At this year’s Urban Health Summer Institute, the Urban Health Collaborative (UHC) is thrilled to be able to host a new course taught by Dr. Jourdyn Lawrence, Assistant Professor of Epidemiology at the Dornsife School of Public Health, Affiliate Faculty with the UHC, and winner of the Drexel Golden Apple teaching award.
Studies have shown that framing certain issues that might seem controversial to the public as a public health issue, such as climate change, can better communicate the necessity to find a solution.
Race, Racism, & Health: From Theory to Praxis provides public health practitioners with the ability to take the conceptual character of racial inequality, translate it into practical ways to address it, and frame solving the issue as a public health imperative.
We had the opportunity to speak with Dr. Lawrence about the course, and her thoughts on the approach as a whole:
How is racial inequality a public health issue? What can the fields of epidemiology and urban health teach us about addressing racial inequality?
In its simplest form, public health is fundamentally concerned with understanding the conditions in which people live and how this shapes their health. Understanding aspects of our society (societies) that result in persistent systematic differences in the ability to do so is baked into our role. The patterns of adverse health that we see as public health practitioners, researchers, etc., are not random or due to chance. Marginalized communities face structural barriers that are a central problem to advancing public health and health as a human right if they remain unaddressed.
Racism shapes who gets sick, who receives care, who survives, and who can access health-promoting resources to shape their self-defined version of a healthy life. This unequal playing field results in adverse health impacts at scale. Members of marginalized communities die younger on average. They develop chronic diseases earlier and experience inequities in time to be seen or diagnosed.
By shaping every domain relevant to health, racism is a cross-cutting issue. It shapes housing access and neighborhood conditions, access to public transit and a social safety infrastructure, wealth and employment, environmental exposures, and on and on. The need to discuss and focus on racial inequality requires an understanding of history and how things came to be, but also efforts to understand, identify, and challenge the social, economic, and political systems that structure the world in which we pursue health. Whether across institutions, between individuals, or implicitly, racism fundamentally shapes the causes of disease and ultimately how people can live and fully enjoy their lives.
What methods has your experience as a researcher taught you to be successful in addressing racial inequities outside of the classroom? Will students be able to learn any of these from this course?
The framing of the course itself is critical, especially in a time like now, because the dominant narrative still presents racial inequities in health as due to individual behaviors, “cultural” factors, or as inevitable, unmodifiable realities. In the class, we’ll acknowledge the roots of this and move to understand how these inequities are produced, how we measure the drivers of these inequities, and how we can contribute our skills to ongoing efforts to intervene in very real ways.
In preparing the course, I’ve drawn on my lived experience, formal training, and collaborative experiences using one aspect of my research on reparations. Throughout the week, we’ll draw on aspects of this collaborative work as a case study/framework in which we can apply each concept covered each day: history & theory, research, praxis, and planning. I’ve been fortunate to not only conduct research that investigates how race-conscious social policies, like reparations, can mitigate harms experienced by Black communities, but also to serve as the Health and Wellness Coordinator on Philadelphia’s Reparations Task Force. In this capacity, I was able to support the work of activists in Philadelphia that culminated in a task force focused on documenting harms and developing potential repair mechanisms for Black Philadelphians. This was work done with folks from Philadelphia, who shared their expertise, resources, ideas, etc., that helped center health as a critical metric of the performance of a reparative proposal and an area where much acknowledgement and repair are needed.
A key part of the course still focuses on how we measure and document racial inequities in health and the structural factors that shape them; however, we also focus on how to move these findings to action that we can take alongside organizations, community leaders and activists, and scholars, who have been deeply engaged in this work, who have been developing responses and challenging these systems despite the pervasive structural inequities.
What are some key tools that students and practitioners will be able to walk away with to address the issue in their own careers?
There are several tools that we’ll explore and become familiar with throughout the course. I wanted to ensure that the course allowed those attending it to leave with a practical toolkit that could be applied in different settings. Ultimately, a set of resources that keep us oriented toward racial health equity.
We’ll assess and use equity evaluation tools, such as Racial Equity Impact Assessments, to examine how different communities could be affected by policies or practices. We’ll develop a critical lens for data literacy, structural analysis & harm report development, health communications, and identifying communities/organizations, policies, etc., already involved in this work and what systems (or institutions) shape these structural barriers to health equity.
A key takeaway that is central to the course itself is that we can and should be involved in conversations and praxis that move our findings beyond the page, and in these efforts, we must ensure that our work and solutions are community-led and community-desired. There are people who have been existing, writing, thinking, acting, long before we’ve come into these spaces, and that must be respected as we lend our skillsets to further these efforts.