Racial equity

Special collection

Racial equity can be defined as "the condition that would be achieved if one's race identity no longer influenced how one fares." (from "Awake to Woke to Work: Building a Race Equity Culture" by Equity in the Center). This collection focuses on racial equity and also includes works that explore the larger diversity, equity, and inclusion (DEI) framework. Our aim is to raise awareness about funding for racial equity efforts as well as activities in the social sector meant to realize racial equity. The collection is part of Candid's Funding for racial equity special issue website.

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Centering Racial Justice to strengthen the Public Health Ecosystem

December 15, 2022

The public health field experienced a collective "moment" in 2020, declaring racism a public health crisis in cities, counties, and states across the country. However, since then, too many have slipped back to "business as usual." The new report Centering Racial Justice to Strengthen the Public Health Ecosystem: Lessons from COVID-19 from Prevention Institute and Big Cities Health Coalition calls on us all to reignite our collective commitment to bold transformational change rooted in equity and racial justice.

Understanding Training and Workforce Pathways to Develop and Retain Black Maternal Health Clinicians in California

May 16, 2023

Despite evidence that greater diversity in health professions increases quality of care, the maternal health field has made little progress on increasing and sustaining the number of Black maternal health care workers. In this study, Urban researchers examine opportunities for and barriers to increasing the workforce of Black obstetrician/gynecologists (OB/GYNs), labor and delivery (L&D) nurses, and midwives, especially in light of the ongoing US maternal health crisis. Through interviews with Black maternal health clinicians and training program staff, we recommend actions that federal and state policymakers, leaders at higher education and health system institutions, and philanthropies can take to address structural barriers to entering and staying within the field and to support a thriving workforce.

Antiracist Institutional Change in Healthcare

March 30, 2023

COVID-19 and the 2020 wave of racial justice demonstrations in the United States moved many healthcare organizations to enact antiracist change goals. Yet, many of these commitments lacked effective strategies and accountability mechanisms. The Institutional Antiracism and Accountability (IARA) Project, situated within the Ash Center for Democratic Governance and Innovation at Harvard Kennedy School, conducted a one-year study of existing antiracist interventions in healthcare organizations and a review of authoritative evidence for institutional accountability.

How Recognizing Health Disparities for Black People is Important for Change

February 13, 2023

February 1st marked the beginning of Black History Month. The 2023 theme for Black History Month is Black Resistance, an exploration of how African Americans have nurtured and protected Black lives, and fought against historic and current racial inequality. In fact, while Black people have made great contributions and achievements in the United States, they continue to face many health and health care disparities that adversely impact their overall health and well-being. These disparities have been exacerbated by the uneven impacts of the COVID-pandemic, ongoing racism and discrimination, and police violence against and killings of Black people. Moreover, the long history of inequitable health outcomes among Black people reflects the abuses faced during slavery, segregation, mass incarceration and their persistent legacies.

Behavioral Health in Ohio: Improving Data, Moving Toward Racial & Ethnic Equity - Report 1: An Overview of Opportunities

January 18, 2023

This report, the first of four, highlights the need for more comprehensive behavioral health data describing the experiences of marginalized racial and ethnic groups. These groups, generally, have worse outcomes in terms of behavioral health than the White population. However, the existing data are not detailed enough to fully address the disparities.

Listening to Black Californians: How the Health Care System Undermines Their Pursuit of Good Health

October 4, 2022

California, home to the most culturally diverse population in the country and the fifth largest Black population of any state, has a major opportunity to be a leader in health equity. But, again and again, research has shown that racism and structural barriers in the health care system prevent Black Californians from achieving the health they actively seek.Long-standing racial and ethnic health disparities laid bare by the COVID-19 pandemic, coupled with the powerful demonstrations against police violence catalyzed by the murder of George Floyd, prompted CHCF to investigate the relationship between racism and health care that leads to unacceptable health outcomes for Black Californians. To identify solutions for dismantling persistent health inequities, CHCF engaged EVITARUS, a Black-owned public opinion research firm in Los Angeles, to conduct qualitative and quantitative research that listens deeply to Black Californians talking about their experiences with racism and health care.Listening to Black Californians is one of the largest studies focused on the health care experiences of Black Californians to date. The qualitative phases, conducted from June to December 2021, included in-depth interviews with 100 Black Californians and 18 focus groups consisting of Black Californians and key health care stakeholders. The interviews and focus groups informed the content of a statewide survey, conducted from March to May 2022, and completed by 3,325 adult Black Californians recruited to reflect the population based on the 2020 US Census and 2019 American Community Survey.

How Student Debt Harms Black Borrowers’ Mental Health

July 28, 2022

Approximately 45 million Americans carry $1.7 trillion in student loan debt, but the financial challenges facing Black borrowers are numerous. Black students are more likely to borrow, borrow more, and are more likely to struggle with repayment than their peers, because they collectively have fewer resources due to the generational and ongoing effects of structural racism. This debt burden has far-reaching financial consequences, and research also shows that student debt contributes to poor mental health. In fact, the toll of student debt on people's mental health can be just as devastating as the financial harm it can cause.Drawing on survey responses from our National Black Student Debt Study, this brief describes how student debt has affected Black borrowers financially and mentally—with 64% of survey participants reporting that student debt negatively impacted their mental health.

Sex, Race, and Politics in the U.S.: A Call to Action to Address Racial Justice in Sexuality Education

June 15, 2022

Sex education is not exempt from the evil of systemic racism and white supremacy woven in American Society. In fact, the mythology of white supremacy is based on an idealized goal of the United States (U.S.) as a white nation state that exerts population controls to maintain power over racial and ethnic minority groups through political, economic, and social dominance.State departments of education, individual school districts, and even sex educators themselves must update their sex education provisions and curricula to ensure comprehensive sex education programs utilize a racial justice lens. This will support young people in developing a shared understanding of how racial stereotypes distort public perceptions of sexuality and impact the lived experiences of POC in America. These steps must be taken in order to create a shared responsibility to resist these stereotypes and the racist behaviors and public policies that perpetuate them.Thus, the purpose of this publication is to offer a rationale and a call to action for creating anti-racist sex education programs that purposefully abandon any "color-blind" approaches to sex education. This resource includes: a timeline of historical experiences of racism; an exploration of the formation of racialized sexual identities and how the sexualization of race was used to suppress and impact marginalized communities including Black, Native American or Indigenous, Asian American, Pacific Islander, and Latinx communities; ways that systemic racism has impacted the classroom and student experiences of sex education; and, finally, examples of how sex educators can incorporate anti-racist lessons into programs in alignment with the National Sex Education Standards (NSES), second edition.

Exposing Hate: The Truth About Attacks on Our Kids, Schools, and Diversity

May 6, 2022

Despite decades of research demonstrating the positive outcomes associated with comprehensive sex education (CSE), there is a small international movement that is well-funded, fear-mongering, and vocal in its opposition to not only advancing this widely supported instruction, but is also starting to attack other school-based programs to affirm the increasing diversity of today's youth. This report reveals the ways in which the anti-CSE movement has morphed with other far-right groups to organize against inclusive programs in public schools, and explores how advocates can best work against these efforts.

Black Women’s and Birth Workers’ Experiences of Disrespect and Abuse in Maternity Care: Findings From a Qualitative Exploratory Research Study in Atlanta, Georgia

April 19, 2022

Public health research has generated increasingly sophisticated theories and methods for linking the biological to the social, and for understanding how historical and current forms of discrimination, trauma and injustice find expression in health outcomes. Stark racial disparities in maternal mortality and severe maternal morbidity are particularly appropriate for this exploration because women's sexuality and reproduction has always been a crucial battleground for social control of disadvantaged groups, for assertions of biomedical dominance and professional hierarchies, and for humiliation—and selective celebration—of individuals to further promote specific gender and racial ideologies.Yet, simultaneously, women's sexuality and reproduction has also provided the setting for women to assert their personhood, express their community and cultural solidarity, and define and demand their political and social citizenship. Over the last four decades, women of color have built social movements to link this profound understanding of the personal and political meaning of reproduction to the wider struggle for social justice across a broad range of social institutions where racism finds different forms of expression–schools, police and courts, voting rights and political representation, media and social discourse. The recent surge of attention to what advocates, scholars, politicians and journalists now routinely call the "Black maternal health crisis" helps to create an important opportunity for research to link to action, indeed for research to be action.This report is just one step towards recognition of the role of racism in maternal health. It describes findings from an exploratory, qualitative research study of Black women's experiences during pregnancy and childbirth in Atlanta, which was conducted in 2018 in partnership between Black Mamas Matter Alliance (BMMA), the Averting Maternal Death and Disability (AMDD) program of Columbia University Mailman School of Public Health, Center for Black Women's Wellness (CBWW), and other local community-based organizations. This was part of a larger study conducted in New York City in 2017 (Freedman et. al., 2020). Specifically, the study in Atlanta sought to understand Black women's perceptions of the disrespect and abuse they experienced during pregnancy and childbirth. By focusing on disrespect and abuse during childbirth, the study links to a wider global movement that is mobilizing around the concept of respectful maternity care (Armbruster et. al., 2011). It also constitutes initial steps in pursuit of a wider agenda led by BMMA and women of color organizations that seek to transform knowledge and how it is generated, and by doing so, build power and shift culture, bending the arc of history toward social justice (Aina et. al., 2019).

Increased Access to Doulas, Midwives and Birth Workers is Key to Improving Michigan’s Black and Indigenous Pregnancy-Related Health Outcomes

April 11, 2022

Michigan has one of the highest death rates among Black pregnant people in the country. Black and Indigenous Michiganders live with reduced access to health care, fewer financial resources, less access to stable housing, and more food insecurity. During pregnancy, these harms are compounded by providers and institutions that devalue their lives. This compounded harm underlies the increased risk of pregnancy-related deaths and complications in Black and Indigenous communities. Medically, pregnancy-related deaths are frequently attributed to blood loss, infection, or heart complications, and pregnancy-related complications are attributed to high blood pressure and blood loss. However, these outcomes reflect systems and institutions that fail to provide Black and Indigenous people with comprehensive, high-quality care. Increasing access to doulas, midwives and birth workers would significantly improve Michigan's Black and Indigenous pregnancy-related outcomes.

Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance

November 17, 2021

In this report, we evaluate health equity across race and ethnicity, both within and between states, to illuminate how state health systems perform for Black, white, Latinx/Hispanic, AIAN, and Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations. Our hope is that policymakers and health system leaders will use this tool to investigate the impact of past policies on health across racial and ethnic groups, and that they will begin to take steps to ensure an equitable, antiracist health care system for the future.