Institutional Racism Research Articles

Comparing the South African and Brazilian student uprisings (2015–2016): Similarities, Circulations, and Distance

ABSTRACT South Africa and Brazil are notorious for having some of the highest levels of (racialised) inequality on the planet, and dysfunctional education systems failing millions in their aspirations for a better life. Over 2015-16, student protests erupted across Brazilian and South African schools and universities, challenging these conditions through strikes, occupations, on-campus and street protests, and intellectual production. This paper builds on a World-Systems theoretical framework to understand the similarities, circulation, and distance between the two contemporaneous movements. In Brazil, the ‘Primavera Secundarista' high school occupations dealt primarily with local political dynamics, such as school closures, and intersectional forms of oppression. In South Africa, the ‘Fallist' university mobilisations demanded free, decolonised education, alongside addressing issues of outsourcing and institutional racism. In the first section, I give a comparative overview of these student movements’ similarities, situating them in their context and highlighting the key concerns and political and pedagogical practices of student activists in each. While these movements did not generally engage with each other, there were some important points of interaction, discussed in the second section. While highlighting these points of connection, I also advance an argument in the third section for why there was nevertheless relatively little direct engagement between these contemporaneous movements that otherwise had so much in common. The points of connection and disconnection between these similar movements offers insights about the functioning of the contemporary World-System and the modes of transnational circulation between movements therein, with lessons for transnational understandings of social movements, especially South-South movements.

Large-scale analysis reveals racial disparities in the prevalence of ADHD and conduct disorders

The primary purpose of this study is to highlight trends in the prevalence of attention deficit/hyperactivity disorders (ADHD) and conduct disorders (CD) between non-Hispanic White and non-Hispanic Black populations and identify potential diagnostic disparities between these groups. De-identified electronic health record data on the TriNetX platform of patients diagnosed with ADHD, CD, or both between January 2013 and May 2023 from 50 healthcare organizations in the US were used to investigate racial and sex disparities in the prevalence of ADHD and CD diagnoses. With a cohort of 849,281 ADHD patients and 157,597 CD patients, non-Hispanic White individuals were ~ 26% more likely to receive ADHD diagnosis and ~ 61% less likely to be diagnosed with CD than non-Hispanic Black individuals. The mean age of diagnosis of ADHD was over 8 years older for White patients than for Black patients, with a disproportionately higher number of White patients diagnosed in adulthood, compared to a comparatively negligible number of Black patients diagnosed with ADHD in the same age group. Additionally, Black females were the cohort least likely to be diagnosed with ADHD, while White females were the cohort least likely to be diagnosed with CD. Race disparities exist between Black and White populations, and sex disparities exist within each population. More information is needed to determine contributors to these differences, although implicit biases and systemic racism may be key contributing factors. Presenting evidence and increasing awareness of culturally relevant diagnoses can reduce unconscious bias and move toward more informed and objective psychiatric evaluations.

Questioning the status quo: Latino community members as researchers in the study of health equity.

Latinos experience disproportionate rates of obesity and related conditions like type 2 diabetes, which are projected to increase (Mohebi et al., 2022). Standard interventions for these issues often fall short due to individual-focused approaches and the lack of culturally sensitive definitions of health that include emotional, physical, political, and social domains (Gutierrez Chavez et al., 2022; Ritchie et al., 2020). Multilevel and multidimensional research efforts, integrating social justice-informed orientations, psychotherapy science, and behavioral medicine, are crucial for addressing these health inequities (Asnaani, 2023; Collins et al., 2018; Rodriguez Espinosa & Verney, 2021). Additionally, critically analyzing researcher and participant roles is essential to avoid perpetuating systemic racism (Cook et al., 2023). This article highlights the need for a paradigm shift in psychotherapy research by (a) describing Latino families' eating patterns and coping strategies for emotional distress through focus groups in the community and (b) illustrating the process behind the community-partnered development of a culturally responsive mindfulness-based health intervention. Importantly, this research approach emphasizes liberation psychology theory in the exploration of structural influences affecting health (Martín-Baró, 1996). While mindfulness techniques are feasible in this population (Cotter & Jones, 2020), Latino communities may not be amenable to the current presentation of mainstream psychological science interventions. Our research paradigm informed the conceptualization of mindfulness techniques through both clinical science and critical lenses. Thus, this study argues for reconceptualizing the definition of a successful psychotherapy study to include community engagement and liberatory principles, making the potential for big needle jumps in addressing health inequities incalculable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Race and Faith: The Role of Congregations in Racial Justice

AbstractFollowing the killing of George Floyd, some congregations more fully entered the conversation on race. Although sometimes reinforcing institutional racism, many religious traditions also have tools for conflict resolution, repentance, and reconciliation. Given this ambivalence, how do congregations engage questions of racial justice, and how is this engagement influenced by race and religious tradition? Our answers come through multimethod data collected over 2 years: (a) Surveys of 2,293 congregants from 35 diverse congregations find that race relations is the issue they most want their place of worship to address, while revealing exhaustion among some Black members; (b) 90 sermons from 15 congregations reveal how clergy talked about race in the weeks after Floyd's murder depended largely on the race of the congregation; and (c) 21 clergy interviews illustrate differences in how clergy use religion to engage race. These diverse data reveal key differences, based on race and religious tradition.

Shit Has to Change, Right? A Call for “Good Trouble” in Tourism

Burnt out, frustrated, and fed up with the glorification of publishing in the tourism academy, the authors in this critical viewpoint touch on counter-ideologies rarely acknowledged within the academy. We discuss the toxicity of publication glorification, systemic racism of the scientific community, the eugenic roots of statistical analysis, and how they may lead to our tourism academy’s downfall and eventual demise. Drawing inspiration from Saldaña’s rant as a method of inquiry and provocation, our letter invites readers to confront the uncomfortable truths about our cult-ish publication norms, imperial and colonial roots of our research methods, and the academy’s complicity in perpetuating inequities. We conclude with a rebellious call for radical change, a new “social justice turn” which includes a list of “shit that has to change” and the building of a coalition of “good troublemakers” in the tourism academy.

"Showing up to the conversation": Qualitative reflections from a diversity, equity, and inclusion book club with emergency medicine leadership.

Diversity, equity, and inclusion (DEI) in health care fosters many positive outcomes including improved patient care. DEI initiatives are often created by or require buy-in from departmental leaders with low DEI literacy. Book clubs are one way to develop DEI literacy. The purpose of this paper is to describe how leaders in the department of emergency medicine (DEM) process the information gained from reading a DEI book through discussion in a book club setting and explore how participation enhances their DEI literacy and fosters self-reflection. This was a qualitative exploratory study based on a constructivist approach. Data were analyzed by four researchers using inductive thematic analysis techniques. Sixty-eight leaders within the DEM participated in 11 book clubs. Nine themes were identified (examination of privilege, initial reaction to discussion about racism, discomfort, worry, self-reflection, release, role recognition, readiness, and education). After prompted examination of their own privilege participants moved through a model of perceived readiness to act. Participants started with feeling paralyzed by the work's enormity or becoming defensive. They then moved toward discomfort with discussions of racism and systemic racism and progressed to discussions around worrying that they were contributing to noninclusive environments. After a period of self-reflection, participants tended to release their paralysis, push aside their defensiveness, accept the role of discomfort, and express the importance of education on these issues. Participants then recognized their role in creating inclusive environments and started discussing what they can do about it, which, for many, was to show up to the conversation. An underlying driver of movement through this model was the education that was provided through the book. By addressing privilege and systemic inequities through the reflective practice and dialogue of a book club, participants demonstrated a growing commitment and perceived readiness to advancing inclusive practices within medicine.

‘You're not supposed to be gay, you're black’: Analysing race and LGBTQ+ youth identity through an intersectional lens

AbstractIn this article, I build upon calls for an intersectional approach in sociocultural linguistic research – particularly in the context of language, gender and sexuality – which attends robustly to the question of race. Through the analysis of four moments of discourse between young LGBTQ+ people, I show how their queer positionality is informed and shaped by their experience as white or racialised youths. In doing so, I demonstrate the intra‐categorical nature of identity and the benefits of a ‘thick’ analytical approach which pays close attention to individual speakers’ positionalities. Furthermore, I argue for sociocultural linguistic research which honours the origins of intersectionality theory by accounting explicitly for the role of systemic racism and white privilege on speakers’ identity constructions.

Transnational resilience: exploring international students’ agency in response to systemic racism in U.S. higher education

This phenomenological inquiry explored how 19 international students in U.S. higher education developed a sense of agency in response to systemic racism. The findings revealed three main factors associated with participants’ sense of agency: (1) transnational role models, (2) the community and social network established in the United States and (3) personal beliefs, values, and morality. By focusing on how international students draw on their transnational experiences and knowledge to develop agency in response to systemic racism, this study contributes to scholarships on learning outcomes associated with international student mobility and their experiences with race and racism. It also adds to the increasing body of research that challenges deficit paradigms toward international students prevalent in scholarly discourse by highlighting their agency and assets. Implications for future research and practice are also discussed.

Racial disparities in prostate cancer in the UK and the USA: similarities, differences and steps forwards.

In the USA, Black men are approximatelytwice as likely to be diagnosed with and to die of prostate cancer than white men. In the UK, despite Black men having vastly different ancestral contexts and health-care systems from Black men in the USA, the lifetime risk of being diagnosed with prostate cancer is two-to-three times higher among Black British men than among white British men and Black British men are twice as likely to die of prostate cancer as white British men. Examination of racial disparities in prostate cancer in the USA and UK highlights systemic, socio-economic and sociocultural factors that might contribute to these differences. Variation by ancestry could affect incidence and tumour genomics. Disparities in incidence might alsobe affected by screening guidelines and access to and uptake of screening. Disparities in treatment access, continuity of care and outcomes could contribute to survival differences. In both localized and metastatic settings, equal access could diminish the observed disparities in both the USA and the UK. An understanding of behavioural medicine, especially an appreciation of cultural beliefs about illness and treatment, could inform and improve the ways in which health systems can engage withand deliver care to patients in minoritized groups affected by prostate cancer. Methods of promotingequity include targeting systemic barriers including systemic racism,proportional recruitment of patients into clinical trials, diversifying the health-care workforce and facilitating care informed by cultural humility.Actively engaging patients and communities in research and intervention might enable the translation of research into increasingly equitable care for patients with prostate cancer in the UK, the USAand globally.

New York City’s Public Health Approach to Reexamining Race-Based Clinical Algorithms

Clinical algorithms are utilized in clinical decision-making — whether for diagnosis or treatment — with the aim of accounting for pertinent biological factors. However, the use of race in some clinical algorithms disproportionately harms patients of color, often delaying necessary care. The erroneous use of race as a biological variable perpetuates the antiquated notion of race essentialism and demonstrates how medical racism is embedded in health care. In 2021, the New York City (NYC) Department of Health and Mental Hygiene launched the Coalition to End Racism in Clinical Algorithms (CERCA). To the authors’ knowledge, CERCA was the first citywide effort to convene seven safety-net and four private health care systems for the elimination of harmful race-based clinical algorithms, representing the health institutions in NYC serving the most patients. Focusing on estimated glomerular filtration rate, vaginal birth after cesarean, and pulmonary function testing, CERCA serves as a platform for health systems to discuss and strategize how to effectively de-implement these harmful race-based algorithms. NYC CERCA serves as a model for how a public health department can leverage its role as a convener by collaborating with health systems to address matters of racial inequities caused by systemic racism in medicine and supporting the swift implementation of reparative initiatives on a systems level.

Climate Change, Racism, and Food Insecurity: Cyclical Impacts of Stressors Exacerbate Health Disparities.

Disadvantaged populations have higher rates of chronic disease, including heart disease, cancer, and diabetes. Race, ethnicity, lower socioeconomic status, and poverty all contribute to these disproportionate rates. Other factors, including systemic racism, climate change, poor diet, lack of food access, and epigenetic influences, that are distributed and experienced differently across vulnerable populations also play a significant role in the development of chronic diseases. This comprehensive review of contributors to chronic diseases emphasizes a unique focus on these identified emerging factors. An ad hoc literature review using OVID Medline and Web of Science was conducted. Findings from prior studies indicate that multiple stressors, both in isolation and in combination, and their negative impacts on both physical and mental health of minorities are exacerbated by climate change. Various stressors dramatically increase chronic disease risk in minority groups. Recommendations for future research to elucidate the impacts of climatic, racial, and dietary adversity with minority populations are presented. Further study in this area is critical for achieving the UN Sustainable Development Goals and improving public health outcomes.

Structural racism: A concept analysis

BackgroundDespite the broad agreement that structural racism is problematic, there remains significant confusion as to what structural racism means and how to research it. PurposePerform a comprehensive concept analysis of structural racism and propose an operational definition. MethodWalker and Avant’s eight-step, iterative method was used for conducting the concept analysis. FindingsStructural racism has five defining attributes: oppressive racial ideologies, dynamic state, inverse-related influence, temporality, and a false sense of “racial equity.” Structural racism has six antecedents: explicit racial bias, implicit racial bias, racial discrimination, institutional racism, cultural racism, and systemic racism. There are three consequences of structural racism: group categorization, unequal treatment, and racial inequities. DiscussionTo combat and defeat the historical and ongoing impact of structural racism, conceptual clarity must be established. Only then can an operational definition be proposed and instruments developed that correspond with the nature of structural racism.

Reducing disparities in the care of atopic dermatitis.

Atopic Dermatitis (AD) is associated with a number of published disparities, including those related to self-identified racial/ethnic populations. Black/African American populations in the United States experience greater AD prevalence, severity, and persistence compared to other demographic groups, such as those who self-identify as White. There is consistent evidence that healthcare, environmental, and socioeconomic factors affect the prevalence, severity, and/or persistence of AD. Additionally, because of institutional and systemic racism, these same risk factors are more prevalent in racial and ethnic minority populations. Herein, we review the underlying causes of racial/ethnic disparities in AD and potential strategies to improve AD diagnosis and disease control.

The Effect of Racial Concordance for Black Patients in Addiction Treatment: A Scoping Review of the Literature.

In the United States, Black people with substance use disorders (SUDs) have less access to treatment and worse treatment outcomes compared to White people. Though systemic racism is the root of these inequities, adapting treatment settings to serve this population may be a pragmatic way to improve access and outcomes. Shared racial identity between a patient and a provider, or racial concordance, is one feature of culturally tailored care that may improve treatment access, experiences, and outcomes for Black people. There is some evidence that racial concordance improves medical treatment for Black patients in non-addiction settings, but it is unknown whether racial concordance affects experiences or outcomes in addiction treatment. We conducted a scoping review guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-to understand the effect of racial concordance on Black patients in addiction treatment. Three reviewers read each title and abstract to identify eligible articles. The inclusion criteria were: (1) Black patients; (2) treatment access, experiences, or outcomes; and (3) patient-provider racial concordance in addiction treatment. One reviewer completed full-text reviews and data extraction. We identified 259 nonduplicate articles and completed full-text reviews of 77 articles. Eleven articles, published between 1971 and 2016, met criteria. Racial concordance was not associated with treatment access or engagement, though it was associated with some positive outcomes including increased perceived provider empathy. Few studies met the review criteria and there were no randomized controlled trials. The studies identified in this review did not provide adequate evidence that racial concordance improved treatment access, experiences, or outcomes for Black patients. Future research should include a wider range of outcome measures, including relational measures (eg, medical trust, discrimination) and examine whether and under what circumstances racial concordance improves experiences and outcomes for Black patients in addiction treatment.

The journey to building a diverse, equitable, and inclusive American Medical Informatics Association.

The American Medical Informatics Association (AMIA) Task Force on Diversity, Equity, and Inclusion (DEI) was established to address systemic racism and health disparities in biomedical and health informatics, aligning with AMIA's mission to transform healthcare. AMIA's DEI initiatives were spurred by member voices responding to police brutality and COVID-19's impact on Black/African American communities. The Task Force, consisting of 20 members across 3 groups aligned with AMIA's 2020-2025 Strategic Plan, met biweekly to develop DEI recommendations with the help of 16 additional volunteers. These recommendations were reviewed, prioritized, and presented to the AMIA Board of Directors for approval. In 9 months, the Task Force (1) created a logic model to support workforce diversity and raise AMIA's DEI awareness, (2) conducted an environmental scan of other associations' DEI activities, (3) developed a DEI framework for AMIA meetings, (4) gathered member feedback, (5) cultivated DEI educational resources, (6) created a Board nominations and diversity session, (7) reviewed the Board's Strategic Planning for DEI alignment, (8) led a program to increase diversity at the 2020 AMIA Virtual Annual Symposium, and (9) standardized socially-assigned race and ethnicity data collection. The Task Force proposed actionable recommendations that focused on AMIA's role in addressing systemic racism and health equity, helping the organization understand its member diversity. This work supported marginalized groups, broadened the research agenda, and positioned AMIA as a DEI leader while reinforcing the need for ongoing transformation within informatics.

A Return to Black Codes: How the Dobbs Decision Debilitated the 14th Amendment

Substantive due process, drawn from the 14th Amendment, has been a consistent judicial doctrine for establishing and protecting the rights and liberties of Black citizens in the face of systemic racism. This prompts a question for political consideration and investigation: if the 14th Amendment is a constitutional equilibrium for rights Black citizens would otherwise not enjoy, could the rescission of a right decided and sustained by the 14th Amendment that is not racially explicit have negative racial implications for Black Americans? This study answers this question through an atheoretical case study on the ruling in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade. This study finds that the ruling in Dobbs weakened the 14th Amendment by allowing parameters to be placed on substantive due process. Though the question before the Court was the constitutionality of Mississippi’s abortion law, the implications of weakening the 14th Amendment are that it allows for the legal and cultural revitalization of Black exclusion that existed under the Black Codes, which has already come to fruition in Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and the end of affirmative action.

Resilient locusts, ignorant people, modern state and scientific knowledge: a late Ottoman human-animal-state history

This article revisits Ottoman history by exploring the enduring relationship between humans and locusts through an animal-human history approach, emphasizing their ‘companionship’ and combined agencies. Instead of focusing on a specific region, the study highlights an empire-wide locust agency by examining the dynamics among humans, locusts, and state policies within the framework of the institutionalization of science. The study traces the evolution of Ottoman locust policies from the Hamidian era’s shift to standardized methods relying on human labor, to the CUP era’s ambitious emphasis on science and increased state racism, categorizing people as ‘ignorant inferiors’. It argues that while scientific knowledge was used to justify state racism to manage locusts and police humans, the resilience of locusts and their relationship with ‘ignorant’ humans and their surrounding environment forced policy changes. By integrating locust agency, this study offers a holistic perspective on the Ottoman past, revealing how locusts, humans, and the state continually influenced each other, and contested the nature of biopolitics and scientific knowledge.

Original Research: Exploring Black Nurses' Perceptions of Workplace Safety and Personal Health.

This study aimed to assess the perceptions of nurses who self-identify as Black or African American regarding their workplace health and safety and to explore how these perceptions are associated with their perceived personal health. Nurses practicing in unhealthy work environments can experience poorer physical and mental health. Recent civil unrest and ongoing dialogue about structural and systemic racism have prompted calls for greater efforts to understand the workplace perceptions and experiences of ethnic minority nurses, and how these influence nurses' personal well-being. But there is a dearth of relevant evidence concerning these nurses, including Black nurses. This cross-sectional, descriptive study involved analysis of secondary data collected from May 1, 2017, through December 31, 2019, by the American Nurses Association's HealthyNurse Survey (N = 19,131). We employed descriptive, bivariate, and multivariate analyses to examine the data for the 1,143 respondents who both self-identified as Black or African American and responded to all items concerning the major variable of personal health. Overall, respondents reported a slight tendency to agree or strongly agree that their practice environments were safe. When looking at various factors explaining personal health, the perception of workplace health and safety was found to be a significant contributing factor. The study findings suggest that, among Black nurses, perceptions about workplace health and safety are associated with perceived personal health. These findings underscore the importance of fostering healthy work environments.

Advancing the grand challenge to eliminate racism: a call to action for citational justice in social work

ABSTRACT The challenge to eliminate racism is not new to social work but achieving its eradication has proven difficult as systemic and structural racism are deeply embedded in systems, laws, policies, and practices that impact both society and the profession. Of great concern is that existing research has reinforced lack of diversity in content and representation in social work. Previous research asserts that Black and Latine individuals were not only less likely to be cited, but more likely to publish on less-cited topics such as racial discrimination, gender-based violence and immigrants. Importantly, The Black Lives Matter, Black in the Ivory and Cite Black Women Movements sparked efforts among numerous academic disciplines and institutions to chart both researcher diversity and recognize how structural racism in science and publishing impacts both Black, Indigenous and People of Color (BIPOC) researchers and the academic disciplines in which they publish. As cited authors are considered thought leaders in their areas of expertise, it is important for the profession to address how structural racism has led to citational disparities for many scholars who are BIPOC. Citational Justice seeks to critically examine the ethics and politics of knowledge production in academia. Using the Grand Challenge to Eliminate Racism as a guiding framework, these authors present several action strategies that social work organizations can utilize across micro, mezzo and macro levels to achieve citational justice.

Lies my child welfare system has told me: The critical importance of centering families' voices in family policing legal advocacy

AbstractThe web of law, regulation and policy which forms the modern day “child welfare” system is organized around one central unifying principle: the notion that these laws, regulations and policies are necessary to protect and save children. Yet an ever‐growing and overwhelming chorus of “lived experts” – individuals who have been impacted as a parent and/or child by what is more aptly called the family policing system – as well as by advocates and scholars, are drawing attention to the degree of harm the system causes to the families it purports to help. Even though the harms the family policing system causes are well known, the family policing system continues to justify these harms as warranted in the name of protecting children. More concerning, even well‐meaning advocates and scholars who acknowledge the harms, implicitly and explicitly continue to perpetuate the big lie that the family policing system's intention is benevolent and caring. The impetus for any law is a story; law identifies a problem and seeks to resolve it. But what happens when the story is false? The stories we tell about the need for family policing perpetuate harm and replicate systemic racism. Most importantly, the impact of these false narratives can be felt through generations of families leaving devastated communities. The stories, perspectives and opinions of those most impacted by the system historically have been, and continue to be, intentionally left out of the making of law and policy, and even in the teaching of the law. Unless the actual perspectives of families are present to challenge the stories that are woven into the law, these narratives will continue to create significant obstacles to critical thought about the law, prevent meaningful legal change, and ultimately cause continued harm to families and communities. In this essay, in the tradition of participatory law scholarship (Note: Rachel Lopez, Participatory Law Scholarship, 123 Colum. L. Rev. 1795 (2023) [“Participatory Law Scholarship or (PLS)… is an emerging genre of legal scholarship written in collaboration with authors… who have no formal training in the law but rather expertise in its function and dysfunction through lived experience.”]), the authors, a parent and professional advocate, and a clinical law professor and attorney, seek to unpack the myths which are built into the laws of family policing. In reckoning with these myths, the paper seeks to propose a critical framework to both acknowledge the intentional trauma and harm caused by the family policing system, and to disrupt and dismantle the fictions that are the underpinnings of the laws and regulations that continue to perpetuate these harms. Ultimately, this paper argues that by centering the lived expertise of families' voices and perspectives in legal advocacy, we can form a cogent vision for true safety for families and communities.