For New Pittsburgh Courier
Studies have shown that racism and prejudice have contributed to racial gaps in health, education, economic stability and housing. Healthy People 2020 is the federal government’s “road map” agenda for building a healthier nation. The statement of our nation’s health recognizes racial discrimination as a social determinant of health that contributes to those racial gaps. Healthy People 2020 describes social determinants of health as conditions in the environments in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning and quality-of-life outcomes and risks.
Advocates are urging health professionals to clearly acknowledge that race and racism play a role in health status and social equity well-being. However, before we ask health professionals to examine their own role in improving the health of populations through achieving racial equity in health, we must first acknowledge past and present policies.
Noble Maseru, PhD, MPH, professor of behavioral and community health sciences, associate dean for diversity and inclusion, Office of the Dean, Graduate School of Public Health, and director, Center for Health Equity, University of Pittsburgh, quotes the Sankofa Bird, “If you want to know your present conditions, look at your past. If you want to know your future, look at your presentactions,” as a reminder.
Historical policies have contributed to differences in housing, education, health care, employment, media, criminal justice, and other systems. Dr. Maseru urges people to look to the past with a health equity lens. Anthony Iton, MD, JD, MPH, senior vice president for health communities with the California Endowment and health equity expert, advises that people need to “…fully illuminate the powerful relationship between social inequities and health inequities.”
Despite not being a native of Pittsburgh, Dr. Maseru was intrigued by Pitt Public Health’s commitment to acknowledging its historical wrongdoings. Pitt Public Health leadership recognized that previous policies have contributed to the limited representation of faculty, as well as students from historically underrepresented groups.
“Systematic inequalities are avoidable,” says Dr. Maseru. “We have the knowledge and the resources to correct the deficiencies.”
One of the ways that Pitt Public Health is addressing these deficiencies is through the community research advisory board (CRAB). CRAB is an initiative of the Center for Health Equity which is housed in Pitt’s Graduate School of Public Health. “CRAB, established in 2001, has been advising academics, service providers, community-based organizations and not-for-profit organizations for almost two decades,” says Dr. Maseru. “They educate about how best to engage vulnerable and historically underrepresented populations in research. They also promote collaboration among those researchers interested in addressing health inequities and/or disparities.”
CRAB is one way to bring attention to historical events, like the Tuskegee Study, and how they have changed the research process. CRAB also acknowledges that these events have contributed to people’s limited participation in research.
“CRAB is the lone organization in Allegheny County that has a diverse membership,” says Dr. Maseru. “It is made up of community-based persons, agency representatives, academics, service providers and students who are experts in community-based participatory research.”
CRAB is a space where people from underrepresented communities can share their experiences of discrimination throughout the research process. Members are encouraged to educate researchers on the best ways to partner with Black, Latinx, Hispanic or other communities of color. CRAB is also helping the not-for-profit and public sectors respond to changing federal demands. New federal requirements for research funding are asking organizations to include a health equity framework in their mission, needs assessment and community benefits agreements.
Dr. Maseru is confident about the future of Pitt Public Health. He envisions change occurring in multiple ways including expanding the reach of the school into the Pittsburgh area. He hopes to see the University of Pittsburgh become a top institution for health equity.
“To do this, we will establish deliberate cross-sector collaborations involving external communities and organizations, as well as internal partnerships with schools and departments across campus,” says Dr. Maseru.
Pitt Public Health will continue to emphasize that health equity is a measure of social progress. This goal can be achieved only by using a Health Equity in All Policies framework. This approach is supported by the Center for Disease Control and Prevention’s Office of the Associate Director for Policy and Strategy. Health equity in all policies is a joint approach that embeds health considerations in policymaking across all sectors. The overall goal is to improve the health and well-being of all. Dr. Maseru pledges to work with the public sector to find ways to improve population health. He would also like to continue to partner with community organizations to develop interventions that will improve the health of Pittsburgh residents.
“In doing the above, we carry out our vision…Advancing Just Health for All,” says Dr. Maseru.