Some time ago, I became disengaged from employ implementation science because the tool did not include anti-racist praxis. While attending a webinar recently, I was struck by the fact that I consciously chose to avoid a method because of its
lack of ability to address racism instead of ensuring I addressed I racism while employing this tool.
As a researcher who understands racism ubiquity and its pervasiveness in every facet of society, I was reminded that while I know this information, the challenge is remembering and identifying how to apply it in all of the potential areas of health services research. Even as an “anti-racist researcher” I am in the process of unlearning some of the rhetoric taught throughout my formal education – that Africana studies, women and gender issues, and health disparities work is nice and narrow bodies of research, thus limiting its broader application to “the” science. What I am now contemplating is how can I use a social and structural determinants of health framework for everything? How can this overarching framework guide any work I do whether it is for Black communities, other communities of color, or the majority?
I return to the simple truth provided by other scholars that we are all harmed by racism, discrimination, gender inequities, classism, and the other interlocking systems of oppression that impede people’s ability to attain optimal health. Whether people acknowledge the harms that structural barriers cause, there are multiple disciplines that show how society is much worse off when oppression, control, and domination are the status quo.
A key part of my evolution as a researcher is constantly asking, how does this address issues of inequity? How does this acknowledge and address structural and underlying causes of poor health and disparities? Why does this method, framework, perspective, approach, omit these known and pervasive aspects of the human life and the social context?
Many scholars are in the process of unlearning epistemologies that promote stratified knowledge production. As one continues the process, they learn that scientific practice is driven by individuals who may be implicitly or explicitly invested in perpetuating false narratives or ill-equipped to interrogate the sociocultural and political implications of the work they produce. Thus, a priori inclusion of health equity frames and approaches can mitigate the exclusion of the ways in which structural inequities change how opportunities and interventions are distributed and experienced by communities.
Thus, in my quest to ensure health equity, I have to remember to use a health equity lens always and do the work to further its broader application in research.