEN DEVELOPED, ONE OF THE
ACCOMPLISHMENTS THAT ARE BEING
USED.
BUT OTHER THAN THAT I HAVE
NOTHING TO ADD.
>> THANKS, VENCE.
THANK YOU TO THE GROUP FOR A
VERY ENLIGHTENING DISCUSSION.
>> THANK YOU.
ROOM 4, I THINK WE'RE SWITCHING
TOPICS NOW.
THIS IS CONSEQUENCES OF
STRUCTURAL RACISM ON HEALTH.
>> YES, THANKS, ACTIVE TIFFANY.
ON BEHALF OF ROOM 4 WE HAD A
WONDERFUL CONVERSATION AROUND
STRUCTURAL HEALTH.
ONE KEY AREA THAT CAME UP WAS
THAT EVEN WITH ALL THE
DISCUSSION THAT WAS HAD OVER THE
PAST FEW DAYS, THE QUESTION
REMAINS HOW DO YOU MOTIVATE
THOSE WHO NEED TO HEAR THIS
INFORMATION THE MOST, PROBABLY
THOSE IN POWER AT INSTITUTIONS
OR ORGANIZATION AND AGENCIES WHO
CAN MAKE THESE CHANGES.
HOW DO YOU MOTIVATE THEM TO TAKE
WHAT INFORMATION HAS BEEN SHARED
AND TO TAKE THE NEW METHODS, THE
NEW DATA AND USE IT TO IMPLEMENT
CHANGES, ESPECIALLY IF THERE'S A
SENSE THAT PEOPLE IN POWER MAY
NOT WANT TO MAKE THESE CHANGES.
SO THERE WAS GREAT DISCUSSION
AROUND WHAT THAT COULD LOOK LIKE
OR A DIFFERENT QUESTION WE ASKED
THE BROADER GROUP TO THINK ABOUT
AS WE CONTINUE TO MOVE FORWARD.
THERE WAS A LOT OF DISCUSSION
AROUND THE NEED TO MAKE SURE
THAT WE'RE ASKING THE RIGHT
QUESTIONS TO GET THE RIGHT
ANSWERS, AND TO COLLECT THE
RIGHT DATA.
MORE ALONG THE CONCEPT OF, YOU
KNOW, SHIFTING AWAY FROM RACE
BUT TOWARDS RACISM WAS A TURNING
POINT, SO A LOT OF DISCUSSION
AROUND THE FACT A LOT OF
RESEARCH IN HEALTH DISPARITIES
USED RACE AS A DRIVER, RACE AS A
PRIMARY INDICATOR OF HEALTH
DISPARITIES, BUT BECAUSE OF THE
WORK OF DR. JONES AND OTHERS IN
THE SPACE TELLING US IT'S RACISM
AND NOT RACE, WE SEE THAT SHIFT.
SO THAT MAKES US THINK ABOUT
WHAT WE NEED TO DO IN TERMS OF
HOW WE'RE ADDRESSING THE
RESEARCH.
IS THE RESEARCH AROUND
STRUCTURAL RACISM AND THE
QUESTIONS THAT WE'RE ACTUALLY
ASKING REALLY GETTING US TO THE
RIGHT ANSWERS?
THERE WAS A DISCUSSION AROUND
SENSITIVE TOPICS.
YOU KNOW, WHEN WE THINK ABOUT
CONSEQUENCES OF STRUCTURAL
RACISM, IN TERMS OF HEALTH, WHEN
WE HAVE THESE DISCUSSIONS, WHEN
WE HAVE THESE WORKSHOPS, WHEN WE
READ THE LITERATURE, IS IT A
POSSIBILITY THAT THE FIELD
ITSELF AND THE WORK THAT'S BEING
DONE MAY BE SEGREGATED AND NEEDS
TO BE MORE INCLUSIVE, ARE WE
OFTEN COMPARING AND MAYBE
PITTING BLACK AND BROWN
POPULATIONS AGAINST ONE ANOTHER.
YOU KNOW, THAT GETS BACK TO THAT
THOUGHT THAT THE CONCEPT WE
HEARD EARLIER AROUND MODEL
MINORITY, AND HOW DO WE MAKE
SURE NOT A BARRIER AS WE MOVE
FORWARD TO BE MORE INCLUSIVE IN
THIS SPACE.
WHEN WE THINK ABOUT THE
PLATFORM, ONE BARRIER WAS THE
DIGITAL DIVIDE, UNEQUAL ACCESS
BEING ABLE TO HAVE DATA ON
HISTORICAL RACISM, AND
STRUCTURAL RACISM RACISM, BUT
THEN WHAT DOES THAT LOOK LIKE IN
THE RESEARCH, IN THE HEALTH
SPACE, IN TERMS OF A SOLUTION?
SO THINKING FORWARD, WE WOULD
KNOW THAT THERE WAS SOME SUCCESS
BEING MADE WHEN YOU DON'T HAVE
TO STILL SEE INEQUITIES WITH
REGARD TO TELEMEDICINE, HEALTH,
INTERNET ACCESS, THAT COULD BE
ALSO DRIVING DISPARITIES, ALSO
DRIVING DISPARITIES IN THE DATA
THAT'S BEING COLLECTED AND USED
TO ANSWER THESE QUESTIONS, IF A
LOT OF THE REAL HISTORICAL
RECORDS ARE SITTING SOMEWHERE IN
A CLOSET AND HAVE NOT BEEN
DIGITIZED AND THEREFORE NOT
HELPING US HAVE AN ACCURATE
PICTURE OF HOW STRUCTURAL RACISM
IS IMPACTING HEALTH.
WHEN THE GROUP GOT TO THE
BRAINSTORMING PART ABOUT, AGAIN,
WHAT WOULD THIS LOOK LIKE IN
TERMS OF SUCCESS, IF WE ACHIEVE
SUCCESS IN THIS SPACE, ONE POINT
THAT RESONATED WITH EVERYONE IT
SEEMED WE WILL KNOW WE'VE
REACHED SUCCESS IN THIS SPACE
WHEN WE HAVE MULTIPLE FORMS OF
EVIDENCE BEING CONSIDERED VALID
AND RIGOROUS, A LOT OF
TRADITIONAL RESEARCH IS LIMITED
IN TERMS OF WHAT'S CONSIDERED TO
BE --
[CROSSTALK]
SO WE'RE KNOWING IF WE START
SEEING MORE STORIES, QUALITATIVE
DATA, INDIGENOUS KNOWLEDGE,
COMMUNITY KNOWLEDGE, BEING VALID
AND RIGOROUS WE'LL FEEL WE MADE
SUCCESS IN THIS SPACE.
THE CONVERSATION SHIFTED TO, YOU
KNOW, NIH MENTIONED COMPASS,
THEY LEARNED ABOUT WHAT COMMON
FUND IS DOING.
AND SO THEY WANTED TO KNOW IF
THIS HAS BEEN REPLICATED.
ONCE THESE MODELS HAVE BEEN
TAKEN UP ACROSS MANY FUNDING
AGENCIES, FUNDING PROGRAMS,
REPLICATED, THIS WILL BE A SIGN
OF SUCCESS, SO THE CONVERSATION
WAS ABLE TO MOVE TO HIGHLIGHTING
MANY OTHER PROGRAMS ACROSS NIH
USING COMMUNITY PROGRAMS,
COMMUNITY CENTERED INITIATIVES
AND INTERVENTIONS TO ADDRESS
THIS.
THEN THE LAST PIECE THAT WE
DISCUSSED IN OUR GROUP WAS
REALLY MAKING SURE THAT IF WE
LOOK BACK DECADES AGO WE
WOULDN'T BE HAVING THIS WORKSHOP
THAT TALKED ABOUT STRUCTURAL
RACISM, AND THAT'S A SUCCESS.
MOVING FORWARD WHAT WE WANT TO
SEE TO KNOW WE'RE STILL MAKING
SUCCESS IN THIS SPACE IS TAKING
ADVANTAGE OF TECHNOLOGICAL
ADVANCES, SPECIFICALLY MAKING
SURE WE'RE USING A.I. AND OTHER
ADVANCES TO RESEARCH STRUCTURAL
RACISM AND HEALTH INEQUITY AND
TO CALL OUT THE BIASES THAT
MIGHT BE EVEN EXISTING IN THE
HEALTHCARE SPACE, IN THE
TREATMENT SPACE, IN TERMS OF HOW
PEOPLE ARE RECEIVING THEIR
TREATMENTS.
SO WE HAD A GREAT DISCUSSION AND
I WELCOME KATHY OR OTHERS FROM
THAT GROUP TO LET ME KNOW IF I
MISSED ANY KEY POINTS.
THANK YOU.
>> THANK YOU.
THAT WAS GREAT.
SO I BELIEVE THAT WAS ROOM 4.
MOVING TO ROOM 5, SIMILAR TOPIC
OF CONSEQUENCES OF STRUCTURAL
RACISM ON HEALTH.
I BELIEVE IT'S BEVERLY BUT I'M
NOT SURE.
EVA.
THANK YOU.
>> IS MY AUDIT GO -- AUDIO GOO?
>> WE CAN HEAR YOU.
>> EXCELLENT.
WE HAD A GREAT DISCUSSION.
I WANTED TO PREFACE, I'M ONE OF
THE WHITE PEOPLE WHO IS DOING
THE SPEAKING BUT THESE ARE
POINTS MADE BY A VERY DIVERSE
GROUP AND VERY ACTIVE
CONVERSATION FROM ALL THE
PARTICIPANTS.
SO KEY FINDINGS AND THINGS WE
IDENTIFIED A LACK OF TRUST
BETWEEN UNDERREPRESENTED
COMMUNITIES AND MEDICAL RESEARCH
FIELDS, CREATING OPPORTUNITIES
FOR COLLABORATIVE PARTNERSHIPS
TO BRIDGE GAPS IN TRUST AND
TRANSPARENCY.
SO MAKING CORRECTIONS TO THAT
LACK OF TRUST.
I WON'T READ ALL THE POINTS
BECAUSE I THINK WE WOULD RUN OUT
OF TIME.
BUT ALSO THE LONG-TERM ASPECTS
OF SOCIAL SUFFERING, SOCIAL
TRAUMA, MAKE THOSE PRIORITIES TO
ADDRESS SO WE CAN HAVE
SUSTAINABLE SOLUTIONS FOR THOSE.
AND THEN GENERAL NEED TO
APPROACH REPRESENTATIVES WITH
AUTHENTICITY AND OPENNESS TO
PRIORITIZE BOTTOM-UP LEARNING
OVER TOP-DOWN ASSUMPTION OF WHAT
ISSUES FACING A COMMUNITY MIGHT
BE.
AND THEN BARRIERS TOWARDS MAKING
PROGRESS, THERE ARE A LOT OF
THEM.
I'LL HIT THE HIGHLIGHTED BULLET
POINTS.
SO ADDRESSING NEEDS OF
UNDERREPRESENTED DEMOGRAPHICS IN
RURAL COMMUNITIES FACING
TRANSPORTATION BARRIERS TO
PARTICIPATION IN RESEARCH.
WE WERE TALKING THERE ABOUT SOME
CLINICAL TRIALS AND GETTING
OTHER PEOPLE TO PARTICIPATE,
HELPING TO OVERCOME BARRIERS TO
ALLOW THAT TO HAPPEN.
HAVING CLEAR AND TRANSPARENT
COMMUNICATION, AND INVESTMENT
FROM POLICYMAKERS TOWARDS
ADDRESSING HEALTH DISPARITIES,
LIKE PROGRESS REQUIRES
ACKNOWLEDGING THE REALITY OF
STRUCTURAL RACISM IN THE UNITED
STATES.
INTERNATIONAL PERPETUATION OF
REDUCTIONIST APPROACHES TO
ADDRESSING PUBLIC HEALTH, SO THE
POINT WAS MADE THAT WE'RE HERE
IN THE UNITED STATES FOR THE
MOST PART TALKING ABOUT THIS BUT
THERE WERE PEOPLE IN THE GROUP
NOT FROM THERE, AND IT'S NOT
JUST THE UNITED STATES' PROBLEM.
ALSO LACK OF FUNDING FOR HEALTH
CARE SERVICES, VARIOUS
DEMOGRAPHICS ACROSS THE U.S.
LIKE, FOR EXAMPLE, IN PARTICULAR
INDIGENOUS GROUPS AND VERY RURAL
COMMUNITIES.
LACK OF OF AWARENESS AND
SUFFICIENT OUTREACH TO CONNECT
COMMUNITIES WITH HEALTH
RESOURCES ALREADY AVAILABLE.
MAYBE THERE ARE PROGRAMS THAT
COULD HELP PEOPLE, JUST THEY ARE
NOT AWARE.
THE MESSAGE HASN'T GOTTEN TO
THEM.
ALSO BREAKING DOWN RESEARCH
SILOS, AND PERSISTENT BEARERS TO
ADDRESSING HEALTH DISPARITIES IN
RESEARCH STEM FROM, ONE, LACK OF
EQUITABLE COMPENSATION.
TWO, LACK OF ACKNOWLEDGMENT AND
LANGUAGE ON STRUCTURAL RACISM,
AND THREE, A LACK OF
COMPREHENSIVE OUTREACH.
RECOMMENDATIONS FOR MAKING
PROGRESS IN THESE AREAS, TO
APPLY SIGNIFICANT FUNDING
TOWARDS COMMUNITY ENGAGEMENT AND
COMMUNITY PARTNERSHIPS.
AND THERE WAS A LOT OF TALK
ABOUT MAKING THOSE ACTUALLY
PARTNERSHIPS AND NOT JUST AN
INSTITUTE DICTATING SOMETHING IN
PARTICULAR.
AND DEVELOPING PROGRAMS THAT
INVITE COMMUNITY MEMBERS TO
ACTIVELY COLLABORATE TOWARDS
COMMUNITY SOLUTIONS SO GETTING
BUY-IN FROM A WHOLE LOT OF
DIFFERENT PEOPLE, DIFFERENT
BACKGROUNDS.
INCREASING DIVERSITY OF RESEARCH
BODIES AND NOT JUST RESEARCH
PARTICIPANTS.
COURSE CORRECTING, ONGOING
MONITORING OF HEALTH
INTERVENTIONS TO EVALUATE
PERFORMANCE LIKE YOU MIGHT GO
OUT AND ASK PEOPLE FOR THEIR
OPINIONS AND WHAT CAN WE DO TO
REACH YOU, WHAT DO YOU NEED FROM
US.
BUT THEN GO BACK THEN THE NEXT
YEAR, FIVE YEARS LATER, AND DID
IT MAKE A DIFFERENCE?
AND IF SO, HOW DO WE ADJUST IT
ACCORDINGLY.
ADDRESSING UNDERLYING OPPRESSIVE
SYSTEMS THAT RESEARCH SYSTEMS
FREQUENTLY ADHERE TO.
FOR EXAMPLE, TAILORING RESEARCH
PROTOCOLS FOR NEEDS AND
LIMITATIONS OF A PARTICULAR
ENVIRONMENT.
AND ENSURING ALSO ADEQUATE
COMPENSATION FOR INVOLVEMENT IN
RESEARCH.
PEOPLE ARE ASKED TO DO THINGS
FOR FREE.
AND INTEGRATING AUXILIARY BODIES
AS A TOOL FOR PATIENTS TO
NAVIGATE COMPLEX HEALTHCARE
SYSTEMS WITH ACCESSIBLE
LAYPERSON FRIENDLY LANGUAGE.
A LOT OF TIMES PATIENTS AREN'T
AWARE OR DON'T UNDERSTAND WHAT
THEY HAVE BEEN DIAGNOSED WITH
AND DON'T HAVE THE BEST OUTCOMES
THEY COULD, IF THAT INFORMATION
WERE PRESENTED IN A WAY THAT MET
THEM WHERE THEY ARE AND THEIR
UNDERSTANDING OF BIOLOGY.
WAS THAT THE LAST QUESTION?
YEAH.
ONE OF THE PARTICIPANTS WANTED
TO MAKE THE POINT ABOUT HAVING
ACTIONABLE PATHWAYS AND POLICIES
PARTICULARLY AROUND EDUCATION
AND DIVERSE RESEARCHERS.
ONE PERSON MENTIONED ONLY I
THINK 1% OF RESEARCHERS WERE
NATIVE PERSONS.
I THINK THAT WAS THE CORRECT
STATISTIC.
AND ALSO MULTI-DISCIPLINARY
APPROACH TO ADDRESSING
STRUCTURAL RACISM AND PUBLIC
HEALTH, INCORPORATING SOCIAL
SCIENCE, PUBLIC POLICY
PERSPECTIVES, SO I THINK ONE OF
THE POINTS ASSOCIATED WITH THIS
IS THAT SOCIAL WORKERS HAVEN'T
REALLY BEEN INVOLVED IN SOME OF
THESE THING, NOT IN A WAY THAT
MEDICAL PEOPLE HAVE, FOR
EXAMPLE.
I THINK THAT MIGHT BE THE END.
>> GREAT.
WELL, THANK YOU SO MUCH.
THAT WAS GREAT.
WE'RE HEARING SOME UNIQUE PIECES
FROM EVERY ROOM, ALSO THEMES
EMERGING, SO THAT'S GREAT.
NEXT ROOM IS ROOM 6.
SWITCHING TOPICS TO PRODUCTIVE
PARTNERSHIPS.
WHO IS DOING THE REPORT-OUT FOR
THAT ONE?
>> ME.
>> GREAT.
>> I DON'T TRUST MY BANDWIDTH,
I'M AWAY NOW.
>> WE HAD A ROBUST CONVERSATION
AROUND A NUMBER OF DIFFERENT
ISSUES THAT ARE THE UNDERBELLY.
AND SO JUST A FEW HIGHLIGHTS, WE
TALKED ABOUT CREDENTIALING AND
HOW CREDENTIALING CAN BE USED AS
A BARRIER FOR THOSE PEOPLE WHO
ARE PROVIDING GREAT RESOURCES
INTO OUR RESEARCH AND PUBLISH
CASES BUT AREN'T OFFERED THE PAY
OR TITLE OR POSITIONS ASSOCIATED
WITH WHAT THEY ARE OFFERING.
AND SO CREATING PATHWAYS TO
FULLY IDENTIFY PEOPLE WHO HAVE
THOSE TALENTS, TO BECOME -- TO
GET DOCTORATE, MASTER'S,
DOCTORATE, ET CETERA, TO BE A
FACULTY SO THEY CAN BE P.I.s
LEADING THIS WORK.
AND REALLY ASSESSING, ASKING
THOSE QUESTIONS LIKE WHY ARE WE
CREATING THESE BARRIERS.
WE TALKED A BIT -- THIS IS
SUMMARIZED, IF I CAN REMEMBER,
SO WE TALKED A BIT ABOUT LOOKING
AT EFFORTS THAT ARE REALLY
LOOKING AT -- IS THIS OUR GROUP?
>> NO.
IT'S GROUP 6.
THEY MUTED ME AND PUT YOU ON.
>> WE'RE GROUP 9, BEVERLY.
>> OH, OKAY.
SORRY ABOUT THAT.
>> OKAY.
SO LET'S REFOCUS, WHO IS DOING
THE REPORT-OUT FOR GROUP 6?
THAT IS --
>> IT'S QUINCY.
THIS IS JUANITA, CO-MODERATOR.
QUINCY IS GIVING IT, HE CAN'T
TURN HIS VIDEO ON.
>> I DID HEAR YOUR VOICE.
ARE YOU ABLE TO SPEAK?
>> YES.
>> OKAY.
>> WE WERE GROUP 6.
I'M DOING THE REPORT-OUT.
ON CREDENTIALING WE TALKED ABOUT
LESS RELIANCE ON LETTERS BEFORE
AND AFTER YOUR NAME, AN
INDIVIDUAL DOING THIS WORK FOR
DECADES SHOULDN'T HAVE TO HIRE
ON OR SUBCONTRACT SOMEONE WITH A
Ph.D. JUST IN ORDER TO GET A
CONTRACT SO RECOGNIZING EXPERTS
OF COMMUNITY, CITIZEN
SCIENTISTS, WORK EXPERIENCE,
WORK AS EXPERTS TO HAVE A SEAT
AT THE TABLE.
WE ALSO HAVE TO RECOGNIZE THE
EMBEDDED STRUCTURAL RACISM IN
TESTING, AND CREDENTIALING TO
KNOW THE INDIVIDUAL MAY BE
COMPETENT BUT UNABLE TO PASS
SOME EXAMS TO GET ANOTHER
CREDENTIAL.
WE DISCUSSED CROSS-SECTOR
ENGAGEMENT, NOT JUST
INTERPROFESSIONAL COLLABORATION
BETWEEN DIFFERENT DISCIPLINES
BUT ALSO DIFFERENT INDUSTRIES
BEING AT THE TABLE, BEING ABLE
TO HAVE A SEAT AT THE TABLE, AND
HAVE SHARED DECISION-MAKING
AUTHORITY.
AND WE MOVED TO SUSTAINABILITY
OF EFFORTS AND RESOURCES,
UNDERSTANDING THE NEED TO TRAIN
JUNIOR P.I.s, JUNIOR
INVESTIGATORS, TO INCREASE THE
WORK PIPELINE.
FUNDING FOR PILOT TESTING, FOR
FEASIBILITY TESTING AND
UNDERSTANDING THAT RELATIONSHIPS
AND TIME TO ESTABLISH AND
MAINTAIN RELATIONSHIPS TAKE MORE
TIME THAN PEOPLE REALIZE.
HOW CAN INDIVIDUALS FIND RIGHT
INFORMATION ON FUNDING
OPPORTUNITIES, REALIZING
SOMETIMES THAT DIGITAL DIVIDE IS
ALSO THE INFORMATION DIVIDE AND
SOMETIMES INDIVIDUALS WHO ARE
QUALIFIED TO APPLY FOR CERTAIN
THINGS JUST DON'T KNOW WHERE
THEY ARE LOCATED.
IMPLEMENTING MORE
INTERDISCIPLINARY ACADEMIC
PARTNERSHIPS, PEOPLE WORKING IN
SILOS, BE BUT IN THE REAL WORLD
DISCIPLINES MUST ENGAGE TO
ADDRESS RACISM.
>> THANK YOU.
SO THAT WAS ROOM 6.
WE APPRECIATE THE REPORT-OUT.
I THINK WE'RE MOVING ON TO OUR
FINAL THREE ROOMS, THEY HAVE THE
SAME TOPIC OF INTERVENTION
RESEARCH.
SO, WHO IS REPORTING OUT FOR
ROOM 7?
>> I AM.
LANGSTON THOMAS HERE , CAN YOU
HEAR ME OKAY?
G OOD, LANGSTON, Ph.D. STUDENT
AT GEORGIA STATE UNIVERSITY,
INTERVENTIONS THAT ADDRESS ROOTS
OF POVERTY AND IMPROVES OUTCOMES
FOR VULNERABLE GROUPS.
OUR GROUP HAD A WONDERFUL
DISCUSSION, I'LL SHARE MAJOR
POINTS.
FIRST QUESTION WHERE WE ARE AND
WHAT ADVANCEMENTS WE'VE SEEN,
DESPITE A LOT OF RESEARCH DONE
ON STRUCTURAL RACISM AND PUBLIC
HEALTH, WE MENTIONED THAT WE
HAVEN'T REALLY SEEN A TON OF
INTERVENTIONS THAT ARE
ADEQUATELY ADDRESSING STRUCTURAL
RACISM, PARTICULARLY ON A MICRO
LEVEL, ON A MACRO LEVEL, EXCUSE
ME, AND CONTINUOUS OR
SUSTAINABLE WAY.
HOWEVER, WE DID DISCUSS TWO
EXAMPLES OF INTERVENTIONS THAT
ARE DOING INTERESTING WORK ON
THE MICRO LEVEL, ONE OF WHICH IS
AN INTERVENTION AT THE COMMUNITY
LEVEL, WITH CHURCHES AND LOCAL
TENANTS THAT AIMS AT IMPROVING
HEALTH THROUGH PROGRAMMING
AROUND SLEEP AND BRAIN HEALTH,
AS WELL AS DIFFERENT EXERCISE
OPTIONS TO IMPROVE HEALTH.
THERE WAS ANOTHER INTERVENTION
WE DISCUSSED, I BELIEVE AT
STANFORD UNIVERSITY, WHERE
RESEARCHERS ARE DEVELOPING THIS
INTERVENTION THAT LEVERAGES
ELECTRONIC HEALTH RECORDS TO
CAPTURE THE SOCIAL DETERMINANTS
OF HEALTH FOR A PARTICULAR
PATIENT SO THE MEDICAL TEAM CAN
HAVE A UNIQUE UNDERSTANDING OF
THAT PERSON'S PREDICAMENT.
AND IN THIS PROJECT STILL
WORKING ON MAKING SURE THAT THE
PROJECT IS COMMUNITY BASED,
INVOLVES STAKEHOLDERS FROM
DIFFERENT DISCIPLINES, AND USES
THE DATA THAT IT COLLECTS TO
PROVIDE SOLUTION ALSO THAT
CENTER COMMUNITY HEALTH RATHER
THAN JUST INDIVIDUAL HEALTH.
IN ADDITION TO DISCUSSING THOSE
TWO INTERVENTIONS WE HIGHLIGHTED
SOME OTHER IMPORTANT ITEMS, SUCH
AS DATA-INFORMED CHANGES,
QUALITATIVE AND QUANTITATIVE,
THE NEED FOR HOLISTIC AND
LONG-TERM INTERVENTIONS, AS WELL
AS USING AN INTERDISCIPLINARY
ANALYSIS AT DIFFERENT ELEMENTS,
DIFFERENT STAGES OF THE RESEARCH
AND EXECUTION PROCESS.
ON THE SECOND QUESTION, ON
REMAINING BARRIERS, TO EFFECTIVE
INTERVENTIONS ONE THING WE
DISCUSSED WAS COMPLEXITY OF
STRUCTURAL RACISM, ALL THE
DIFFERENT WAYS THAT IT CAN
MANIFEST AND DIFFERENT ACTORS
INVOLVED IN PERPETUATION OF
STRUCTURAL RACISM.
WE ALSO TALKED ABOUT THE NEED
FOR GOOD DATA, AND HOW DATA
ISN'T ALWAYS CONSISTENTLY
COLLECTED, IT'S NOT ALWAYS
PRODUCING METRICS THAT ARE THE
APPROPRIATE INDICATORS, AND IT'S
NOT ALWAYS PRODUCING
STANDARDIZED METRICS THAT WE CAN
USE ACROSS COMMUNITIES.
WE ALSO DISCUSSED THE LACK OF
COMMUNITY ENGAGEMENT AT EVERY
STEP OF THE RESEARCH PROCESS,
AND EXECUTION PROCESS, AND HOW
THAT CAN HAVE IMPLICATIONS FOR
OVERSIGHT AND ACCOUNTABILITY TO
ENSURE THAT THE INTERVENTION IS
ACTUALLY SERVING WHO IT NEEDS TO
SERVE.
WE ALSO TALKED ABOUT THE LACK OF
CONSISTENT AND SUSTAINABLE
FUNDING TO PROVIDE FOLKS WHO ARE
WORKING ON SOLUTIONS,
PARTICULARLY PREVENTIVE
SOLUTIONS, AS OPPOSED TO
REACTIVE SOLUTIONS, TO PURSUE
THEIR WORK IN A WAY THAT ALLOWS
THEM TO FOCUS ON WORK WITHOUT
FINANCIAL CONCERNS BURDENING
THEM.
THERE'S ALSO, YOU KNOW, AS WAS
MENTIONED, WAS I MENTIONED
BEFORE, LACK OF
INTERDISCIPLINARY TEAMS THAT
HAVE SHARED PRIORITIES, SHARED
COMMITMENTS TO IMPROVING
OUTCOMES FOR A PARTICULAR GROUP
AND SHARED POLITICAL WILL EVEN
BEYOND THE SCOPE OF RESEARCH.
THE FINAL QUESTION WE DISCUSSED,
RECOMMENDATIONS FOR PROGRESS.
AND TO FINISH QUICKLY, WE
DISCUSSED THE NEED FOR MORE
TRANSPARENCY, ABOUT THE GOOD
WORK THAT IS BEING DONE, AS WELL
AS DIFFERENT EFFORTS TO FOSTER
DYNAMIC COLLABORATION AMONG
THOSE WHO ARE DOING GOOD WORK IN
THE SPACE OF INTERVENTION.
WE ALSO DISCUSSED THE NEED TO
BUILD INTERDISCIPLINARY TEAMS
THAT ARE COMMUNITY CENTERED AND
ACTION ORIENTED.
ON THAT WE TALK ABOUT INCLUDING
ACTION MODEL IN OUR
INTERVENTION-BRACED RESEARCH.
YOU KNOW, MODELS THAT HAVE CLEAR
POLICY IMPLICATIONS, AND ACTIONS
FOR INDIVIDUALS, TEAMS,
COMMUNITY MEMBERS, OTHER
STAKEHOLDERS WHO ARE DIGESTING
THIS RESEARCH FOR THE SAKE OF,
AGAIN, IMPROVING OUTCOMES IN THE
REAL WORLD.
I INVITE ANYONE ELSE FROM THE
TEAM TO FILL ANY HOLES I LEFT,
BUT I APPRECIATE THE DISCUSSION
WE HAD AND I PLAN ON USING THAT
A LOT IN MY WORK, MY Ph.D.
WORK, AND MY COMMUNITY WORK AS
WELL.
>> THAT'S GREAT.
WONDERFUL REPORT-OUT.
AND RIGHT ON TIME, BY THE WAY.
RIGHT ON THE NOSE.
OKAY.
NEXT GROUP IS GROUP 8, THE GROUP
I WAS IN.
BROOKE I BELIEVE WILL BE DOING
THE REPORT-OUT.
>> MY NAME IS BROOKE MONTGOMERY,
ASSOCIATE PROFESSOR AT
UNIVERSITY OF ARKANSAS FOR
MEDICAL SCIENCES, HONORED TO BE
IN THE DESIGN INTERVENTIONS
GROUP THAT.
IS THE WORK THAT I DO.
FIRST QUESTION, THE NOTABLE
INTERVENTIONS AS THEY RELATED TO
STRUCTURAL RACISM, CERTAINLY
WANTING TO ACKNOWLEDGE THE WORK
THAT'S BEEN DONE IN BIOMARKERS,
EPIGENETICS, ALLOSTATIC LOAD,
AREA DEPRIVATION INDEX, MORE
HOLISTIC VIEWS OF STRUCTURAL
DISADVANTAGE.
THE IMPORTANCE OF TRAINING
PROGRAMS AS A TOOL FOR
ADDRESSING STRUCTURAL RACISM,
AND SO THE NCI IMPROVE STUDY WAS
HIGHLIGHTED.
WITHIN THAT THINKING ABOUT THE
NATURAL HISTORY STUDIES DONE
WHEN LEGISLATION OCCURS THAT
IMPACTS STRUCTURAL RACISM,
REDUCES BARRIERS TO FINANCES,
ECONOMIC WELL-BEING, SOCIAL
WELL-BEING, SO THINKING ABOUT
THE EARNED INCOME TAX CREDITS,
THOSE CHANGES RELATED TO HOUSING
AND EVICTIONS DURING COVID, AS
WELL AS THE GUARANTEED
SUPPLEMENTAL INCOME PROJECTS
BEING DONE ACROSS THE NATION
NOW.
ANOTHER INTERVENTION THAT WE
WANT TO HIGHLIGHT THAT WE'RE
REALLY MAKING ADVANCEMENTS FOR
THE MOBILE HEALTH UNITS TO
ADDRESS TRANSPORTATION BARRIERS
AND FOOD AND HEALTHCARE DESERTS,
AS WELL AS COMMUNITY-BASED
PARTICIPATORY RESEARCH, NOT JUST
BEING A METHOD IN AND OF ITSELF
IS AN INTERVENTION TO HELP
ADDRESS INEQUITY, THINKING ABOUT
THE USE OF COMMUNITY HEALTH
WORKERS AND JUST BUILDING OF
COMMUNITIES TO NOT ONLY
RECOGNIZE THE DEFICITS BUT ALSO
ALL THE AMAZING PROTECTIVE
FACTORS, INDIGENOUS KNOWLEDGE
AND INTERGENERATIONAL
SOLIDARITY, LASTLY TO THINK
ABOUT MULTI-PHASE OPTIMIZATION
STUDIES, COMMUNITY BUILDING
CAPACITY PROJECTS AS ONEs THAT
ARE ADDRESSING STRUCTURAL
RACISM.
SECOND QUESTION, THE BARRIERS
AND CHALLENGES TO DOING
INTERVENTION WORK WITHIN THAT
FOCUS ON STRUCTURAL RACISM,
CERTAINLY FUNDING AND
REIMBURSEMENT HAS BEEN DISCUSSED
BY A LOT OF SPEAKERS, JUST TO
HIGHLIGHT CERTAINLY COMPENSATING
OUR COMMUNITY PARTNERS AND
LEADERS, BUT ALSO THE FUNDING
RESTRAINTS AROUND DOING
SCIENTIFICALLY RIGOROUS WORK,
WHERE YOU CAN GET IT THROUGH THE
REVIEW COMMITTEES, AND ALL THAT.
A LOT OF TIMES FOCUSED ON
INTERPERSONAL DIFFERENCES BUT
WANTING TO GO TO MODIFIABLE
AERIAL UNITS WHERE IT'S BEYOND
ZIP CODES AND COMMUNITIES AND
COUNTIES, STILL BEING IN THAT
VERY LIMITED SPACE OF NIH
FUNDING AND AMOUNT THE CAP OF
$500,000 PER YEAR, THAT THAT IS
LIMITING TO GETTING THE BIG
CHANGE THAT WE ALL ARE TRYING O
ACHIEVE.
ANOTHER BARRIER IS LANGUAGE,
COMMUNITY PARTIERS USING
DIFFERENT LANGUAGE, EVEN IN
ACADEMIA WE'RE USING DIFFERENT
LANGUAGE, LACK OF AGREEMENT OF
THE DEFINITIONS OF STRUCTURAL
RACISM, AND HOW THAT AFFECTS
HEALTH.
IN PARTICULAR THE PEOPLE IN
POSITIONS OF POWER WITH RESPECT
TO ACTUALLY DISTRIBUTING THE
FUNDING MAY HAVE A DIFFERENT
CONCEPTUAL DEFINITION THAN THOSE
ACTUALLY APPLYING FOR THE
FUNDING.
WANTING TO HAVE MORE CREATIVITY
WITHIN THE SCIENCE FROM JUNIOR
INVESTIGATORS COMING INTO THIS
SPACE.
THERE'S ALSO THE ANTIQUATED LENS
SOME DECISION MAKERS HAVE ABOUT
WHAT IS RIGOROUS SCIENCE, AND
MAKING SURE THOSE AREAS ARE ALL
BEING FUNDED.
AND ALSO HIGHLIGHTING THE NEED
FOR REVIEWER TRAINING IN FOCUS
AREAS, REVIEWERS MAKING
DECISIONS ABOUT WHAT PROJECTS
NEED TO BE NEED NEEDLES -- NEED
ALSO TO BE TRAINED ABOUT THIS
EMERGING FIELD.
ANOTHER BARRIER -- YES, AND THE
LAST ONE WAS REALLY A GREAT
DISCUSSION ABOUT THE QUESTION 3,
BIG IDEAS, WANTING TO HIGHLIGHT
THOSE PHASE FUNDING CYCLES LIKE
THE COMPASS STUDY BEING AN
EXAMPLE, A FOCUS ON MORE
SUSTAINABLE RESEARCH,
SUSTAINMENT IN RESEARCH, YOU
FIND A SUCCESSFUL INTERVENTION,
A LOT MAY BE INTEGRATION OF
RESEARCH AND IMPLEMENTATION AS
WELL AS ALIGNMENT OF PUBLIC
HEALTH IMPACT STATEMENTS, A
FOCUS ON THE HEALTH OF THE
POPULATION.
ANOTHER BIG IDEA WAS
SUPPLEMENTAL FINDING MECHANISMS
THAT WERE ACROSS DISEASES,
ACROSS I.C.s, MORE EDUCATION
IN HEALTH, HEALTH EDUCATION
ABOUT WHAT WE'RE DOING, BUT ALSO
THINKING ABOUT THOSE SPACES IN
MORE ADVERSARIAL REGIONS, HOW
CAN THE NIH BE MORE SUPPORTIVE,
SEEN PROTECTIVE, OF THE MASS
EXODUS OF RESEARCHERS OF COLOR,
RESEARCHERS DOING THIS TYPE OF
WORK, FROM STATES THAT THAT IS
NO LONGER ACCEPTABLE, EVEN
AGAINST THE LAW, AND HOW THAT --
WHAT CAN THE NIH DO LEVERAGING
INDIRECT COST AND FEES TO
PROMOTE THAT TYPE OF WORK AND
INCENTIVIZE THE RESEARCHERS WHO
ARE IN THESE SPACES ACTUALLY
DOING THE WORK AND THE
PARTNERSHIPS AS OPPOSED TO
COMING FROM LIBERAL INSTITUTIONS
AND THEN USING THE PARTNERSHIPS
HERE WE'VE BEEN FOSTERING.
LAST BUT NOT LEAST TO MOVE TO A
MORE SUFFICIENTLY POWERED STUDY
TO SUPPORT THE ANALYSIS OF
SUBGROUPS AS WE'RE MOVING
FORWARD.
THAT'S IT.
>> THANK YOU BROOKE.
GREAT JOB.
LAST ROOM 9, WE GOT A LITTLE BIT
OF A SNEAK PREVIEW OF IT.
SO WE'RE EXCITED TO HEAR THE
REST, BEVERLY.
THANK YOU.
>> FROM THE TOP, GROUP 9 HAD
ROBUST CONVERSATION AROUND
BUILDING PARTNERSHIPS,
RELATIONSHIPS BEFORE WE START
DOING THE ACTUAL RESEARCH.
AND MAKING SURE THAT AS WE
ENGAGE WITH PEOPLE THAT WE'RE
NOT GOING INTO MINDSETS OF ONE
AND DONE, ENSURING PARTICIPANTS
AND THOSE WHO SUPPORT THIS WORK
AND PARTICIPATE IN RESULTS AND
SOLUTIONS, SO ACTUALLY USING THE
RESEARCH TO PROVIDE SOLUTIONS
FOR THOSE SPACES THAT HAVE BEEN
INVOLVED IN THE WORK.
RECOGNIZING THE POWER OF THE
PEOPLE TO MAKE THOSE CHANGES AND
THAT THE ACADEMIC TIMELINES ARE
OFTEN NOT ALIGNED OR IN SOME
WAYS IN CONFLICT WITH THE PEOPLE
THAT ARE PARTICIPATING AND ONE
THING THAT WAS BROUGHT UP WAS
REIMBURSEMENT CYCLE.
SO THE REIMBURSEMENT CYCLE CAN
BE A BARRIER AND POINT OF
CONFLICT WHEN ENGAGING IN
COMMUNITY ENGAGED WORK AND
PARTNERSHIPS.
IT IS OUR RESPONSIBILITY TO WORK
WITHIN THOSE SYSTEMS TO CHANGE
HOUSE SYSTEMS ARE WORKING WITH
OUTSIDE OF ACADEMIA.
WE TALKED ABOUT THE DISCIPLINARY
BIAS.
AND THAT THERE'S A HIERARCHY OF
RESEARCH THAT IS VALUED AND
COMMUNITY ENGAGED RESEARCH CAN
BE DEFINED AS SERVICE, AS
COMPARED TO OTHER TYPES OF WORK
AND THAT COMPARISON MIGHT BE
SEEN AS NOT VALUED, ALSO A
BARRIER FOR PEOPLE TO TENURE AND
OTHER FORMS OF ADVANCEMENT.
WE TALKED ABOUT IN ACADEMIA A
VALUE OF QUANTITATIVE OVER
QUALITATIVE AND WE NEED TO SHIFT
TO RAISING THE VALUE OF THE
QUALITATIVE RESEARCH.
AND DELIVERING RESEARCH IN
FORMATS THAT GO BEYOND
PUBLICATION, AND TO THAT THE
COMMENT WAS MADE BY DR. THOMAS
THAT WE EXPAND THE STEM TO STEAM
SO OTHER ARTISTIC MEDIUMS TO BE
USED TO SHARE RESULTS BUT ALSO
SHARE PARTICIPANTS FROM THEIR
CREATIVE SPACES IN A WAY THAT'S
MEANINGFUL FOR THOSE PEOPLE
ENGAGING WITH THIS WORK.
ADDRESSING THOSE ROOT
MISUNDERSTANDINGS, IN OUR
TRAINING OFTEN WE START WHERE
OUR WORK BEGINS WITHOUT
PROVIDING SOME KIND OF
BACKGROUND TO MAKE SURE WE'RE
STARTING WITH THE SAME
UNDERSTANDING, PARTICULARLY
AROUND RACE, RACE NOT BEING
CAUSAL, RACE NOT BEING A DRIVER
BUT HOW WE TREAT PEOPLE BASED ON
RACIALIZED CATEGORIES,
PRESENTING A POLE US OF
RACE-BASED DATA.
A BOLUS OF RACE-BASED DATA.
WE NEED TO REEVALUATE TENURE SO
IT IS INCLUSIVE OF CONSIDERATION
OF THINGS THAT FACULTY ARE
PASSIONATE ABOUT.
THIS BEGINS TO LIMIT NUMBER OF
SCHOLARS WHO WANT TO STAY IN
ACADEMIA BECAUSE THEY WOULD
RATHER DO THE WORK SOMEWHERE
ELSE.
WE TALKED ABOUT CONNECTING
HEALTH AND WELLNESS, WITH REGARD
TO COMMUNITY SPACES, ALLOWING
FOR SELF-MONITORING, A GREAT
IDEA IF YOU'RE AT THE
BARBERSHOP, FROM DR. THOMAS, PUT
YOUR PHONE ON SOMETHING THAT
PROVIDES INFORMATION THAT TELLS
YOU HOW YOU'VE BEEN LIVING IN
BETWEEN YOUR HAIRCUTS THAT MIGHT
BE INFORMATIVE, SO INCORPORATING
THAT TECHNOLOGY INTO SPACES SO
IT'S KIND OF USER FRIENDLY IN
THE MOMENT.
ALSO WITH THAT TECHNOLOGY
ADDRESSING VULNERABILITY SO WE
PROTECT THOSE PEOPLE AND THEY
PROVIDE EDUCATION, HOW TO USE
THESE TECHNOLOGIES SAFER.
WE TALKED ABOUT REDUCING THE
TIMELINE FOR WHICH THE DATA
AROUND TRANSLATING SCIENCE,
TAKING APPROXIMATELY 14 YEARS TO
COMPLETE, BUT IF WE WERE USING
THE SCIENCE ALREADY PUBLISHED
PERHAPS WE COULD REDUCE THE
TIMELINE FOR WHICH RESEARCH
BECOMES USABLE.
ALSO, LOOKING AT PATHWAY WORK,
TAPPING INTO ADULT POPULATIONS,
WHO ARE ALREADY WORKING AT
UNIVERSITIES, MAYBE WORKING AT
SOME NON-PROFIT ORGANIZATIONS WE
ENGAGED WITH TO GET THOSE
CREDENTIALS, SO THEY CAN BECOME
FACULTY AND P.I.s OF THE WORK,
AND WE SPEND LEST TIME TEACHING
PEOPLE HOW TO ENGAGE IN
COMMUNITY IF WE HAVE PEOPLE
OUTSIDE OF ACADEMIA BEFORE
FACULTY MEMBERS AND P.I.s.
THERE'S WORK THAT'S HAPPENING,
INCREASING ABILITY TO PUBLISH
IT'S NOT BEING PUBLISHED BECAUSE
IT'S NOT A VALUE SYSTEM IN THOSE
SPACES, PARTNERING PEOPLE
ALREADY DOING WORK FOR THE
BENEFIT OF PUBLISHING SO THAT
THEN BECOMES AN AWARENESS AND
ALSO TEMPLATE FOR SOLUTIONS OF
CHANGES WITHIN THOSE
COMMUNITIES.
AS WELL AS EMPHASIZING
IMPLEMENTATION SCIENCE, AND
HAVING IMPLEMENTERS ALREADY
DOING THIS WORK INCORPORATED
IMPLEMENTATION SCIENCE SPACE.
THANK YOU.
>> THANK YOU.
THOSE WERE SOME WONDERFUL
REPORT-OUTS.
I HOPE EVERYBODY NOT ONLY
ENJOYED HEARING THE TAKEHOME
MESSAGES FROM SOME GROUPS BUT
ENJOYING BEING PART OF THE
GROUPS.
WE ENJOYED THE OPPORTUNITY TO
ENGAGE AND BRING TOGETHER SOME
VOICES ON SOME COMMON THEMES.
THANK YOU.
AT THIS POINT WE'RE MOVING TO
OUR FINAL SESSION, FINAL PORTION
OF THE WORKSHOP.
THANK YOU FOR THOSE WHO ARE
STILL WITH US AT THE END OF DAY
2.
I'M GOING TO TURN IT OVER TO DR.
KATHY ETZ TO LEAD US THROUGH THE
LAST SECTION.
G THANK YOU, I'M GOING TO SAY,
WOW, WOW, WOW.
THIS HAS BEEN TREMENDOUS AND I
THINK MANY OF US ARE BLOWN AWAY
BUT EVERYTHING WE'VE HEARD.
SO THE FIRST THING I WOULD LIKE
TO DO IS ACTUALLY INVITE DR.
CAMILLE HOVER, CO-CHAIR OF THE
OVERALL UNITE INITIATIVE, JUST
TO SHARE SOME BRIEF REFLECTIONS.
CAMILLE, IF YOU CAN TURN YOUR
CAMERA ON.
GREAT.
>> I AM.
THANK YOU.
BY THE WAY I'M NOT A DOCTOR.
I HAVE MY MSW, AN EXECUTIVE
OFFICER BUT NOT AN M.D. OR
Ph.D., JUST WANT TO MENTION
THAT.
THANK YOU FOR OFFERING ME THE
OPPORTUNITY TO BE WITH YOU ALL
TODAY.
UNITE HAS BEEN SO EXCITED TO BE
ABLE TO SUPPORT THIS MEETING.
I WANT TO THANK YOU, TO THE
SPEAKERS AND PARTICIPANTS FOR
DEVOTING TIME AND ENERGY, THE
WONDERFUL INSIGHTS THAT CAME
ABOUT OVER THE LAST TWO DAYS.
UNITE IS CONTINUING TO WORK AT
NIH TO CONSIDER HOW STRUCTURAL
RACISM IMPACTS ALL ASPECTS OF
THE NIH WORK.
THE NIH WORKFORCE, EXTRAMURAL
SCIENCE WORKFORCE, ALSO
HIGHLIGHTED IN THIS MEETING,
RESEARCH TOO THAT CAN HELP
ALLEVIATE THE HEALTH DISPARITIES
OF RACIAL AND ETHNIC MINORITIES.
AS NIH STAFF, WE'RE EXCITED AND
DEVOTED TO LEVERAGE WHAT WE'VE
LEARNED IN THE LAST TWO DAYS AND
FEEDBACK YOU'VE SHARED WITH US
TO IMPROVE OUR RESEARCH TO
ADDRESS STRUCTURAL RACISM.
THIS FIELD OF RESEARCH IS
RAPIDLY ADVANCING BUT WE HAVE
MUCH MORE WORK TO DO.
WE LOOK FORWARD TO SEEING HOW IT
CONTINUES TO EVOLVE, AS
INTERDISCIPLINARY APPROACHES, AS
CONSIDERED AS THIS MEETING, ARE
LEVERAGED TO ENSURE WE BRING ALL
OF OUR EXPERTISE TOGETHER TO
PROVIDE A SCIENTIFIC FOUNDATION
TO ADDRESS STRUCTURAL RACISM.
THANK YOU AGAIN, AND I
APPRECIATE YOU INVITING ME HERE.
I'LL TURN IT BACK TO YOU.
>> THANKS, CAMILLE.
AND ONE OF THE THINGS THAT CAME
OUT IN THIS MEETING WE NEED TO
PAY LESS ATTENTION TO THE
LETTERS THAT COME AFTER
SOMEBODY'S NAME, SO YOU'RE IN
GOOD COMPANY HERE.
I'M GOING TO SAY SUPER QUICKLY
IN THE INTEREST OF TIME THERE'S
NOT TIME TO GO OVER EVERYTHING.
I WANTED TO PULL OUT A COUPLE
THINGS.
ONE IN THE BREAKOUT WE HEARD
THERE'S A LACK OF CENTRAL
REPOSITORY FOR METHODS AND
RESOURCES, AND THAT'S SOMETHING
THAT THE UNITE N COMMITTEE HAS
NOTED AND IS WORKING ON NOW.
A COUPLE PHRASES THAT I LOVED IN
THIS MEETING, ONE FROM HEALING
ARC, FRAME IT, FIX IT, END IT.
STORIES WHERE IT'S AT, THE REAL
EMPHASIS ON QUALITATIVE DATA AND
OTHER FORMS OF EVIDENCE.
AND STOP OTHERING, THE NEED TO
SHIFT OUR LANGUAGE THAT WE'RE
ALL ONE AND ONE OF OF MY VERY
FAVORITES GREETING PEOPLE BY
ASKING HOW ARE THE CHILDREN.
SO WITH THAT I WANT TO THANK
EVERYBODY FOR BEING HERE.
I'M GOING TO TURN IT OVER TO
TIFFANY AND FRANK WHO WILL
INVITE MEMBERS OF THE PLANNING
COMMITTEE TO SHARE SOME FINAL
THOUGHTS.
>> THANK YOU, KATHY.
I WANT TO THANK THE PLANNING
COMMITTEE.
THERE'S A FEW OF THEM ON THE
ZOOM TODAY.
SO WE HAVE ARIEL GILMAN,
JUANITA, VANESSA, AND CALVIN, IN
THAT ORDER, IF YOU WOULD LIKE TO
GIVE ANY FINAL THOUGHTS OR
REMARKS, PLEASE DO SO, THANK
YOU.
>> THANKS SO MUCH FOR A GREAT
WORKSHOP.
REALLY APPRECIATE EVERYONE WHO
HAS SPOKEN AT THE WORKSHOP AND
PARTICIPATED THROUGHOUT.
TO MY OWN, ONE PERSONAL KEY
TAKEAWAY FROM THIS MEETING,
TODAY DR. GRIFFITH AND OTHERS
THROUGHOUT THE MEETING BROUGHT
UP IMPORTANCE OF
INTERSECTIONALITY, AND
PERSONALLY WOULD LOVE TO SEE
SOLID GUIDANCE FROM THE FIELD OR
BEST PRACTICES DEVELOPED FOR
MEASURING AND STUDYING
STRUCTURAL INTERSECTIONAL
DISCRIMINATION.
I THINK, YOU KNOW, OBVIOUSLY
WE'RE STILL -- THERE'S STILL A
LONG WAY TO GO FOR MEASURES AND
METHODS FOR STUDYING STRUCTURAL
RACISM BROADLY, BUT I THINK
THAT'S ONE POINT I WOULD LOVE TO
SEE SOME FUTURE GUIDANCE ON.
SO THANKS SO MUCH, AGAIN, FOR A
GREAT WORKSHOP AND I'LL PASS IT
ON TO THE NEXT COLLEAGUE.
>> JUANITA, ARE YOU STILL WITH
US?
>> YES.
I DIDN'T KNOW IF I WAS NEXT OR
NOT.
THANKS, FRANK.
OVER THE PAST TWO DAYS I THINK
THE MAIN WORD I HEARD REPEATED
WAS COMMUNITY.
AND I ALSO WANTED TO NOTE THAT
ONE OF THE THINGS THAT WE CAN
TAKE BACK IS THAT THERE IS A
NEED FOR STRUCTURAL CHANGE AND
HOW WE CONDUCT RESEARCH ON
STRUCTURAL RACISM AND ALSO ON
HEALTH DISPARITIES RESEARCH.
AND THINK THAT'S SOMETHING THAT
WE'VE BEEN THINKING ABOUT WITH
DEPTH AND BREADTH, WHICH HAS
BEEN EMPHASIS OF THIS WORKSHOP,
BUT I THINK THAT WE ARE HEARING
EVERYONE SAY THAT THERE NEEDS TO
BE A STRUCTURAL CHANGE IN THE
WAY THAT WE FUND AND CONDUCT AND
ENGAGE WITH BIOMEDICAL RESEARCH
ON STRUCTURAL RACISM, AND HEALTH
DISPARITIES.
AND I'VE BEEN OVERWHELMED BY THE
RESPONSE TO THIS WORKSHOP.
AND ENGAGEMENT THAT WE'VE ALL
HAD OVER THE PAST TWO DAYS.
SO THANK YOU FOR ALLOWING ME TO
BE PART OF IT.
>> THANK YOU.
VANESSA MARSHALL, ARE YOU STILL
WITH US?
>> YES, I'M HERE.
I SEE WORDS.
I WANT TO THANK EVERYONE FOR
ATTENDANCE AND ENGAGING IN A
WONDERFUL TWO DAYS OF OUR
WORKSHOP.
AND LOOKING FORWARD TO MAKING
SURE THAT WE CAN ADDRESS SOME OF
THE CONCERNS AND ISSUES THAT WE
DISCUSSED OVER THE LAST TWO
DAYS.
THANKS AGAIN.
>> THANK YOU, VANESSA.
CALVIN CHOI?
>> THIS IS KELVIN CHOI, SENIOR
INVESTIGATOR, NATIONAL INSTITUTE
ON MINORITY HEALTH AND HEALTH
DISPARITIES.
I'M ALSO ADVISER OF THE NIH
HEALTH DISPARITY INTEREST GROUP
SO IT'S GREAT TO SEE ALL OF YOU,
THE FACES I'VE SEEN BEFORE,
PARTICIPATING IN OUR LECTURES
AND WORKSHOPS.
WONDERFUL TWO-DAY WORKSHOP, THAT
I'VE HEARD A LOT OF GREAT AND
IMPORTANT IDEAS, I THINK THE
FIRST THING I WANT TO SAY IS
THAT WE HAVE TO, WE HAVE TO,
EMPHASIZE THAT ADDRESSING HEALTH
DISPARITIES IS IMPROVING THE
HEALTH OF THE ENTIRE POPULATION.
WITHOUT ADDRESSING HEALTH
DISPARITIES WE'RE NOT GOING TO
IMPROVE THE HEALTH OF THE ENTIRE
POPULATION.
THEY ARE NOT TWO SEPARATE
PROBLEMS, IT'S ONE PROBLEM
TOGETHER.
FOR SO LONG IT'S BEEN SOMETHING
SOMEBODY'S GOING TO ADDRESS,
OTHER PEOPLE FOCUSING ON
IMPROVING HEALTH OF THE ENTIRE
POPULATION.
NO, THESE TWO ARE ONE PROBLEM,
WE HAVE TO WORK ON THEM
TOGETHER.
I THINK IT'S IMPORTANT TO
REALIZE PARADIGM SHIFT THAT
NEEDS TO HAPPEN, THAT FOR SO
LONG BIOMEDICAL RESEARCH FOCUSED
ON PARADIGM ON QUANTITATIVE
METHODOLOGY, AND I THINK WE NEED
TO UNDERSTAND, WE NEED TO SHIFT
THE PARADIGM AND SHIFT PARADIGM
FROM HOW WE WRITE OUR RFA TO HOW
THEY SHOULD BE REVIEWED NOT JUST
AT GRANT APPLICATION PROCESS BUT
ALSO JOURNALS, JOURNAL ARTICLES,
AND THOSE ARE AREAS THAT WE'RE
GOING TO HAVE THE MOST
RESISTANCE.
AGENCY CAN MAKE CHANGES IN
PROGRAMMING AND FUNDING AT THE
END OF THE DAY TO PUBLISH IN
JOURNAL, JOURNAL EDITORS AND
REVIEWERS ARE THE GATE KEEPER.
PARADIGM SHIFT NEEDS TO HAPPEN
THROUGHOUT THE DISCIPLINE, NOT
JUST IN A FEW AREAS.
THE LAST THING, VERY HAPPY TO
HEAR DR. GRIFFITH MENTION THE
OTHER SIDE OF THE COIN.
WHITENESS ISN'T A PIECE OF THE
RESEARCH THAT DESERVES MORE
ATTENTION HOW DO WE ADDRESS
PERVASIVENESS OF WHITENESS,
CHANGE THE EFFECT OF WHITENESS,
HOW DO WE AT LEAST HELP PEOPLE
REALIZE WHITENESS IS RESISTING
SOME CHANGES TO PUT IN PLACE AND
HOW DO WE CHANGE HOW WE THINK
ABOUT WHAT IT MEANS, THAT'S
ANOTHER IMPORTANT AREA OF
RESEARCH.
WHILE WE CONTINUE TO ADDRESS THE
CONSEQUENCES OF STRUCTURAL
RACISM, TO CHANGE STRUCTURAL
RACISM WE NEED TO CHANGE
WHITENESS.
THANKS, ALL OF YOU, FOR YOUR
TIME AND ATTENTION.
A GREAT WORKSHOP.
I'VE LEARNED A LOT FROM ALL OF
YOU, AND LOOKING FORWARD TO
CONTINUING CONVERSATIONS.
>> THANK YOU, KELVIN.
I WANT TO MENTION, AND KATHY
MENTIONED, COMMITMENT TO
STRUCTURAL RACISM, AND NIMHD AND
OBSSR HAS A FUNDING
ANNOUNCEMENT, INTEGRATING CITIES
DISCIPLINES IN CRIMING,
EDUCATION, SOCIOLOGY TO WORK
TOGETHER AND HAVE A PUBLIC DATA
REPOSITORY.
GOOGLE NIA NETWORK ON STRUCTURAL
RACISM YOU'LL SEE THE FUNDING
ANNOUNCEMENT, OR E-MAIL ME.
WE'RE AT THE END, TIFFANY.
DO YOU HAVE ANY OTHER REMARKS?
>> NO.
EXCEPT TO SAY THAT IT WAS A
WONDERFUL TWO DAYS.
I ENJOYED ALL THE SPEAKERS AND
THE CONVERSATIONS.
I HOPE YOU ALL ENJOYED IT AS
WELL.
THANK YOU FOR YOUR ATTENTION AND
PARTICIPATION, EVEN THOUGH THE
CONVERSATION IS ENDING FOR TODAY
IT'S GOING TO CONTINUE HERE SO
THANK YOU FOR YOUR
CONTRIBUTIONS.
WE'LL BE WORKING, LOOKING AT
THESE IN THE DAYS AND WEEKS AND
YEARS TO COME.
THANK YOU SO MUCH.