Understanding the Past as a Foundation for the Future of Public Health

Illustration of a wooden sign post with arrows pointing to the past, present, and future

During a recent grantee meeting of the Research-Evaluation-Learning unit of the Robert Wood Johnson Foundation (RWJF), we had the opportunity to hear from several amazing thought-leaders on the ways the past should inform the future of research and public health. What follows are select highlights from just a few of the engaging conversations that took place during the two day conference. 

Versions of History

In conversation with Dr. Claire Gibbons, an RWJF Senior Program Officer, Dr. Clint Smith, renowned journalist and author of How the Word is Passed, shared his insights into how our understanding of history impacts public health. Dr. Smith discussed how there is an ecosystem of ideas and narratives that help us ground ourselves in the country in which we live and operate. How do these different ideas and narratives differ and how does everyone confront or fail to confront the complexity of history? He shared that our history is full of moral inconsistencies, epitomized by Thomas Jefferson. Jefferson famously wrote that “all men are created equal,” and yet he also owned 600 enslaved Black men, women, and children and wrote that enslaved people lacked the emotional capacity to love and the acumen to create art or beautiful things.

Dr. Smith also shared his experiences chatting with individuals at historical sites around the country. In these conversations it became apparent that for many people in this country history is not about the review and interrogation of original sources (e.g., the Declaration of the Confederacy). Instead history is about the stories they are told. The more complicated, complex story of this country challenges some people's sense of the country and sense of self. 

While many fields, such as public health training, focus primarily on the present and ignore the past, this needs to change. We need a shared understanding of the country we live in, as well as the history of the systems and structures within in order to advance health, racial equity, and racial justice.

Structural Racism & Reparations 

As a prime example of this, Trevor Smith, the Director of Narrative Change of Liberation Ventures, moderated a panel discussion on strategies for closing the Black-White wealth gap. Panelists included Dr. William Darity Jr., Professor at the Samuel DuBois Cook Center on Social Equity at Duke University; Dr. Seft Hunter, Director of Black Led Organizing and Power Building at Community Change; and LaDon Love, Executive Director of SPACEs In Action. 

The panelists discussed the history and policies that led to existence and expansion of the Black-White wealth gap, policies that disproportionately benefited white individuals and families while oppressing Black individuals and families. Beyond slavery, numerous federal policies were purposefully implemented in discriminatory ways to ensure benefits accrued primarily, or solely, for white Americans, including the Homestead Act of 1862, New Deal policies of the 1930s, and the GI Bill for WW2 veterans. There were also policies of inaction that led to the hundreds of massacres resulting in the tremendous loss of Black lives and stealing of Black properties and goods.

With the understanding that the historical policies that led to the development of the Black-white wealth gap were primarily federal comes the understanding that the solutions require federal action. During the discussion Dr. Darity outlined the extent of the wealth gap with estimates ranging widely depending on how it is calculated, with a mean difference between Black and white households of $840,000. Based on this estimate, the total cost to close the wealth gap is somewhere between $14 and $15 trillion. While action at the community and local level is meaningful and important, only the federal government has the capacity and funding to right these historical wrongs and close the wealth gap, moving from disparity, to equity, to justice.

The Future of Research & The Role of Researchers

As expressed by Dr. Alonzo Plough, RWJF Chief Science Officer and Vice President of Research-Evaluation-Learning, achieving health equity requires a different kind of research and different kinds of researchers. This will involve an interrogation of the canons of research, which will have to change to develop the kind of knowledge base we need to provide actionable evidence to change systems and policies. Dr. Plough went on to say that the “real missing piece in knowledge is robust community-driven knowledge building.” 

Dr. Plough then raised questions for thought: how do we bring knowledge to action to identify and address the drivers amplifying the inequitable impacts of structural racism. What are ways to bring community voice into the policy and research discourse in a more actionable and equitable way? What do we have to do on the academic and research side to disrupt the publication process to make journal publications more accessible? What can we do to open up journals to have a broader base of understanding?

We also heard from a panel of researchers, Mariana Arcaya, DSc; Rachel Hardeman, PhD, MPH; Xavier Morales, PhD; and Brian Smedley, PhD, on the work they’re doing to interrogate research practices to move toward antiracist research. Dr. Hardeman said it best, when she mentioned that we need to think about how we want to change and shift the paradigms in our fields - we have to start from the ordinariness of racism that’s baked into our society in so many ways that we don’t think about. Dr. Arcaya shared the process that her department at MIT went through to come to a common understanding of what it would mean to conduct antiracist research in urban studies and planning. 

Dr. Smedley highlighted that research alone is not going to achieve health and racial equity – we need to connect research strategically with advocates and equity campaigns. In a similar vein, Dr. Morales also highlighted the need to be action-oriented, to be intentional about putting together multiracial teams and including power building organizations, to build healthy communities by transforming power structures and help them address the issues that are most important to them in a sustainable way. 


There are some things we can do as individuals and organizations to bolster our work to advance health and racial equity in the US. While working in the present and looking to the future, we also need to recall how past policies and injustices have shaped the contexts in which we all live, work, play, and learn. And we need to carefully interrogate approaches to research, knowledge creation, and dissemination of findings. I want to end with something Dr. Smith shared – his hope that many more academics, historians, and social scientists will contribute to the public discourse and that academic institutions will value and prioritize knowledge creation more broadly. He went on to say that there should be more researchers in those spaces because there's so much brilliance, so much knowledge, that can be shared. 

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Steph Chernitskiy is the Evidence for Action (E4A) Communications Manager and a frequent contributor to the E4A Methods Blog. 

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