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"Racism - prevention "
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Community organising against racism : 'race', ethnicity and community development
Gary Craig and his contributors blend theory and practice-based case studies to review how different community development approaches can empower minority ethnic communities to confront racism and overcome social, economic and political disadvantage.
Book
Structural racism and the social determinants of health
[...]is the direct effect of experiencing racism at the hands of institutions or individuals. Exposure over the life course, together with having to remain vigilant and the anticipatory stress of possible future racist encounters, is likely to continue affecting the mental health of people from ethnic minorities in the longer term.7 Secondly, racism can lead to ethnic inequalities in the social determinants of health. The third way that racism can damage health is through the operations of health and care systems, particularly ethnic inequalities and experiences of discrimination and racism in maternity and mental health services. The NHS Race and Health Observatory has shown that barriers to accessing NHS services for patients from ethnic minority backgrounds include lack of appropriate treatment for particular health issues; poor quality or discriminatory treatment from healthcare staff; lack of appropriate interpreting services; and delays in, or avoidance of, seeking help for health problems because of fear of racist treatment from NHS healthcare professionals.12 Lack of data on racism, ethnic inequalities, and health limit analyses.
Journal Article
Mitigating structural racism to reduce inequities in sepsis outcomes: a mixed methods, longitudinal intervention study
Background
Sepsis affects 1.7 million patients in the US annually, is one of the leading causes of mortality, and is a major driver of US healthcare costs. African American/Black and LatinX populations experience higher rates of sepsis complications, deviations from standard care, and readmissions compared with Non-Hispanic White populations. Despite clear evidence of structural racism in sepsis care and outcomes, there are no prospective interventions to mitigate structural racism in sepsis care, nor are we aware of studies that report reductions in racial inequities in sepsis care as an outcome. Therefore, we will deliver and evaluate a coalition-based intervention to equip health systems and their surrounding communities to mitigate structural racism, driving measurable reductions in inequities in sepsis outcomes. This paper presents the theoretical foundation for the study, summarizes key elements of the intervention, and describes the methodology to evaluate the intervention.
Methods
Our aims are to: (1) deliver a coalition-based leadership intervention in eight U.S. health systems and their surrounding communities; (2) evaluate the impact of the intervention on organizational culture using a longitudinal, convergent mixed methods approach, and (3) evaluate the impact of the intervention on reduction of racial inequities in three clinical outcomes: a) early identification (time to antibiotic), b) clinical management (in-hospital sepsis mortality) and c) standards-based follow up (same-hospital, all-cause sepsis readmissions) using interrupted time series analysis.
Discussion
This study is aligned with calls to action by the NIH and the Sepsis Alliance to address inequities in sepsis care and outcomes. It is the first to intervene to mitigate effects of structural racism by developing the domains of organizational culture that are required for anti-racist action, with implications for inequities in complex health outcomes beyond sepsis.
Journal Article
Comics as anti-racist education and advocacy
In the broader societal context of the USA, examples of structural racism include discriminatory lending practices that continue to bar Black, Indigenous, and people of colour from home ownership and access to quality education and initiatives that place the burden of harmful environmental exposures on minoritised neighbourhoods or limit access to public transportation, public spaces, voting rights, and healthy food options. In contemporary health care, it includes the persistence of racialised medicine and science, unequal access to health care, clinical training programme ranking systems that disadvantage minority students, persistently disparate outcomes in Black maternal and infant mortality and any number of health and health-care disparities, and the continuing under-representation of communities of colour in academic medicine, health-care leadership, research, and on the boards of health-care organisations. In A Sense of Belonging, a comic published in The New England Journal of Medicine, physician Anita Blanchard discusses how racial disparities are driven by generational privilege, calling it the “oldest form of ‘affirmative action'” which “continues to challenge efforts to create a level playing field for physicians from minorities that are underrepresented in medicine”. In residency, however, her comics have become more outward looking and explore such topics as physician workflow, the difficulties of providing equitable patient care under the USA's current health insurance model, sexual harassment, physician wellness, and structural racism.
Journal Article
Epidemic orientalism : race, capital, and the governance of infectious disease
\"For many residents of Western nations, COVID-19 was the first time they experienced the effects of an uncontrolled epidemic. This is in part due to a series of little-known regulations that have aimed to protect the global north from epidemic threats for the last two centuries, starting with International Sanitary Conferences in 1851 and culminating in the present with the International Health Regulations, who organize epidemic responses through the World Health Organization. Unlike other equity-focused global health initiatives, their mission -- to establish \"the maximum protections from infectious disease with the minimum effect on trade and traffic\" -- has remained the same since their founding. Using this as his starting point, Alexandre White reveals the Western capitalist interests, racism, and xenophobia, and political power plays underpinning the regulatory efforts that came out of the project to manage the international spread of infectious disease. He examines how these regulations are formatted; how their framers conceive of epidemic spread; and the types of bodies and spaces it is suggested that these regulations map onto. Proposing a modified reinterpretation of Edward Said's concept of orientalism, White invites us to consider \"epidemic orientalism\" as a framework within which to explore the imperial and colonial roots of modern epidemic disease control\"-- Provided by publisher.
BOOK
Youth, multiculturalism and community cohesion
\"This book discusses the meaning and practice of British community cohesion policies, youth identities in racially-tense areas and the British government's attempts to \"prevent violent extremism\" amongst young Muslims\"-- Provided by publisher.
Book
Improving The Measurement Of Structural Racism To Achieve Antiracist Health Policy
Antiracist health policy research requires methodological innovation that creates equity-centered and antiracist solutions to health inequities by centering the complexities and insidiousness of structural racism. The development of effective health policy and health equity interventions requires sound empirical characterization of the nature of structural racism and its impact on public health. However, there is a disconnect between the conceptualization and measurement of structural racism in the public health literature. Given that structural racism is a system of interconnected institutions that operates with a set of racialized rules that maintain White supremacy, how can anyone accurately measure its insidiousness? This article highlights methodological approaches that will move the field forward in its ability to validly measure structural racism for the purposes of achieving health equity. We identify three key areas that require scholarly attention to advance antiracist health policy research: historical context, geographical context, and theory-based novel quantitative and qualitative methods that capture the multifaceted and systemic properties of structural racism as well as other systems of oppression.
Journal Article