Creating Inclusive and Equitable Cultural Practices by Linking Leadership to Systemic Change

Race, Healthcare, and Health Disparities: A Critical Review and Recommendations for Advancing Health Equity

An overwhelming body of evidence points to an inextricable link between race and health disparities in the United States. Although race is best understood as a social construct, its role in health outcomes has historically been attributed to increasingly debunked theories of underlying biological and genetic differences across races. Recently, growing calls for health equity and social justice have raised awareness of the impact of implicit bias and structural racism on social determinants of health, healthcare quality, and ultimately, health outcomes. This more nuanced recognition of the role of race in health disparities has, in turn, facilitated introspective racial disparities research, root cause analyses, and changes in practice within the medical community. Examining the complex interplay between race, social determinants of health, and health outcomes allows systems of health to create mechanisms for checks and balances that mitigate unfair and avoidable health inequalities. As one of the specialties most intertwined with social medicine, emergency medicine (EM) is ideally positioned to address racism in medicine, develop health equity metrics, monitor disparities in clinical performance data, identify research gaps, implement processes and policies to eliminate racial health inequities, and promote anti-racist ideals as advocates for structural change. In this critical review our aim was to (a) provide a synopsis of racial disparities across a broad scope of clinical pathology interests addressed in emergency departments-communicable diseases, non-communicable conditions, and injuries-and (b) through a race-conscious analysis, develop EM practice recommendations for advancing a culture of equity with the potential for measurable impact on healthcare quality and health outcomes.

Building a Social Justice Framework for Cultural and Linguistic Diversity in ABA

ABA may be uniquely positioned to have broader impacts with culturally and linguistically diverse (CLD) client populations, not only due to its growth and increased social acceptability, but also because a segment of the field practices within the education system. Decades of misinformation have potentially reduced the widespread reliance on learning pedagogies derived from behavior analytic research. Disseminating ABA technologies depends on an advocacy-based approach to close gaps from research-to-practice. Social justice is both an approach and a framework that can be integrated into our strategic planning for the field. This article describes how to apply social justice guidelines when working with CLD students and families. There are culturally relevant considerations that can be included in our research, training, and service delivery, in particular if we want the field to grow in a sustainable fashion. Behavior analysts must consider it an ongoing long-term objective to engage in culturally informed assessment, culturally and linguistically relevant intervention, culturally focused advocacy and collaboration with families, and use self-assessment of their cultural competence.

Increasing Access and Quality of Behavior-Analytic Services for the Latinx Population

Latinxs are the largest minority group in the United States, making up approximately 18% of the total population. Although there is a critical need for the behavioral health care system, including behavior analysts, to provide services to support the needs of the Latinx community, access to quality behavioral and mental health services continues to be lacking for the Black, Indigenous, and people of color populations. This article highlights some of the cultural and language factors that should be considered by behavior-analytic providers who have a shared responsibility to make culturally and linguistically appropriate services available to this population. Additionally, recommendations for systemic action across service providers, professional organizations, behavior-analytic training programs, and researchers are suggested to address these barriers. Recommendations for bringing about this systemic change are suggested across three domains: (a) increasing diversity in the behavior-analytic workforce, (b) enhancing training in cultural- and language-related issues, and (c) conducting research on cultural and language adaptations to behavior-analytic evidence-based treatments.