“By integrating diversity, equity, and inclusion in all phases of evaluation, we are able to examine cultural, structural, and contextual factors from the perspective of those most impacted by the problems. CREE examines impacts through a lens that values the culture of participants and gives them a voice in the process.” – Chandria Jones (LEEAD Alum)
“One of my passions involves teaching organizations the importance of using evaluation as a tool for learning as well as a tool for action, particularly for sexual and reproductive health, rights, and justice initiatives.” – Nicole Clark (ACE Evaluation Member)
Expanding the Bench (ETB) was so pleased to be able to attend Sharing Knowledge 2020 sponsored by the Robert Wood Johnson Foundation (RWJF). ETB Co-Director Elizabeth Waetzig traveled to Jackson, MS for this conference with the theme of Racial Justice and Health. She was joined by Chandria Jones (Leaders in Equitable Evaluation and Diversity (LEEAD) Program Alum) and Nicole Clark (Advancing Culturally-responsive and Equitable (ACE) Evaluation Network Member). The three learned so much from the diverse researchers, practitioners, and thought leaders. Attendees and presenters discussed how we can harness cross-disciplinary evidence to address the drivers of inequitable life outcomes and advance social change with a focus on one of the nation’s most durable and original forms of oppression-racism. Chandria and Nicole share their experiences and learnings from the conference:
Chandria Jones’s Reflections
These were just a few of the words that continued to resonate with me after attending the 2020 Sharing Knowledge Conference in Jackson, Mississippi, March 4-6, 2020. Over two days, RWJF, in collaboration with AcademyHealth and the National Collaborative for Health Equity convened a cross-sectional community of researchers, practitioners, decision-makers, and thought leaders to explore the evidence base for building a Culture of Health. With the conference theme of “Racial Justice and Health,” participants engaged in meaningful dialogue around how to harness transdisciplinary evidence to address the drivers of inequitable life outcomes and advance social change. Through plenaries, breakout sessions, and workshops, we explored the role of health and cross-sectoral leadership in struggles for equity and justice with an emphasis on racism. I walked away from the conference “full,” inspired, and ready to challenge others to do better and be better. The following are a few ways we can challenge ourselves and others.
First, I challenge us to change the narrative. One of the most memorable breakout sessions that I attended was on How Culture Shapes Equity and Health. This session exposed the ways cultural narratives and symbols impact the well-being of communities. We discussed issues of colorism and the master narrative of invisibility for Native Americans and how such dominant narratives impact health. In order to work towards equity, we must change these narratives to ones that recognize the intersectionality of people and place values on culture.
Engage in racial healing. From colonization to microaggressions, communities of color have had a long history of trauma and oppression. The W.K. Kellogg Foundation defines racial healing as “a process that restores individuals and communities to wholeness, repairs the damage caused by racism, and transforms societal structures into ones that affirm the inherent value of all people.” In order to transform communities and shift our national discourse, we must acknowledge past wrongdoings and begin rebuilding authentic relationships based on a shared understanding that values our common humanity.
Address structural inequalities and imbalances of power in decision-making. The conference opened with a welcoming session at the Two Mississippi Museums, and I participated in a Historic Civil Rights Driving Tour of Jackson. These walks down memory lane in Mississippi reminded me that the historical roots of racism run deep within the United States. As noted in several of the conference sessions, we continue to see structural racism related to black women and maternal mortality, housing, economics, and mass incarceration. Our focus should be on challenging the systems that create inequities, and we must work to shift the balance of power that set up policies and practices that disproportionately affect communities of color and marginalized populations.
Build meaningful relationships. Convenings like this are great opportunities to network and make new connections. The conference created a safe space to engage with people from different sectors, geographic locations, cultural backgrounds, and life experiences. People were open to building connections that helped them to challenge their own personal assumptions about racial justice and health. I met so many wonderfully amazing and thought-provoking people at this conference including my fellow ETB travelers, Elizabeth Waetzig and Nicole Clark, and fellow Terps from the Maryland Center for Health Equity at the University of Maryland School of Public Health. Sometimes you have to go far away to meet amazing people in your own backyard.
Finally, I challenge us to use culturally responsive and equitable evaluation (CREE) in our efforts towards racial justice and health. The conference opening plenary on Racial Injustice as a Public Health Problem highlighted how culture shapes health and the negative impacts of discriminatory policies, healthcare provider racial bias, and limited access to quality healthcare. CREE can be used to assess efforts towards racial justice and hold organizations accountable for their actions. By integrating diversity, equity, and inclusion in all phases of evaluation, we are able to examine cultural, structural, and contextual factors from the perspective of those most impacted by the problems. CREE examines impacts through a lens that values the culture of participants and gives them a voice in the process. I like to think of CREE as the method that gives power to voices that can transform systems. It creates rigor in evaluation and empowers communities of color, youth, and other marginalized populations to make systems change.
Thank you Expanding the Bench for the enriching experience and opportunity to attend the 2020 Sharing Knowledge Conference and represent LEEAD Scholars and Alum.
Nicole Clark’s Reflections
I was invited by the Expanding the Bench Team to attend the 2020 Sharing Knowledge conference in Jackson, Mississippi, with RWJF. The 2020 theme, “Racial Justice and Health” excited me as I am currently serving as an evaluation consultant on several projects with organizations eager to address how race, racism, and inequities impact community health.
Out of all the amazing and informative sessions I attended and the individuals I had conversations with, the session that resonated with me the most was “The Impacts of Racism and Bias in Healthcare on Maternal and Child Health”, a panel featuring writer and journalist Linda Villarosa, Susan Beane, MD (executive medical director of Healthfirst New York), and Joia Crear-Perry, MD, FACOG (founder and president of the National Birth Equity Collaborative).
One of my passions involves teaching organizations the importance of using evaluation as a tool for learning as well as a tool for action, particularly for sexual and reproductive health, rights, and justice initiatives. Maternal health, through my engagement with client organizations as well as my commitment to bettering the lives, health, and lived experiences of women and girls of color, has quickly become an area of interest of mine. So, attending this particular session was timely.
At the beginning of the session, Villarosa asks, “If the United States is the most medically advanced country, why do we have the poorest health outcomes, why is maternal morbidity on the rise?” The session specifically addressed poor Black maternal health outcomes. “Is there something about Black bodies that are having more difficulties in childbirth?” In response, Beane shared, “We’re looking at [the maternal health crisis at an] extremely macro level that doesn’t reflect reality. We’re seeing women having babies with poor outcomes if we look for it. The question is, what are we looking for?”
As evaluators, we teach our staff and clients the importance of crafting appropriate evaluation questions and asking the right data collection questions. Crear-Perry shared that we place blame on individuals for poor health outcomes based on race, without addressing where biases come from. These narratives, Crear-Perry, often come from the media as well as how medical professionals are educated and trained.
What happens in providers’ offices? What are patients thinking and feeling about their own health experiences compared to what historical data has shown? Beane shared that the issues start before a patient enters the health center, during labor and delivery, as well as postpartum. One of my past evaluation clients was a collective of community organizations that provided free community-based doula care for marginalized communities. This initiative showed how the inclusion of the doula was viewed as an invaluable support for pregnant women and their families, but also as a source of health advocacy strategy within the healthcare system and economic empowerment for women seeking doula certifications.
When asked how should public health operationalize the idea that racism, not race, shapes health outcomes, both Beane and Crear-Perry advocated for 1) providers to ask patients what barriers they feel prevent them from achieving their best outcomes AND to ask them what factors contributed to their best health outcomes; 2) creating space for people to have freedom of reproductive choice; and 3) making more efforts to “disrupt the system” when these systems are stuck on how care has to happen.
I walked away from this session (and from the conference overall) with a greater sense of excitement for what racial equity and health equity can be, and how we as evaluators can be charged to use data as a tool for advocacy.