Perspectives on Racism: Reflections on Our Collective Moral Responsibility When Leveraging Arts and Culture for Health Promotion

Engaging Antiracist And Decolonial Praxis To Advance Equity In Oregon Public Health Surveillance Practices

Public health surveillance and data systems in the US remain an unnamed facet of structural racism. What gets measured, which data get collected and analyzed, and how and by whom are not matters of happenstance. Rather, surveillance and data systems are productions and reproductions of political priority, epistemic privilege, and racialized state power. This has consequences for how communities of color are represented or misrepresented, viewed, and valued and for what is prioritized and viewed as legitimate cause for action. Surveillance and data systems accordingly must be understood as both an instrument of structural racism and an opportunity to dismantle it. Here, we outline a critique of standard surveillance systems and practice, drawing from the social epidemiology, critical theory, and decolonial theory literatures to illuminate matters of power germane to epistemic and procedural justice in the surveillance of communities of color. We then summarize how community partners, academics, and state health department data scientists collaborated to reimagine survey practices in Oregon, engaging public health critical race praxis and decolonial theory to reorient toward antiracist surveillance systems. We close with a brief discussion of implications for practice and areas for continued consideration and reflection.

Stacked Up Against Us: Using Photovoice and Participatory Methods to Explore Structural Racism's Impact on Adolescent Sexual and Reproductive Health Inequities

While structural racism has profound impacts on adolescent health, little is known about how youth synthesize racialized experiences and work to dismantle systems of oppression. This article provides an overview of a Youth Participatory Action Research study that used Photovoice and community mapping to explore how structural violence, like racism, impacts the sexual and reproductive health of historically excluded youth as they navigate unjust socio-political landscapes. Youth participants used photography and community maps to identify how the experience of bias, profiling, and tokenism impacted their ability to navigate complex social systems. With youth voices prioritized, participants explored ways to address structural racism in their lives. The importance of co-creating opportunities with and for youth in critical reflection of their lived experience is emphasized. Through an Arts and Cultural in Public Health framework, we provide an analysis of the ways structural racism functions as a gendered racial project and fundamental cause of adolescent sexual and reproductive health inequities, while identifying pathways toward liberation in pursuit of health and well-being.

Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEARTPDX

The social determinants of health (SDH) have long been considered a core mechanism through which racial health inequities are (re)produced and incubated in the U.S. Moreover, scholars have expressly—and appropriately—named structural racism as a precursor to inequities associated with SDH. However, while research on racial health inequities—SDH-related or otherwise—continues to grow, communities of color remain grossly underrepresented as public health researchers and practitioners. Additionally, although SDH are experienced in a very local sense, much research and practice fails to more deeply and thoroughly engage and center local community knowledges. Thus, much work around SDH and racial health inequities presents, ironically, as structurally racist itself—being done/led mostly by White scholars and in ways that do not “center the margins”. Moreover, in the context of public health practice, youth perspective is seldom centered within local health department (LHD) community SDH assessment efforts. With these challenges in mind, this paper introduces and discusses the development of the youth health equity and action research training (yHEART) program as a model for public health researchers/practitioners to engage public health critical race praxis (PHCRP) to better understand and respond to local SDH in communities of color. Specifically, we highlight the significance of PHCRP principles of “voice” and “social construction of knowledge” in advancing antiracism in research and LHD practice related to local SDH. First, we articulate core conceptual and theoretical groundings that informed the yHEART program’s development and animate its ongoing training and research activities. Second, we outline the program’s core training components and overall process, and provide some brief illustrative examples of work completed during the program’s first iteration—yHEART PDX, Vol.I: Youth Participatory Research on Local Social Determinants of Health. We then close with a discussion that reflects on program strengths, challenges, and implications for SDH and racial health equity research/practice in light of growing calls for an antiracist public health.

Interdisciplinarity, interprofessionality, and racial diversity in the anti-racist training of health professionals: voices and learnings

ABSTRACT This is a critical-reflective report on the experience of an elective course aimed at training health professionals in fighting racism. It was offered during the COVID-19 pandemic to undergraduate students from all the health subspecialties at the University of São Paulo. From the description and reflection on the proposed teaching and evaluation activities, we sought to recognize and learn/apprehend the contribution of the integration of knowledge (interdisciplinarity), professions (interprofessionality), and racial diversity in the teaching-learning process aimed at fighting racism. The perspectives of students, monitors, and teachers are reported. The support of guest teachers allowed this initiative to address racism and its influences on the health of black people, and the educational strategies encouraged students’ cultural production. The initiative proved to be a possibility for introducing changes in health education in favor of both comprehensive care and interprofessional collaboration in dismantling racism.

Interdisciplinaridade, interprofissionalidade e diversidade racial na formação antirracista do profissional de saúde: vozes e aprendizados

RESUMO Trata-se de relato crítico-reflexivo sobre a experiência de disciplina optativa voltada à formação de profissionais da saúde no combate ao racismo, oferecida aos estudantes de graduação da área de saúde na Universidade de São Paulo, durante a pandemia de Covid-19. A partir da descrição e da reflexão sobre as atividades de ensino e avaliação propostas, buscou-se reconhecer e apre(e)nder a contribuição da integração de saberes (interdisciplinaridade), de profissões (interprofissionalidade) e da diversidade racial no processo ensino-aprendizagem voltado ao combate ao racismo. São relatadas perspectivas de discentes, monitoras e docentes. A oferta da disciplina, com apoio de convidados, permitiu que o projeto abordasse o racismo e suas influências na saúde das pessoas negras e estimulou a produção cultural dos estudantes. A iniciativa mostrou-se uma possibilidade de introduzir mudanças na formação dos futuros profissionais de saúde em prol tanto da integralidade do cuidado quanto da colaboração interprofissional no combate ao racismo.

Visualizing DEPICT: A Multistep Model for Participatory Analysis in Photovoice Research for Social Change

As a critical narrative intervention, photovoice invites community members to use photography to identify, document, and discuss issues in their communities. The method is often employed with projects that have a social change mandate. Photovoice may help participants express issues that are difficult to articulate, create tangible and meaningful research products for communities, and increase feelings of ownership. Despite being hailed as a promising participatory method, models for how to integrate diverse stakeholders feasibly, collaboratively, and rigorously into the analytic process are rare. The DEPICT model, originally developed to collaboratively analyze textual data, enhances rigor by including multiple stakeholders in the analysis process. We share lessons learned from Picturing Participation, a photovoice project exploring engagement in the HIV sector, to describe how we adapted DEPICT to collaboratively analyze participant-generated images and narratives across multiple sites. We highlight the following stages: dynamic reading, engaged codebook development, participatory coding, inclusive reviewing and summarizing of categories, and collaborative analysis and translation, and we discuss how participatory analysis is compatible with creative, interactive dissemination outputs such as exhibitions, presentations, and workshops. The benefits of Visualizing DEPICT include feelings of increased ownership by community researchers and participants, enhanced rigor, and sophisticated knowledge translation approaches that honor multiple forms of knowing and community leadership. The potential challenges include navigating team capacity and resources, transparency and confidentiality, power dynamics, data overload, and streamlining "messy" analytic processes without losing complexity or involvement. Throughout, we offer recommendations for designing participatory visual analysis processes that are connected to critical narrative intervention and social change aims.