Racial Equity Research Articles

Artificial Intelligence to Promote Racial and Ethnic Cardiovascular Health Equity

Artificial Intelligence to Promote Racial and Ethnic Cardiovascular Health Equity

Crossroads of Care: A Black Social Worker’s Insights into the Lives of Black Men from Adolescence to Adulthood

ABSTRACT This autoethnographic study, “Crossroads of Care: A Black Social Worker’s Insights into the Lives of Black Men from Adolescence to Adulthood,” explores the intersections of race, education, and mental health throughout the life course of Black men. Drawing on varied professional and personal experiences – from providing telehealth services for college students to being a resource within a predominantly Black high school – the research illuminates systemic barriers and profound effects of marginalization and isolation. Emphasizing evidence-based social work interventions and culturally relevant care, the study underscores the importance of narrative therapy and self-disclosure in addressing Black men’s multifaceted needs. The findings contribute to discussions on racial equity in mental health and education, offering actionable recommendations for practitioners, policymakers, and educators to strengthen support systems. Advocating for a comprehensive care model, this research endeavors to empower Black men across various life milestones, enhancing well-being by addressing the complexities of race, education, and mental health.

A Path Toward Racial Justice in Education: Anti-Racist Policy Decision Making in School Districts

The U.S. education system has been a critical site in the nation’s ongoing fight for racial equity. Yet, despite many attempts to promote equity within and across schools, efforts fall short in a system designed to uphold norms rooted in whiteness and white supremacy. We need anti-racist educational leaders who can identify and push back at the racial bias embedded in educational policies. Through a research-practice partnership with a Midwestern high school, we sought to understand how an anti-racist policy decision-making protocol can be used to redress inequitable policies to be racially just. The anti-racist policy decision-making protocol promotes social justice by empowering school practitioners to become policy agents. Implications from our findings point to the need for school practitioners to be critically introspective and identify and directly address the politics of whiteness that can ensue when working in partnership to do anti-racist policy change.

“Constant dropping wears away a stone”: Chinese international women instructors’ duoethnography on advancing racial equity

Faculty of color are constantly experiencing trauma and racial inequities in inherently Eurocentric educational spaces where their histories, knowledge, and experiences are delegitimized and marginalized. Employing critical race feminism (CRF) and White racial identity development model, this article details ways in which two Chinese international women instructors grappled with tensions and trauma and celebrated (small) joys and successes within Predominantly White Institutions (PWI) in the United States. We drew on duoethnography, a dialogic methodological approach grounded in social justice, to make meaning of, (re)construct, and advance racial equity in pedagogy. We examined and analyzed four sources of data: our personal narratives, transcripts of eight Zoom meetings, reflection journals, and informal conversational exchanges. We identified three strategies for navigating dissonance and conflicts: 1) being vulnerable, 2) recognizing shared and differing marginalization or privileges, and 3) building allies intentionally and strategically.

Study protocol: a mixed-methods study of the implementation of doula care to address racial health equity in six state Medicaid programs

BackgroundRacial inequities in severe maternal morbidity (SMM) and mortality constitute a public health crisis in the United States. Doula care, defined as care from birth workers who provide culturally appropriate, non-clinical support during pregnancy and postpartum, has been proposed as an intervention to help disrupt obstetric racism as a driver of adverse pregnancy outcomes in Black and other birthing persons of colour. Many state Medicaid programs are implementing doula programs to address the continued increase in SMM and mortality. Medicaid programs are poised to play a major role in addressing the needs of these populations with the goal of closing the racial gaps in SMM and mortality. This study will investigate the most effective ways that Medicaid programs can implement doula care to improve racial health equity.MethodsWe describe the protocol for a mixed-methods study to understand how variation in implementation of doula programs in Medicaid may affect racial equity in pregnancy and postpartum health. Primary study outcomes include SMM, person-reported measures of respectful obstetric care, and receipt of evidence-based care for chronic conditions that are the primary causes of postpartum mortality (cardiovascular, mental health, and substance use conditions). Our research team includes doulas, university-based investigators, and Medicaid participants from six sites (Kentucky, Maryland, Michigan, Pennsylvania, South Carolina and Virginia) in the Medicaid Outcomes Distributed Research Network (MODRN). Study data will include policy analysis of doula program implementation, longitudinal data from a cohort of doulas, cross-sectional data from Medicaid beneficiaries, and Medicaid healthcare administrative data. Qualitative analysis will examine doula and beneficiary experiences with healthcare systems and Medicaid policies. Quantitative analyses (stratified by race groups) will use matching techniques to estimate the impact of using doula care on postpartum health outcomes, and will use time-series analyses to estimate the average treatment effect of doula programs on population postpartum health outcomes.DiscussionFindings will facilitate learning opportunities among Medicaid programs, doulas and Medicaid beneficiaries. Ultimately, we seek to understand the implementation and integration of doula care programs into Medicaid and how these processes may affect racial health equity.Study registration The study is registered with the Open Science Foundation (https://doi.org/10.17605/OSF.IO/NXZUF).

The California Community Colleges dual enrollment student journey: An equitable journey from participation to matriculation?

AbstractAcross the nation, community colleges have expanded dual enrollment programs to increase college enrollment and completion, particularly among historically underserved populations. The California Community College system—the largest system in the nation—is no different and recently expanded its dual enrollment programming to include College and Career Pathways Partnerships, in addition to Middle College High School and Early College High School. This article presents an original analysis of California Community Colleges Chancellor's Office system data to understand the dual enrollment student journey and any equity gaps that might exist in participation and outcomes, including college‐level math and/or English participation and completion, award attainment, and postsecondary matriculation. Though dual enrollment programs can be strategy to support equity, the authors find racial and regional equity gaps persist in both students’ access to these programs and their success. However, practitioners can take action to ensure it is an equitable journey at their school or college.

Planting one thousand seeds of entrepreneurs

Research methodology This case is based on secondary information and data about the Goldman Sachs One Million Black Women initiative and youth entrepreneurship programs from press releases, news articles and websites. The protagonist has been disguised. This case has been classroom-tested in a core MBA course in both face-to-face and online delivery methods. Case overview/synopsis In March 2021, Goldman Sachs launched its One Million Black Women initiative which expanded its inclusive growth goals to support Black women entrepreneurs who were under-represented and under-resourced. This initiative is one of Goldman Sachs’s sponsored programs that aid existing entrepreneurs. This program would invest $10bn over the next decade to advance racial equity, promote entrepreneurial activity and increase and economic opportunities for these highly motivated and resilient Black women. With the buzz from this initiative, Johnnetta who was a Black female manager at a financial services competitor of Goldman Sachs conceived another approach to groom and grow future generations of women of color entrepreneurs. Her idea was to implement youth entrepreneurship programs in middle schools in states with high populations of students of color. Based on a psychological theory of entrepreneurship approach, these students would learn about entrepreneurship and gain hands-on experience with starting and operating a business. The program was called “Planting 1000 Seeds of Entrepreneurs” to develop a pipeline of savvy, well-prepared future women of color entrepreneurs. Johnnetta’s dilemma was whether to pitch this new youth entrepreneurship program as an employee at her employer as a diversity, equity and inclusion (DEI) initiative or start this program as an entrepreneur of a nonprofit in which she would have sole autonomy to administer this program. This case will enable students to develop ideas into a compelling business pitch while sparking debate about approaches to foster DEI initiatives that will have impactful economic benefits for women of color entrepreneurs. Complexity academic level This case is best suited for upper-level undergraduate or graduate students taking business administration courses in management, entrepreneurship, women studies or other courses that cover topics or modules related to DEI initiatives involving women in business.

Supporting Latinx First-Generation Professionals

Institutions must adequately support Latinx first-generation professionals if we are to make significant progress in our racial equity work. While in the Educational Leadership doctoral program (CANDEL) at the University of California, Davis, my personal and academic experiences led me to conduct qualitative research on the experiences of Latinx first-generation professionals in student affairs. I sought to understand how institutional norms influenced their self-efficacy and how Latino and Latina professionals experienced them differently. Among the findings was the pervasiveness of professional invalidation and how Latina participants viewed their perceived shortcomings as personality traits, compared to Latino participants who viewed them externally and more skills based (Fuentes, 2021). These are critical findings that colleges and universities need to assess to understand how workplace norms contribute negatively to their experiences. As higher education institutions continue to work towards better serving Latinx first-generation students, Latinx-first generation professionals must not be ignored or taken for granted.

A Framework for Using Regional Scenarios in Racial Equity Planning

Problem, research strategy, and findings Planning under uncertainty and planning for racial equity both require imagination. In confronting the uncertain future, regional planners often opt for exploratory scenario planning: telling multiple future stories to prepare for any outcome. For equity planning, imagination supports vision beyond the deeply unequal present condition, wherein policy tinkering is insufficient for necessary change. And yet, scenario planning and equity planning are estranged. Although regional planners wish to engage both, they lack guidance on how. I look to close this gap by providing a framework (the Framework) for using scenarios in equity planning. The Framework builds on the five types of racial equity, a six-stage hybrid scenario process, and the three outcomes of public-sector scenarios. Using the Framework, I assessed the inclusion of equity in the Delaware Valley Regional Planning Commission’s Dispatches From Alternative Futures scenario plan. This plan successfully raises racial equity as a concern for the future of the Philadelphia (PA) region. However, the stakeholder group was not sufficiently diverse for deliberative equity and the scenario planners did not use tools that could assess the distributional outcomes. Neither epistemic nor restorative equity were a significant part of the scenario plan, leaving open the possibility for co-designed scenarios for a racial equity future. Takeaway for practice Metropolitan planning organizations (MPOs) can use the Framework to ensure that exploratory scenarios advance equity goals. Although the Framework can supply a starting point for MPOs, the most important voices are those from Black, Indigenous, and people of color (BIPOC) and other marginalized communities. Scenario planners should consider how they can reach out to community members not just as stakeholders but as co-creators of a more epistemically equitable scenario planning process, one that addresses the uncertainties and aspirations that already percolate within these communities.

Racial Equity, Diversity and Inclusion in Bioethics: Recommendations from the Association of Bioethics Program Directors Presidential Task Force

Recent calls to address racism in bioethics reflect a sense of urgency to mitigate the lethal effects of a lack of action. While the field was catalyzed largely in response to pivotal events deeply rooted in racism and other structures of oppression embedded in research and health care, it has failed to center racial justice in its scholarship, pedagogy, advocacy, and practice, and neglected to integrate anti-racism as a central consideration. Academic bioethics programs play a key role in determining the field’s norms and practices, including methodologies, funding priorities, and professional networks that bear on equity, inclusion, and epistemic justice. This article describes recommendations from the Racial Equity, Diversity, and Inclusion (REDI) Task Force commissioned by the Association of Bioethics Program Directors to prioritize and strengthen anti-racist practices in bioethics programmatic endeavors and to evaluate and develop specific goals to advance REDI.

Racial and Ethnic Equity, Diversity, and Inclusion in Pediatric and Adolescent Gynecology: A Call to Action From a North American Perspective

Racial and Ethnic Equity, Diversity, and Inclusion in Pediatric and Adolescent Gynecology: A Call to Action From a North American Perspective

Gender and racial price disparities in the NFT marketplace

This paper empirically investigates the causal impact of avatar gender and race on transaction prices within the Non-Fungible Token (NFT) marketplace. The impetus behind this investigation is grounded in the observation that NFT investors frequently represent a younger, wealthier, and politically progressive demographic, which raises the question of whether this marketplace is less susceptible to prejudice and social bias. Contrary to such expectations, our analysis reveals pronounced gender and racial disparities in NFT prices. Specifically, female CryptoPunks avatars are transacted at a 36.8% lower price compared to their male counterparts (i.e., avatars with similar image attributes), while black CryptoPunks avatars are transacted at a 30.7% lower price compared to their white counterparts. We further identify that avatar features linked to high-tech or higher education attributes (e.g., 3D glasses, Virtual Reality glasses, Nerd glasses) can effectively counter these disparities. We verify the causal patterns revealed in the NFT dataset with a controlled experiment, where NFT buyers are randomly shown the comparable avatars that exhibit variations in race or gender, enabling us to evaluate the impact of these attributes on buyer choices and willingness-to-pay. The experiment confirms the gender (male) and race (white) price premium in the NFT market and suggests that buyers exhibit a preference for NFT avatars resembling their personal identity. We offer insights into policy strategies aimed at promoting racial and gender equity within the NFT marketplace.

Influence of Community Cultural Wealth on Undergraduate Hispanic and Black Women's Persistence in the STEM+C Workforce Pipeline

To promote racial and gender equity in the field of science, technology, engineering, mathematics, and computing (STEM+C), we investigated prominent influences on historically underrepresented minority (HURM) women's persistence in undergraduate education. With the underrepresentation of Black and Hispanic women in the computing workforce, this study focused on the experiences of this population as they persisted in their undergraduate education at a Hispanic Serving Institution (HSI) in Texas. This pilot study employed the ACCEYSS STEM+C Majors (ASCM) survey instrument and the counter-life herstory interview protocol to illuminate the community cultural wealth (CCW) factors and relevant lived experiences that influenced Black and Hispanic women's persistence in undergraduate computing education. To center justice and equity, we utilized a modified CCW framework (MCCW) as the theoretical framework to provide an antideficit understanding of how women of color access their strengths to persist in postsecondary education. The MCCW framework was modified to include spiritual capital as a critical source of fortitude and resilience in Black and Hispanic communities. Our findings highlight ways in which CCW factors influenced Black and Hispanic women's persistence in undergraduate computing education in response to better understand this population in their attainment and representation in STEM+C disciplines.

Cultural Competence in Community-Level Initiatives to Advance Racial Equity in Homeless Services

Cultural Competence in Community-Level Initiatives to Advance Racial Equity in Homeless Services

Insights into Retrofitting Fellowships in Family Planning with Principles of Equality, Race, and Cultural Literacy

The Centering Equality, Race, and Cultural Literacy in Family Planning (CERCL-FP) program aims to break racial silence and dismantle structural racism in the field of family planning, by providing racial equity workshops and trainings. ObjectiveThe objective of this study was to begin a multi-phased, rigorous evaluation to determine the impact and outcomes of the work of CERCL-FP. Study DesignA needs assessment with former graduates and current directors of fellowships in family planning was conducted using qualitative interviews. The focus of these interviews was to determine the ability, readiness, and willingness of the field of family planning to retrofit new curricula grounded in equity, race, and cultural literacy. ResultsNine (N=9) interviews were completed with seven board certified obstetrician-gynecologists and two board certified family medicine physicians. Three themes were identified: 1) Establishing the Distribution of Work; 2) The Push/Pull of Change from Inside and Outside: Curricula and Faculty Responsibilities; and 3) Reproductive Justice and Fellowships in Family Planning. Despite acknowledging the need to retrofit the field of family planning with content grounded in equity, race, and cultural literacy, there are structural, institutional, and individual level barriers that have limited the adoption of CERCL-FP curricula within family planning curriculum nationwide. ConclusionFindings from this study illuminate multiple barriers that should be considered when expanding foundational knowledge of clinicians and researchers.

Racial equity, reflection, and organizational change in museums

Racial equity, reflection, and organizational change in museums

Filling the blindspots: Assessing distributive equity in fund allocation of Florida's local housing program for disaster recovery

Despite the role of local assistance in addressing households' disaster recovery needs, few studies have examined the role of localized programs in filling the gaps that might exist in federal programs. To address the question of whether local recovery funds distribute resources to socially vulnerable neighborhoods and how local assistance fits into the broader federal disaster assistance landscape, we take Florida's State Housing Initiatives Partnership (SHIP) program as a case study. The SHIP program can help fill neighborhood-level gaps left by the Federal Emergency Management Agency's (FEMA) Individual Assistance program by aiding neighborhoods with the higher proportions of 1) those who did not receive federal assistance or 2) those who had residual damages not fully covered by federal assistance. The study finds that SHIP funds typically flow into socially vulnerable neighborhoods with a higher proportion of Black and Hispanic residents, even without specific social or racial equity measures built into program regulations. The study highlights the importance of balancing the consistency of fundamental rules and having flexibility in distributing funds.

Advancing Racial Equity with the Aquarium Conservation Partnership

ABSTRACT Historic and present-day systemic racism frequently excludes Black, Indigenous, and people of color (BIPOC) from engaging in aquarium efforts toward conservation, research, advocacy, and education. But to realize the conservation missions of aquariums—creating a more equitable and sustainable world in which people and nature thrive—we need a diversity of perspectives and voices driving adaptive, lasting solutions. In this article, the co-authors describe how a diverse coalition of U.S. aquariums is working to integrate racial justice with their conservation initiatives and to transform their sector. They outline the formation of the Aquarium Conservation Partnership (ACP) Equity Work Group, progress toward an ACP Equity Commitment, and the restructuring of ACP governance. They describe how these efforts, like equity work across the broader cultural attractions sector, have been imperfect and uncertain; but they yield lessons that may provide reassurance, encouragement, and guidance to similar coalitions committed to racial equity.

“It Has to Be the Common Thread”: Weaving Attention to Racial Equity and Justice Across Lines of Inquiry and Evaluative Criteria

“It Has to Be the Common Thread”: Weaving Attention to Racial Equity and Justice Across Lines of Inquiry and Evaluative Criteria

Improving Diabetes Equity and Advancing Care (IDEA) to optimize team-based care at a safety-net health system for Black and Latine patients living with diabetes: study protocol for a sequential, multiple assignment, randomized trial

BackgroundDiabetes is the eighth leading cause of death in the USA. Inequities driven by structural racism and systemic oppression have led to racial/ethnic disparities in diabetes prevalence, diagnosis, and treatment. Diabetes-self management training (DSMT), remote glucose monitoring (RGM), and tailored support from a community health worker (CHW) have the potential to improve outcomes. This study will examine the implementation of these interventions in a safety-net healthcare setting.MethodsUsing implementation science and racial equity principles, this study aims to (1) evaluate the appropriateness; (2) measure fidelity; and (3) compare the effectiveness of varying the combination and sequence of three interventions. An exploratory aim will measure sustainability of intervention adherence and uptake. This mixed-methods trial employs a sequential, multiple assignment randomized trial (SMART) design, patient focus group discussions, and staff interviews. Eligible Black/Latine patients will be recruited using patient lists extracted from the electronic medical record system. After a detailed screening process, eligible patients will be invited to attend an in-person enrollment appointment. Informed consent will be obtained and patients will be randomized to either DSMT or RGM. At 6 months, patients will complete two assessments (diabetes empowerment and diabetes-related distress), and HbA1c values will be reviewed. “Responders” will be considered those who have an HbA1c that has improved by at least one percentage point. “Responders” remain in their first assigned study arm. “Nonresponders” will be randomized to either switch study arms or be paired with a CHW. At 6 months participants will complete two assessments again, and their HbA1c will be reviewed. Twelve patient focus groups, two for each intervention paths, will be conducted along with staff interviews.DiscussionThis study is the first, to our knowledge, that seeks to fill critical gaps in our knowledge of optimal sequence and combinations of interventions to support diabetes management among Black and Latine patients receiving care at a safety-net hospital. By achieving the study aims, we will build the evidence for optimizing equitable diabetes management and ultimately reducing racial and ethnic healthcare disparities for patients living in disinvested urban settings.Trial registrationClinicalTrials.gov: NCT06040463. Registered on September 7, 2023.