NCSD and its staff have been involved in ongoing efforts to increase awareness and further understanding around social justice issues and health disparities as they relate to the study of Health Equity. One of these efforts has been to host monthly brown bag discussions where a different staff member leads a group conversation centered around a certain social justice issue and how it relates to public health. By way of these blog posts, NCSD hopes to publicize our discussions, and encourage further conversations related to these issues.

For February’s brown bag discussion, NCSD tackled the broad issue of race and racism, and how it relates to the work that we do. Our Capacity Building Manager, Leandra Lacy, lead a discussion related to Camara Phyllis Jones’ article, “Levels of Racism: A Theoretic Framework and a Gardener’s Tale.” Like the title suggests, Jones’s article breaks down racism as existing on three different levels: institutionalized, personally mediated, and internalized.

Racism often rears its ugly head within public health in a variety of ways for a variety of reasons, much as it does in other fields. Institutionalized racism is often the first barrier faced by people of color in accessing care and is also one of the more difficult to overcome due to how ingrained it is within society. Difficulties in accessing quality education, housing, and gainful employment all combine to create major obstacles, especially when attempting to access medical facilities and care. Inequities in social and economic conditions are reflected in the profound disparities in STD incidences among racial and ethnic minorities. Personally mediated racism is much more direct and is often what we think of when we talk about racism in general. It can be intentional and unintentional. Racially biased health providers often spend less time, both consciously and subconsciously, with minority patients or even avoid treating them all together. Even when health care is available and accessible, fear and distrust of health care institutions can dissuade many racial/ethnic minorities from following through with care due to fears of provider bias, or the perception that these biases may exist. Internalized racism refers to one’s own acceptance of the negative messages outsiders say about the group the person is a part of. It often manifests itself as a member of one group not believing, or actively working against other members of their own group. Internalized racism and oppression often lead to people losing a sense of self-worth or judging people who are the same race or sexuality as them for superficial reasons. The rejection of one’s culture, and an embrace of “whiteness” or “straightness” are common forms of internalized racism and oppression.

Since racism is a system of oppression, we all have a part to play in dismantling the system one piece at a time. Many on the NCSD staff agreed that recognizing and coming to terms with one’s own biases and preconceived notions is the most important step in addressing issues of racism in the public health field. Racism is a complex and deeply ingrained aspect of our society that requires cooperation from all groups if we desire to see an end to it. Understanding the various levels of racism and how they manifest themselves is of paramount importance in dismantling these oppressive systems.

The numbers show that those within various minority groups are often adversely affected by STDs and HIV, which can be attributed in large part to systems of racism. Health departments and providers must make it a priority to address all three forms of racism in their jurisdictions if they are to improve their outreach to these communities. Public health providers must also put substantial effort into hearing directly from the populations they wish to serve and use that information to form innovative solutions that help these communities overcome the barriers they face. If successful, these actions will serve to empower people to demand and expect better care from the providers that seek to serve them.