For many public health researchers, the ultimate goal of the research project is to initiate positive change that will improve population health and advance racial equity. However, for many of us, our institutions, training, research approaches and methodologies, and knowledge sharing practices are not conducive to achieving this goal. Changing the way research is done (i.e., who is involved, how they are involved, and when they are involved) is critical to centering racial equity and ensuring the actionability of the findings.
We’ll discuss how racial equity frameworks and processes help to ensure that we’re asking the right questions, conducting the research in a way that aligns with our values of improving health for members of the community and advancing racial equity, interpreting the results in a contextually appropriate way, and sharing them with the people that can use them to create change. Racial equity frameworks can also ensure that there is a tangible, sustainable benefit for communities after completion of the project.
Below are a few strategies that we’ve used that may prove helpful as you begin to center racial equity. This is not an exhaustive list or the last word in integrating equity perspectives.
Before using racial equity approaches, it helps to reflect on your positionality and where you are in your understanding about race and racism and what this means for you as an individual and for the communities you’re working in and with. One approach is to start by thinking about your personal identities (e.g., gender expression, socioeconomic status, profession, race/ethnicity, and educational attainment) and lived experiences. How might these different identities afford you inherent power and privileges in everyday and/or professional spaces? How might they impact how you are viewed by your team members and the community you're working in? Encourage members of your team to do the same. This can help keep everyone open to the process and cognizant of these dynamics, and help the group identify who should fill the forward-facing roles in different spaces and settings (e.g., recruitment of participants, presentations to funders).
It’s also important to consider the positionality of your organization or institution and what that means for working in and with communities, particularly when past interactions have led to mistrust or trauma. Many researchers, irrespective of race or ethnicity, are employed at and/or funded by institutions steeped in White Supremacy Culture (WSC). Generally, WSC promotes what are considered norms and processes for how research is done and elevates certain types of knowledge (e.g., academic attainment vs. lived experience) and activities (e.g., publication in a peer-reviewed journal vs. sharing findings with community members) as valuable. So for each stage of the research, it’s helpful to come back to the characteristics of WSC and interrogate how they are showing up in your work and ways to combat them as a team.
Elevate community member knowledge and use that knowledge to center how you frame your research in collaboration with communities. Share power with community members and groups, building a space where they have a voice in every stage of the research process – from identifying community needs and potential solutions (i.e., interventions) to designing the research and selecting instruments to interpreting and disseminating the findings. With them, identify the sustainable changes you want to leave in the community once the project is over. Centering equity and conducting research equitably also means compensating these individuals appropriately for their time and energy. These individuals and other team members can also help hold the work and project team accountable to ensure the research is done in a way that uplifts, values, respects, and involves the community.
Additional approaches are to flatten hierarchies within your team, develop and interrogate a racial equity framework, and spend time within the community “under study” to better understand the challenges being faced and potential solutions to those challenges. The people closest to the problem are also closest to the solutions.
Putting Evidence Into Practice
For the Pop-Up Village project, our team worked with organizations, service providers, and pregnant people in the community through a human-centered design process to determine what challenges community members were facing in their pregnancies to identify and test potential solutions (i.e., interventions).
- Issue #1: There are a lot of services for pregnant people in San Francisco, but accessing them is difficult because of burdens related to geography (i.e., services are accessed in different places across the city) and inefficiencies (i.e., there are several services and it is unclear which service(s) will address various needs). The proposed solution was to bring all of these providers together monthly, to deliver services side by side and in a more collaborative and coordinated way.
- Issue #2: It’s not just pregnant people who are facing challenges, but their families as well. The proposed solution focuses on serving both individuals and families as a whole.
- Issue #3: There is a lack of trust in institutions, particularly the city-run entities (providing safety net services) and UCSF (a large academic institution). The proposed solution is to build relationships, involve community members and organizations to partner, and commit to creating positive sustainable solutions in communities.
- Issue #4: Pregnant people want to be celebrated and uplifted, rather than pathologized, during their pregnancies and birthing experiences. The Pop-Up Village is organized and implemented in a way that celebrates this time in the lives of the participants. The team is intentional about who is filling forward-facing roles involving interactions with pregnant people.
A New Crisis Intervention Model? Non-Police Alternative Emergency Response Programs, Racial Equity, and Health Justice
During the height of the COVID-19 pandemic, the Justice, Health, and Democracy (JHD) Impact Initiative convened a network of mayors and policymakers from across the country to tackle urgent issues through an innovative, rapid response policymaking model. The initial work was related to the urgent need to bring children back to school, but the network also recognized the urgent need to end mass criminalization and promote racial health equity as part of a response to the community demands following George Floyd’s murder. With this in mind, JHD convened a network of scholars, policymakers, practitioners, and individuals with lived experience and charged them with identifying principles and solutions for redressing mass criminalization and the racialized harms of policing. From this arose the project on alternative emergency response programs, which is currently being implemented and evaluated by E4A grantees in three cities across the continental US.
The group determined that it was important to understand the possible ways in which alternative emergency response programs may unintentionally perpetuate the very harms they are attempting to disrupt. In conjunction with a community advisory board (CAB), the research team developed a framework with questions to ask at each stage of the research project. They also determined appropriate compensation for CAB members, for providing constructive feedback and critiques, as well as making the team answerable for the work being done.
Forming partnerships with individuals within the community with lived experience helps build rapport and trust, as well as a better understanding of the complex contextual factors impacting the individuals and broader community. Additionally, bringing in local artists, content creators, graphic designs, and others to disseminate the findings, allows for more culturally appropriate and innovative interpretations and representations of the findings.
Research projects aiming to advance racial equity and improve community health, need to center racial equity in every stage of the research process. This starts from the very beginning with developing research questions and continues beyond the research project itself with lasting and sustainable benefits to the communities at the center of the project. Authentically partnering with community members and those with lived experiences, goes a long way toward centering and upholding values of equity. Here we’ve presented some helpful practices based on our own experiences, and would love to hear what approaches are working best for you and your teams when it comes to centering equity. Connect with E4A to share your insights.