Collecting Race-Based Data in Health Research: A Critical Analysis of the Ongoing Challenges and Next Steps for Canada

The COVID-19 pandemic has had a global effect. The disproportionate impact on Indigenous peoples and racialized groups has brought ethical challenges to the forefront in research and clinical practice. In Canada, the Tri-Council Policy Statement (TCPS2), and specifically the principle of justice, emphasizes additional care for individuals "whose circumstances make them vulnerable", including Indigenous and racialized communities. In the absence of race-based data to measure and inform health research and clinical practice, we run the risk of causing more harm and contributing to ongoing injustices. However, without an accepted framework for collecting, maintaining, and reporting race-based data in Canada, more guidance is needed on how to do this well. Importantly, a framework for collecting race-based data should build on existing guidance from Indigenous and other structurally marginalized communities, the TCPS2, recommendations from the World Health Organization, and involve relevant stakeholders. In this paper, we describe historical examples of unethical studies on Indigenous and racialized groups, discuss the challenges and potential benefits of collecting race-based data, and conclude with objectives for a pan-Canadian framework to inform how race-based data is collected, stored, and accessed in health research.

Can White allyship contribute to tackling ethnic inequalities in health? Reflections on the experiences of diverse young adults in England

Ethnic diversity and racism have not featured strongly in English research, policy or practice centred on understanding and addressing health inequalities. However, the COVID-19 pandemic and the Black Lives Matter movement have shone fresh light on deep-rooted ethnic inequalities and mobilised large segments of the population into anti-racist demonstration. These recent developments suggest that, despite strong counterforces within national government and the mainstream media, there could be a shift towards greater public awareness of racism and potentially a willingness to take individual and collective action. This paper addresses these developments, and specifically engages with the contested notion of 'allyship'. We bring together the experiences of 25 young adults living across England and prior literature to raise questions about whether and how racialized White individuals can play a role in dismantling systemic racism and reducing ethnic inequalities in health. Our analysis reveals a variety of complexities and obstacles to effective and widespread allyship. Findings suggest the need to nurture contingent, responsive and reflexive forms of allyship that can attend to the harms inflicted upon racially minoritized people as well as push for systemic transformation. White allyship will need to take a variety of forms, but it must be underpinned by an understanding of racism as institutional and systemic and a commitment to tackling interlocking systems of oppression through solidarity. The issues addressed are relevant to those occupying public health research, policy and practice roles, as well as members of the public, in England and other multi-racial settings.Copyright © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Joy as a mode of resistance: An examination of Black Girl Hockey Club's ongoing quest for racial justice

Through a case study of the Black Girl Hockey Club (BGHC) founded by Renee Hess, this doctoral research project investigates how an online sports network operates as a community of resistance to racism, uniting political action with the joy of sport. Hess initially established media sites including a Twitter handle, ' Blackgirlhockey' as a fan account, to attract Black women who enjoyed watching and engaging with hockey cultures. The COVID 19 pandemic and the 2020 global racial uprisings transformed the Black Girl Hockey Club into a site for hockey fandom while simultaneously influencing hockey environments and users of the site to address racism. This dissertation uses mixed-methods to employ an in-depth case study of the BGHC, a not-for-profit organization and digital network with over 30K Twitter followers. The thesis integrates theoretical and methodological frameworks of critical media studies, Black feminist theory, critical race theory, anti-racism, and social movements. The thesis demonstrates that cyber networks can enable participants to initiate social change within their own communities. The effectiveness of hashtag feminist sports activism was demonstrated through an analysis of BGHC's #getuncomfortable campaign. Various outcomes related to involvement with Black Girl Hockey Club were explored including the blurring of on and offline engagement and the development of political consciousness among users of the site. Research participants acquired intellectual empathy, humility and a collective agency related to anti-racism movements. The Black Girl Hockey Club community clearly developed 'networks of hope' that produced visible cracks to the dominant social order (in hockey cultures). Another measured outcome was an increase of social capital, individual and collective agency achieved through active involvement with Black Girl Hockey Club. The research illuminates the effective functionality of feminist cyber networks and supports the plausibility and advancement of anti-racism efforts in hockey cultures both virtually and offline. This thesis broadens sport and social movement literature by exploring how the pleasures associated with sport - in this case the love of hockey-became linked to anti-racist activism in an online community. It reveals how an affective mode, joy, shapes a social movement. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Twin pandemics, intertwined (intergroup) solutions: Support for mitigating racism benefits vaccine hesitancy.

The present research examines the potential that support for efforts aimed at mitigating systemic racism might have beneficial consequences related to vaccination attitudes (e.g., vaccine willingness). Specifically, the present research examines the hypothesis that Black Lives Matter (BLM) support is related to reduced vaccine hesitancy, and that prosocial intergroup attitudes are a theoretical mechanism. It tests these predictions across social group lines. Study 1 examined state-level indicators tied to BLM protests and discourse (i.e., Google searches, news reports) and COVID-19 vaccine attitudes among US adult racial/ethnic minority (N = 81,868) and White (N = 223,353) respondents. Then, Study 2 investigated, respondent-level, BLM support (measured at time 1) and general vaccine attitudes (measured at time 2) among US adult racial/ethnic minority (N = 1,756) and White (N = 4,994) respondents. It tested a theoretical process model that included prosocial intergroup attitudes as a mediator. Study 3 tested a replication of the theoretical mediation model using a different sample of US adult racial/ethnic minority (N = 2,931) and White (N = 6,904) respondents. Across studies and social groups (i.e., racial/ethnic minority and White respondents), as well as controlling for demographic and structural covariates, BLM support and state-level indicators were found to be related to lower vaccine hesitancy. And, Studies 2-3 provided some evidence that prosocial intergroup attitudes are a theoretical mechanism; the studies provided evidence of partial mediation. Holistically, the findings have the potential to advance understandings of how support and discourse related to BLM and/or other anti-racism efforts can be associated with positive public health outcomes such as reductions in vaccine hesitancy.

Black Physicians' Experiences with Anti-Black Racism in Healthcare Systems Explored Through An Attraction-Selection-Attrition Lens.

Anti-Black racism is a specific form of racism directed at Black people. In healthcare, there are poignant examples of anti-Black racism in the recruitment, selection, and retention stages of the job cycle. Research shows that anti-Black racism is associated with inequitable work outcomes and the under-representation of Black physicians. However, empirical findings are scattered with no organizing framework to consolidate these findings. To add to the literature, in this paper we present the attraction-selection-attrition (ASA) model (Schneider, 1987) as an organizing framework to discuss Black physicians' experiences with anti-Black racism and discrimination throughout their careers. We draw from previous literature to highlight specific experiences of Black physicians at each stage of the job cycle (i.e., attraction, selection, retention), and we offer considerations on how practitioners can mitigate anti-Black racism throughout the job cycle. In the wake of COVID-19 and highly publicized social justice movements, healthcare systems are seeking ways to increase the recruitment, selection, and retention of Black physicians to ensure health equity. We believe this guide will be valuable to practitioners, leaders, researchers, and program directions seeking to advance diversity, equity, and inclusion of Black physicians in their healthcare systems. We conclude by providing practical implications and directions for future research.

Social policy: a critical and intersectional analysis

Positioning social struggles equally high as policy makers in shaping social policy, particularly following the intensified needs generated by the covid-19 lockdowns, is an imperative of Williams' way of combining intersectionality into critical social policy. In other words, Williams introduces an approach to social policy which is not only inclusive concerning activists conducting social struggles, but also inclusive for scholars applying critical social policy in all intersecting social positions. What social forces currently have the transformative power to challenge the neo-liberal managerialist forms of contemporary welfare policies?. [Extracted from the article]

Using the Consolidated Framework for Implementation Research to Promote Anti-Racism in Social Work Higher Education

Recognizing a clear call to dismantle traditionally racist structures within our nation, doctoral students at the University of Pittsburgh School of Social Work formed the Anti-Racist Doctoral Program Student Committee (ARDPSC) to push for systemic changes within our school and profession to eliminate anti-Black racism. Our student-led initiative is an innovative approach for two reasons. First, we strengthened our community virtually despite the limitations of COVID-19 and virtual spaces. Second, although collective organizing among students can be seen as threatening, we held a tension between agitation and collaboration, and contributed to, rather than disrupted, implementation of anti-racist reform. We map our experiences onto the Consolidated Framework for Implementation Research (CFIR) using narrative data and documents produced by our committee. First, we describe how we built anti-racist group processes, established brave working environments, and integrated processes to reflect on change at various system levels. Next, we describe our actions to push our school and profession to be anti-racist and assess outcomes using the CFIR. Finally, we share our reflections on how to continue this work. We hope to document our experiences and reflect on how social work student groups can contribute to dismantling white supremacy and rebuilding institutions with an anti-racist approach. © 2022 Authors,.

Building a Diverse Psychiatric Workforce for the Future and Helping Them Thrive: Recommendations for Psychiatry Training Directors.

The COVID-19 pandemic and murder of Mr George Floyd served as catalysts for examining antiracism efforts in psychiatry training programs and health care systems. Our recruitment and retention of Black, Indigenous, and other racial/ethnic minority psychiatry trainees has not met the demand for care and does not represent the communities served. Training directors at a critical juncture in creating systemic changes to recruitment, retention, policies, and curricular competencies to address ongoing inequities and disparities in health care. We describe several strategies and considerations for training directors in supporting a diverse psychiatric workforce.

"Trickle-Down" Racial Empathy in American Higher Education: Moving Beyond Performative Wokeness and Academic Panels to Spark Racial Equity

Recent racial justice protests in response to police-related brutality in the U.S. illuminate tensions reflective of persistent power differentials and social and racial traumas of which the U.S. education system has played a pronounced role in both historically producing and, more recently, reproducing by trafficking in an ethos of "trickle-down" racial empathy. Asking questions of the reader, this reflection explores how institutions of higher education persistently fail to accurately diagnose and problematize systemic racism and their role in mediating it, thus failing to engender impactful policy toward diversity, equity, and inclusion within and outside of their academic communities.

CONFRONTING WHITENESS IN SOCIAL WORK EDUCATION THROUGH RACIALIZED STUDENT ACTIVISM

In 2010, a group of racialized doctoral students at an elite university in Canada collectively mobilized against institutional racism within their school of social work. They insisted that their school confront the ways in which White supremacy was embedded within various policies and practices. These early initiatives led to the creation of the Racialized Students’ Network (RSN). Although the RSN has ended, it has produced a new generation of scholars who continue to interrogate Whiteness and White supremacy. It has also offered roadmaps through which newer generations of racialized social work scholars can advance anti-racist and decolonial feminist perspectives within postsecondary social work institutions in Canada. In this article, the authors, who are now tenure-track or tenured professors at Canadian universities, demonstrate the ways in which graduate student anti-racist activisms are a central avenue for confronting Whiteness and institutional racism. Through a collaborative autoethnographic methodology, this article draws from the authors’ personal experiences within the RSN, the group’s source documents, and their collective analysis on how the RSN has informed their ongoing activism. They discuss how their everyday experiences align with current anti-racist struggles and movements to shape their actions and responses in academe. The RSN Model of Racialized Students’ Activism is presented to demonstrate the collective processes the student activists explored to reflect and apply their intersecting identities to support racialized students and address systemic racism.Alternate :En 2010, un groupe d’étudiants racisés, aux études doctorales dans une université canadienne, s’est mobilisé collectivement contre le racisme institutionnel au sein de leur école de travail social. Ces étudiants ont insisté pour que leur école confronte les façons dont la suprématie blanche s’ancrait dans diverses politiques et pratiques. Ces premières initiatives ont conduit à la création du Racialized Students’ Network (RSN). Bien que le RSN n’existe plus, il a donné naissance à une nouvelle génération de chercheurs qui continuent de s’interroger sur la blancheur et la suprématie blanche. Il a également offert des feuilles de route grâce auxquelles les nouvelles générations de chercheurs en travail social racisés peuvent faire progresser les perspectives féministes, antiracistes et décoloniales au sein des programmes de travail social dans les établissements postsecondaires au Canada. Dans cet article, les auteurs, qui sont maintenant professeurs titulaires ou permanents dans des universités canadiennes, démontrent comment les activismes antiracistes des étudiantes et étudiants sont une avenue centrale pour confronter la suprématie blanche et le racisme institutionnel. Grâce à une méthodologie autoethnographique collaborative, cet article s’inspire des expériences personnelles des auteurs au sein du RSN, des documents sources du groupe et de leur analyse collective sur la façon dont le RSN a influencé leur activisme actuel. Ils discutent de la manière dont leurs expériences quotidiennes s’alignent sur les luttes et les mouvements antiracistes actuels pour façonner leurs actions et leurs réponses dans le milieu universitaire. Afin de démontrer les processus collectifs entrepris par les activistes étudiants pour refléter et utiliser leurs identités entrecroisées afin de soutenir les étudiantes et étudiants racisés et confronter le racisme systémique, le modèle d’activisme des étudiantes et étudiantes racisés du RSN est présenté.

Hiding in plain sight: How incorporating honest discussion of racial and social (in)justice into medical education can inspire change.

The carnage wrought by systemic racism through social, judicial, and health injustices compels us to work towards a system that is fair and just for patients and colleagues. The evidence that change is necessary in medicine is hiding in plain sight in literature, oral histories, medical records, and news media. Notwithstanding this evidence, changing a system 400 years in the making will require a major paradigm shift. One of the many ways our department sought to catalyze such a shift was through media consumption, reflection, and discussion. Reading and studying literature and humanities in medicine can awaken our consciousness by making medicine an embodied practice that considers the totality of patients' lives in ways that a disembodied, purely scientific approach cannot. Thus, we started a Racial and Social Justice Book Club to normalize discussions about racial and social (in)justice and examine everything through an anti-racist lens. Herein, we describe our experiences in the inaugural year of the Book Club, a space to lend credence and dignity to the voices, experiences, and stories of folks who have long been marginalized by power structures in America, including medicine.

Moving from dialogue to demonstration: assessing anti-racist practice in social work education utilizing simulation

The stark racial health disparities associated with the COVID-19 pandemic coupled with the apparent rise of white supremacy in the United States (U.S.) supports the necessity of anti-racist social work education and practice. Anti-racist practice is particularly salient given the significant numbers of Black, Indigenous, People of Color (BIPOC) served by social workers across the country. This paper highlights ways in which racism continues to permeate the country and the implications for social work practice and education, and how assessment of anti-racist practice has historically and continues to be absent in social work education. After reviewing the coming changes to the Council on Social Work Education’s (CSWE) Educational and Policy Accreditation Standards (EPAS) associated with centering anti-racism in social work education, the paper then offers a rationale for utilizing simulation in student assessment of anti-racist practice behaviors. In order to ensure that social work students are meeting the mandate associated with practicing through an anti-racist lens and are ready to effectively collaborate with BIPOC communities, social work students must be adequately assessed while engaged in their educational training. [ FROM AUTHOR] Copyright of Social Work Education is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Advancing critical race pedagogical approaches in social work education

The recent COVID-19 pandemic drew a sharp focus on existing inequities for racialized communities in Canada and globally. A paucity of research-informed transformative learning models in social work has resulted in the persistent centering of Western ways of knowing. Current efforts do not adequately address the nuances of systemic and structural racial inequities, leaving students unprepared to deal with these issues in the classroom and in practice. We propose critical race pedagogy as an essential framework to promote and enrich social work learning environments where students can engage in courageous conversations about race, racism, power and oppression. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Racism and the mental health of East Asian diasporas in North America: a scoping review.

BACKGROUND: The COVID-19 pandemic heightened anti-Asian racism towards East Asian diasporas in North America. Experiences of racism encountered by East Asian communities have been documented to negatively impact their mental health. METHODS: A scoping review was undertaken following Arksey and O'Malley's (2005) methodology to (a) map the foci of literature on racism and the mental health of East Asian diasporas in North America and (b) identify gaps in the current literature. RESULTS: A total of 1309 articles were identified in May 2021. Based on the inclusion criteria, 35 records were included. Two distinct mental health foci were found: mental health outcomes and mental healthcare access and utilization. The majority (n = 22) of the articles focused on racism at the interpersonal level. Six articles provided anti-racism solutions at the individual level, such as overcoming biases. Five articles targeted anti-racism solutions from both the individual and institutional levels, while 1 article addressed barriers at the institutional level, such as dismantling sanctioned power hierarchies. CONCLUSION: The expanding knowledge base on COVID-19-related racial discrimination is reminiscent of previous literature examining the history of anti-Asian racism in North America. Greater attention is needed to navigate impactful anti-racism solutions for East Asian populations' mental health in North America.

Screening for Toxic Stress Response and Buffering Factors: A Case-Based, Trauma-Informed Approach to Health Equity.

Introduction: Exposure to adverse childhood experiences (ACEs) can lead to a toxic stress response with impacts on health that affect health equity. As part of our Health Equity, Social Justice, and Anti-racism curriculum, our aim was to introduce second-year medical students to a case-based method using a template-based screening and application of toxic stress, buffering factors, and resiliency-fostering tools to address health disparities and inequities with a trauma-informed care approach. Methods: We developed an asynchronous e-learning module that demonstrated the impact of ACEs by introducing students to screening for toxic stress response and buffering factors on health, their role as health equity determinants, and the use of brief in-clinic resilience-fostering tools in patient care. This was followed by a synchronous, facilitated, small-group, virtual discussion of a clinical case. Pre- and postworkshop surveys assessed changes in knowledge, skills, and attitudes. A 3-month follow-up survey assessed students' behavioral changes. Results: Sixty-four students completed the learning module. Paired t-test analysis showed a statistically significant increase in students' knowledge, skills, and attitudes regarding the Educational Objectives, with a survey response rate of 98%. Three months after the workshop, a third of students were applying these concepts, with a survey response rate of 87%. Discussion: Implementing this case-based curriculum in trauma-informed patient care helped increase opportunities for equitable health in patient encounters by providing students with the skills to screen for toxic stress, buffering, and brief in-clinic resiliency-fostering tools. Such skills will become even more impactful as we emerge from the COVID-19 pandemic.

Get to know me, homey: exploring critical, relational and racial literacy possibilities in co-excavative letter writing

Purpose: There is currently a dearth of research on the implications of the epistolary as a site for knowledge production. This paper aims to demystify the process of academic theorizing through the co-authors’ co-excavative epistolary method. Design/methodology/approach: Through co-excavative epistolary practices, the co-authors’ relationship was deepened, the collective sense was made of Covid-19, and racial literacy-centered academic theorizing commenced. In the co-authors making meaning of their letter-writing data, they provide examples of and analyze their co-excavative letter-writing process. Findings: The co-excavative epistolary method deepened the co-authors’ relationship to one another and improved their ability to produce useful and complicated knowledge. Research limitations/implications: The co-excavative epistolary exchanges mark a new site for academic theorizing and incite creative approaches to academic co-writing, as well as more transparency about the academic writing process in general. Social implications: Co-excavative methods disrupt traditional academic sites of knowledge production and engender space for relational intimacy. Originality/value: The work introduces both a new method, co-excavative epistolary writing and a new rational framework, the critical dignity relational framework. © 2022, Emerald Publishing Limited.

For an anti-racist applied linguistics: problematizations about silenced discourses and the (re)existence of blackness

The arrival of the COVID-19 pandemic brought us challenges both individually and collectively. Hence, we found some data that have made us aware of the (lack of) attention given to the population that are less supported by public policies, such as the black people. We pay attention to the inequalities that had already existed before this period of health crisis, as they need, urgently, to be researched in different areas of knowledge, including Applied Linguistics. Taking all of that into consideration, this research aims at analyzing discursive interactions between Facebook users, after seeing an image that promoted an online debate about black representation in textbooks, posted by the Secretaria Municipal de Educação do Rio de Janeiro (SME/RJ). The results showed us two types of speeches: one that silenced the initiative that aimed at promoting a racial debate in the field of education, and the other one that valued this practice. To sum up, we reinforce that research which have language as a central role in the interactions among people must problematize the uses of language that minimize initiatives aimed at promoting social justice. © 2021. All Rights Reserved.

Structural Discrimination in Pandemic Policy: Essential Protections for Essential Workers.

An inordinate number of low wage workers in essential industries are Black, Hispanic, or Latino, immigrants or refugees - groups beset by centuries of discrimination and burdened with disproportionate but preventable harms during the COVID-19 pandemic.

Not a token! A discussion on racial capitalism and its impact on academic librarians and libraries

PurposeThe purpose of this article is to introduce the concept of racial capitalism in the context of academic libraries.Design/methodology/approachThis paper draws on Leong's (2013) extended theory of racial capitalism and identifies how neoliberalism and racial capitalism are tied as well as how it is manifested in academic libraries through tokenism, racialized tasks, consuming racial trauma, cultural performance demands, workload demands and pay inequity.FindingsThe article ends with some suggestions in how to address these problematic practices though dismantling meritocratic systems, critical race theory in LIS education and training, and funding EDI work.Originality/valueThe article explores a concept in the academic library context and points to practices and structures that may commodify racialized identities.