MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Examining racism in health services research: A disciplinary self‐critique

Citation Type: Journal Article

Publication Year: 2020

DOI: 10.1111/1475-6773.13558

PMID: 32976632

Abstract: Racial disparities in health have existed in the United States for centuries. 1 In 1899, WEB Du Bois noted the prevalence of poor health among black people, describing it as an important indicator of societal racial inequality. 2 Black Americans continue to have substantially worse health and shorter life expectancies than their white counterparts. 1,3 Particularly in health services research, evidence of black-white disparities in health and health care costs have been acknowledged for decades. However, much of this work has been divorced from the social context of deeply seated racial oppression (read: racism) that has created it. This dangerously incomplete view of disparities often fails to evoke racism as the fundamental cause of these injustices. 4 By separating health disparities from racism, we fail to recognize disparities as inequi-ties-that is avoidable injustices. Instead, we focus on individual differences rather than the systems and structures that uphold and replicate them. Disciplinary self-critique, a tenet of public health critical race praxis (PHCRP), helps a discipline shine a light on itself from within in order to understand how its norms may inadvertently buttress inequities either within the discipline or in society at large. 5 PHCRP also defines the term "outsiders within" as people who are members of a field but often marginalized within it because of their social identity. We, the authors of this commentary , represent the outsiders within. We understand and appreciate the discipline of health services research, its strengths and visions. We care deeply about how health services research can and should address health inequities and propel our discipline toward more equitable realization of its mission to produce new knowledge about the structure, processes, and effects of health services for individuals and populations. This commentary will interrogate the ways we as health services researchers pose our research questions, create methodological approaches, and interpret our findings. We, the authors, hope that this commentary will serve as a disciplinary self-critique that will expose how our disciplinary practices are steeped in white supremacy. This commentary asserts that without acknowledging shortcomings within our discipline, we cannot identify solutions to the most vexing health equity issues in our field. 1 | R ACIS M , WHITE SUPREMAC Y, AND HE ALTH S ERVI CE S RE S E ARCH Structural racism lies underneath, all around, and across society. It refers to the normalization and legitimization of an array of dynamics historical , cultural, institutional, and interpersonal-that routinely advantage whites while producing cumulative and chronic adverse outcomes for black people. 6 Structural racism encompasses (a) history, which lies underneath the surface, providing the foundation for white supremacy in this country; (b) culture, which exists all around our everyday lives, providing the normalization and replica-tion of racism; and (c) interconnected institutions and policies, they key relationships and rules across society providing the legitimacy and reinforcements to maintain and perpetuate racism. 6 To produce antiracist research and to achieve health equity, we must acknowledge the influence of white supremacist ideologies within our discipline. However, our traditional notions of white supremacy keep us focused on hate groups and vulgar language rather than a culture and ideology born from the premise of black inferiority and false notions of race as biological that have permeated the ways in which we conduct our research. As a result, a white racial frame-the overarching worldview that encompasses important racial ideas, terms, images, emotion and interpretation, and lens by which white supremacy is perpetuated-then legitimizes structural racism by providing a narrative , belief system and worldview that upholds and sustains it. 7 Our long-held belief systems drive the research questions we ask, the methods we employ, and the interpretation of our research findings. By interrogating it head on, we have everything to gain in the fight for racial health equity and the production of antiracist research. A disciplinary self-critique of our: 1. Research questions. Predominant notions about race shape the way we as health services researchers frame our research questions. For example, research questions are often phrased as "what causes Black people to have so many disadvantages compared to whites; and, what forces are at work?" This question or variations of it are widely used and accepted among health services researchers and at first look appear innocuous This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Url: /pmc/articles/PMC7518806/

Url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7518806/

User Submitted?: No

Authors: Hardeman, Rachel; Karbeah, J’Mag

Periodical (Full): Health Services Research

Issue: Suppl 2

Volume: 55

Pages: 777

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop