Racial Inequality Research Articles

Decolonisation is not even a footnote: On the dominant ideologies and smokescreens in South African higher education

The turn to democracy in South Africa brought hope for a higher education sector that would play a key role in tackling racial inequalities and injustices. However, transformation promises ended up being largely smokescreens for maintaining entrenched racist and capitalist logics rooted in colonialism and apartheid. Instead of focusing on epistemic decolonisation, universities became commodified and commercialised neoliberal enterprises focused on the maintenance of Eurocentric epistemic hegemony. In this conceptual article framed within the decolonial theoretical framework, we critically interrogate how two dominant ideologies – the Rainbow Nation and neoliberalism – have sidelined fundamental transformation and epistemic decolonisation in South Africa. Focusing on the Department of Higher Education and Training’s Strategic Plan 2020–2025, we illustrate that decolonisation is not government’s priority and that neoliberal visions continue to dominate strategic planning for higher education. We argue that the lack of political will and policy alignment from the government will contribute to the further entrenchment of coloniality, Eurocentricity and neoliberal logics at universities. We conclude with the call for critical engagement with the history of universities and their role in propagating and supporting colonialism and apartheid and argue that progressive scholars and students must continue to organise within South Africa and beyond and work on the radical dismantling of the Eurocentric and neoliberal universities.Contribution: While other scholars have engaged separately with neoliberalism and the Rainbow Nation and their impact on higher education in South Africa, in this article, we bring these two ideologies together to show how they have combined to prevent decolonisation of higher education.

Assessing spatial and racial equity of subway accessibility: Case study of New York City

Enhancing the utility of public transportation through easy and equitable access has become one of the focal points in the pursuit of social justice goals. This study aims to provide a comprehensive analysis of equitable access to the subway system in New York City (NYC) based on geography and race/ethnicity, shedding light on the complex relationship between transportation equity, racial diversity, and urban dynamics. New York City is selected as the case study due to its diverse demographic makeup, extensive public transportation system, and paucity of previous research on the racial justice dimensions of its subway system. Gravity index is employed to investigate the accessibility of the NYC subway system in terms of distance from stops and the frequency of service while equity is analyzed by Gini coefficients and Lorenz curves. To conduct this analysis, American Community Survey (ACS) data and The General Transit Feed Specifications (GTFS) are used. The findings reveal that accessibility to the subway system varies across New York City's outer boroughs, with Queens, the largest borough by area, notably standing out due to its limited availability of subway stations. Moreover, the study uncovers stark racial disparities in accessibility within boroughs, with the non-Hispanic Black community in Queens (which represents 17 % of the borough's population) facing a pronounced lack of easy access to subway stations. These insights underscore the urgent need for targeted interventions and policy reforms to address the identified disparities. Policymakers and transportation planners should prioritize initiatives such as increasing subway infrastructure in underserved areas, improving the frequency of service, and enhancing connectivity to reduce racial and spatial inequities in subway accessibility.

Neoliberalism and the Complexities of Conceptualizing Community School Policy for Racial Equity

Full-service community schools are increasingly adopted as educational policy nationwide to transform educational institutions into community hubs, addressing racial and social disparities and countering deficit narratives related to marginalized youth and families. As the movement toward community schooling as an educational policy gains momentum, more research is needed to understand the complex process of conceptualizing such an initiative for racial equity. Spanning from the early planning stages to 3 years into the implementation of community schooling, this paper uncovers the tensions that emerge as school and district leaderships’ interpretation of the purpose of community schooling and root cause of racial inequity unveil conflicting conceptualizations of the community school initiative: community schooling rooted in neoliberal ideals of efficiency, coordination, and service choice, on one hand, and those rooted in more transformative approach with systemic reflection and change in classrooms, schools, and other institutions on the other.

Racial Inequities in Receiving Neoadjuvant Treatment in Patients With Pancreatic Cancer Are Associated With Worse Outcomes in Louisiana.

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths. In recent years, the approach to managing this malignancy has evolved toward embracing neoadjuvant treatment (NAT), backed by studies reporting its survival benefit. This study aimed to identify factors that contribute to disparities in NAT utilization and their impact on outcomes in patients with PDAC who underwent resection in Louisiana. Data on diagnosed PDAC cases were obtained from the Louisiana Tumor Registry between 2000 and 2020. We conducted multivariable logistic regression to adjust for potential confounding factors in assessing the covariate relationships with NAT use. Multivariate Cox regression analysis was performed to determine which factors were associated with survival. Chained multiple imputation was performed on covariates with missing data in multivariable regressions. The study encompassed 2121 patients who underwent resection for PDAC. Upon controlling for potential confounding variables, Black patients were on average 5.7% less likely to receive NAT than their White counterparts (ATE = 5.7, aOR= 0.56, 95% CI = 0.40-0.80, p = 0.001). After adjustment for confounding factors, there was a significant decrease in the risk of overall death for patients who received NAT (aHR = 0.82, 95% CI = 0.71-0.94, p = 0.006). There was no significant interaction between race and NAT for the risk of death. Black patients with PDAC were less likely to receive NAT before resection in Louisiana. Overall survival improved in patients who underwent NAT. These differences were independent of insurance status and poverty zip codes, and future investigations should identify modifiable barriers to access and receipt of NAT in patients with PDAC.

Effect of same-sex marriage legalisation on the health of ethnic minority lesbian, gay and bisexual people: a quasi-experimental study

BackgroundThe UK legalised same-sex marriage in 2014. We examine whether same-sex marriage legalisation (SSML), an exogenous policy change, affected the health outcomes among ethnic minority lesbian, gay, bisexual and other...

Understanding the Implementation of Law 10.639/03 through Aspects of Brazilian Society and the Education System

ABSTRACT This manuscript analyzes the development of African studies in Brazil in the context of the implementation of Law 10.639/03, enacted in January 2003, which constituted an important step for teaching about Africa and the African diaspora in schools. We will present information that helps to understand key characteristics of Brazilian society, using data provided by the Instituto Brasileiro de Geografia e Estatística, with a focus on the functioning of the Brazilian educational system. In this context, it is important to highlight the role of public measures implemented in the 2000s that facilitated a more democratic education and addressed racial and social inequalities. Central to this agenda is the understanding of the implementation of Law 10.639/03, which mandated the teaching of African history and Afro-Brazilian peoples’ history throughout the country’s basic education system. The impact of this law was extensive and also affected higher education, which had to adapt to train professionals capable of implementing this mandate. However, as we argue, it is not possible to understand Law 10.639/03 in isolation; it must be studied in conjunction with other public policies, considering the Brazilian educational system and the societal interest in learning more about African history.

“Our American Optimism”: Race, Recognition, and Belonging in Claudia Rankine’s Don’t Let Me Be Lonely: An American Lyric

This paper explores Claudia Rankine’s representation of the feelings of racialisation in her 2004 poetry collection Don’t Let Me Be Lonely: An American Lyric. Contextualising this work within wider debates in Afropessimist philosophy, it considers how the poet’s portrayal of emotional pain, depression, and numbness exemplify a form of ‘social death’ instigated by the ubiquitous violence of antiblackness. Through close readings of select sequences, it argues that Rankine frames death as an ongoing structure of African American experience, rather than a singular event. In turn, this paper also considers how her innovative and hybrid “American Lyric” form functions to create a new grammar for Black self-expression in an ostensibly ‘post-race’ culture that obfuscates contemporary systems of racial inequality. It argues that Rankine’s collection cultivates an ethics of attention to the experiences and pain of others, offering poetry as a form of “exhausted hope” to challenge the dehumanising force of White supremacy.

Incorporating multiracial and multiethnic experiences into genetic counseling practice and research: A necessary opportunity.

The conflation of race and genetic ancestry can have harmful consequences. Biological conceptualizations of race have long been used to justify inequities and distract from social structures that afford opportunities to some that are unjustly denied to others. Despite recent efforts within the scientific community to distinguish between the sociopolitical constructs of race and ethnicity and the biological constructs of genetic ancestry and genetic similarity, their conflation continues to influence genomic research and its translation into clinical care. One overlooked aspect of this problematic conflation is the extent to which discrete monoracial and monoethnic categorization systems persist and perpetuate unequal benefit-sharing in the clinical translation of genomic technologies. In genetic service delivery, reliance on discrete racial and ethnic categories undermines the clinical translation of genomic technologies for large segments of the global population. For multiracial and multiethnic individuals, who have complex identities that defy discrete categorization systems, the potential benefits of genomic discoveries are especially elusive. Scholars have recently begun to call for the inclusion of multiracial, multiethnic, and admixed individuals in race, ethnicity, and ancestry frameworks in genetics and genomics. However, little work has been done to explore and address the unique challenges and opportunities posed by multiracial/multiethnic individuals in genetic counseling specifically. We discuss how conceptualizing diversity along discrete racial and ethnic lines perpetuates inequitable patient care and limits efforts to increase inclusion and belonging within genetic counseling. Moreover, we argue that ongoing efforts to mitigate racial inequity must actively challenge the paradigm of monoracial and monoethnic categories to accomplish their goal.

Beyond the Demographics of the Special Education Workforce: Developing Intersectional Competence to Sustain Teachers of Color

This case demonstrates how school administrators’ development of intersectional competence can disrupt racial inequity in special education. Intersectional competence refers to educators’ preparedness to recognize how schooling is implicated in multiple, intersecting systems of oppression, collaborate with relevant stakeholders who themselves navigate multiple social marginalizations, and consider sociocultural differences while making instructional decisions. Examining how federal legislation approaches racial disparities in special education and its emphasis on personnel preparation for students with disabilities, the authors argue that recruiting, preparing, and sustaining racialized teachers is more complex than simply focusing on their racialized identities.

Exploring everyday racist symbolism in community recreation spaces: a critical race content analysis

ABSTRACT There has been a palpable shift in the public’s collective consciousness about the realities of racism in recent years. Community recreation organizations, like all other institutions, are not exempt from promoting racial inequity through taken for granted policies and practices. The purpose of this study was to explore some of the racist symbolism found within everyday artifacts at local community centres in a sub-urban area of Ontario, Canada. A Critical Race Content Analysis methodology was used to analyze bandages, promotional materials, and sunscreen. This study found that bandages in first aid supplies were exclusively for White skin tones, images in promotional materials featured mostly White people, and the sunscreen products stocked were not made for dark skinned folx. A discussion on the implications of each finding is provided followed by limitations and recommendations for research and practice.

Death of a Parent, Racial Inequities, and Cardiovascular Disease Risk in Early to Mid-adulthood.

Black Americans experience the death of a parent much earlier in the life course than White Americans on average. However, studies have not considered whether the cardiovascular health consequences of early parental death vary by race. Using data from the National Longitudinal Study of Adolescent to Adult Health, we explore associations between early parental death and cardiovascular disease (CVD) risk in early to mid-adulthood (N = 4,193). We find that the death of a parent during childhood or adolescence (ages 0-17) or the transition to adulthood (ages 18-27) is associated with increased CVD risk for Black Americans, whereas parental death following the transition to adulthood (ages 28+) undermines cardiovascular health for both Black Americans and White Americans. These findings illustrate how a stress and life course perspective can help inform strategies aimed at addressing both the unequal burden of bereavement and high cardiovascular risk faced by Black Americans.

The Problems (and possible solutions) of assessing risk, race and recidivism in long operating drug treatment courts

Formal criminogenic risk tools can be an important control in assessing racial inequities in access to treatment courts and in evaluating both proximal and distal outcomes from those programs. To achieve this potential, however, it is important that risk tools themselves operate in a racially neutral fashion and that they operate consistently over the period assessed. Tools that are not properly calibrated by race and changes in the tools used over the life of a program are therefore significant evaluation concerns. Our paper is the first to assess the adequacy of an important risk-needs instrument, the LSI-R, across racial groups in a drug treatment court setting. The main contribution of the current study is not as a test of that instrument, which has been widely studied in other settings. Rather, because two different criminogenic risk tools were used over the study time period, we took this opportunity to explore the use of a readily constructible “proxy” measure of risk to support analysis of risk and race interactions over the life of the program.

Living less safely through the pandemic in England for people with serious mental and physical health conditions: qualitative interviews with service users and carers of Black African, Caribbean, and South-Asian descent.

COVID-19 Ethnic Inequalities in Mental health and Multimorbidities (COVEIMM) is a mixed methods study to explore whether COVID-19 exacerbated ethnic health inequalities in adults with serious mental and physical health conditions. We analysed data from electronic health records for England and conducted interviews in Birmingham and Solihull, Manchester, and South London. Sites were selected because they were pilot sites for the Patient and Carer Race Equality Framework being introduced by NHS England to tackle race inequalities in mental health. Prior to the pandemic people in England with severe mental illnesses (SMIs) faced an 11-17-year reduction in life expectancy, mostly due to preventable, long-term, physical health conditions. During the pandemic there was a marked increase in deaths of those living with an SMI. This qualitative interview study aimed to understand the reasons underlying ethnic inequalities in mortality and service use during the COVID-19 pandemic for adult service users and carers of Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi backgrounds living with serious multiple long-term mental and physical health conditions. We took a participatory action research approach and qualitative interviews undertaken by experts-by-experience and university researchers Participants were purposively sampled by ethnicity, diagnoses, and comorbidities across three geographically distinct sites in England. Transcriptions were coded inductively and deductively and analysed thematically. Findings indicated multiple points along primary and secondary health pathways for mental and physical health that have the potential to exacerbate the unjust gap in mortality that exists for Black and Asian people with SMIs. Issues such as timely access to care (face-to-face and remote), being treated in a culturally appropriate manner with empathy, dignity and respect, and being able to use services without experiencing undue force, racism or other forms of intersectional discrimination were important themes arising from interviews. These poor experiences create systemic and enduring healthcare harms for racialised groups with SMIs that need to be addressed. Our findings suggest a need to address these, not only in mental health providers, but across the whole health and care system and a need to ensure more equitable healthcare partnerships with service users, carers, and communities from racialised backgrounds who are often excluded.

Regeneration, predatory inclusion, and migrant experiences in declining rural areas in Spain and Germany

ABSTRACT Declining rural areas have become central sites for migrant settlement. In the hope that migration will counteract rural shrinkage, migrants are increasingly portrayed as catalysts to revitalize communities. This article critically examines migration to declining rural areas vis-à-vis rural reception and regeneration policies. Drawing on qualitative research including interviews, focus group discussions, and participant observations, we compare migrants’ settlement experiences and their positions in rural revitalization processes in northeast Spain and eastern Germany. Our research illustrates that local reception and regeneration policies do not only sideline the role of newcomers as rural place-makers, who contribute to the sustainment (or expansion) of local services and infrastructures. They also result in conditions of ‘predatory inclusion’, in which migrants’ settlement is shaped regarding their potential ‘use’ for revitalizing local economies and housing markets in exploitative terms and along racialized lines. Facing precarious labor and housing conditions, migrants tend to reside only temporarily in our investigated areas. This article contributes to a growing body of migration research in rural areas and explains that attempts at regeneration through migration can run the risk of ignoring migrants' structural conditions, needs, mobility aspirations and life plans, thereby reinforcing racial and class-based inequalities present in rural areas.

Overcoming the Impact of Students for Fair Admission v Harvard to Build a More Representative Health Care Workforce: Perspectives from Ending Unequal Treatment.

Policy Points In a recently commissioned report on solutions for eliminating racial and ethnic health care inequities entitled Ending Unequal Treatment, the National Academies of Sciences, Engineering, and Medicine found a health workforce that is representative of the communities it serves is essential for health care equity. The Supreme Court decision to ban race-conscious admission constraints pathways toward health workforce representativeness and equity. This paper draws on the National Academies report's findings that health care workforce representativeness improves care quality, population health, and equity to discuss policy and programmatic options for various participants to promote health workforce representativeness in the context of race-conscious admissions bans.

Centering Racial Health Equity in Systematic Reviews Paper 5: A Methodological Overview of methods and interventions

We aim to 1) evaluate the methods used in systematic reviews of interventions focused on racialized populations to improve racial health equity, and 2) examine the types of interventions evaluated for advancing racial health equity in systematic reviews. We searched MEDLINE, Cochrane and Campbell databases for reviews evaluating interventions focused on racialized populations to mitigate racial health inequities, published from January 2020 to January 2023. We analyzed 157 reviews on racialized populations. Only 22 (14%) reviews addressed racism's role in driving racial health inequities related to the review question. Eleven percent (7) of reviews considered intersectionality when conceptualizing racial inequities. Two-thirds (105, 67%) provided descriptive summaries of included studies rather than synthesizing them. Among those that quantified effect sizes, 54% (21) used biased synthesis methods like vote counting. The most common method assessed was tailoring interventions to meet the needs of racialized populations. Reviews mainly focused on assessing interventions to reduce racial disparities rather than enhancing structural opportunities for racialized populations. Reviews for racial health equity could be improved by enhancing methodologic quality, defining the role of racism in the question, usingreliable analytical methods, and assessing process and implementation outcomes. More focus is needed on assessing structural interventions to improve opportunities for racialized populations and prioritize these issues in political and social agendas.

Listen up! perspectives of people of color who use augmentative and alternative communication in the United States

Every individual has a fundamental right to communicate and access equal opportunities to fully participate in society. However, this right may not be fully manifested for individuals with communication access needs especially those from underrepresented groups. This project had two aims, to determine 1) the specific experiences, challenges, and aspirations related to the cultural identities of people of color (POC) who use augmentative and alternative communication (AAC) and 2) how AAC service providers and manufacturers can support POC AAC users in a culturally and linguistically responsive manner. We conducted an online, asynchronous focus group with seven participants over eight weeks. The participants’ responses were coded qualitatively. Seven major themes were identified: AAC is a Culture, AAC System Features, Self-Identity as a Person of Color who uses AAC, Experience with Service Providers, Improvements to the Field of AAC, Racial Inequities in AAC Support, and Future Research. Suggestions are provided regarding how service providers and manufacturers can serve as better allies to support POC who use AAC.

Centering Racial Health Equity in Systematic Reviews Paper 2: Themes from Semi-structured Interviews

ObjectiveIn the context of profound and persistent racial health inequities, we sought to understand how to define racial health equity in the context of systematic reviews and how to staff, conduct, disseminate, sustain, and evaluate systematic reviews that address racial health equity. Study Design and SettingThe study consisted of virtual, semi-structured interviews followed by structured coding and qualitative analyses using NVivo. ResultsTwenty-nine individuals, primarily US-based, including patients, community representatives, systematic reviewers, clinicians, guideline developers, primary researchers, and funders, participated in this study. These interest holders brought up systems of power, injustice, social determinants of health, and intersectionality when conceptualizing racial health equity. They also emphasized including community members with lived experience in review teams. They suggested making changes to systematic review scope, methods, and eligible evidence (such as adapting review methods to include racial health equity considerations in prioritizing topics for reviews, formulating key questions and searches, and specifying outcomes) and broadening evidence to include designs that address implementation and access. Interest holders noted that sustained efforts to center racial health equity in systematic reviews require resources, time, training, and demonstrating value to funders. ConclusionInterest holders identified changes to the funding, staffing, conduct, dissemination, and implementation of systematic reviews to center racial health equity. Action on these steps requires clear standards for success, an evidence base to support transformative changes, and consensus among interest holders on the way forward.

Applying a Health Equity Lens to Better Understand End-of-Life Prognostication.

Racial and ethnic inequity exists throughout the lifespan, including at the end of life (EOL). Although prognostication is inherently fraught with uncertainty, many underrepresented minorities get prognoses that are overly optimistic, which can exacerbate inequity by depriving patients of details needed to make informed decisions and plan for EOL care. This article applies a health equity lens to facilitate better ethical and clinical understandings of how to care for patients of color more equitably at the EOL.

Consumption of food markers of a healthy diet according to racial groups of women in Brazil.

This article aims to analyze the consumption of healthy food consumption markers, according to racial groups of Brazilian women interviewed in the 2019 National Health Survey (NHS). This work was a cross-sectional study with data from 45,148 white and black women, aged ≥ 20 years. The variables used were the consumption of fruits, vegetables and legumes, beans, and fish. The association between color/race and the dietary intake indicators was tested using crude Poisson regression and adjusted to estimate prevalence ratios and 95% confidence intervals (95%CI). The prevalence of the consumption of fruits and vegetables was statistically higher among white women, while fish and beans was higher among black women. After adjusting for socioeconomic and demographic variables, it was found that black women remained only less likely to consume fruit (PR = 0.91; 95% CI: 0.88-0.95) and only more likely to consume beans (PR = 1.07; 95% CI: 1.04-1.10) than whites. There were racial inequalities for the consumption of healthy foods among Brazilian women, indicating that color/race defined a dietary pattern for black women that put them in vulnerable conditions in terms of fruit consumption.