At the Dawn of 2024 - Brief Words of Encouragement

Dearest sojourners,

Warmest greetings from the Center’s new home in Atlanta, GA. As outlined in my June 2023 blogpost, the Center is intentionally pausing externally-facing activities, but know that we remain as engaged and committed as ever. To honor that commitment to the pause, I share only a briefest set of reminders here.

Today is the first day of 2024. Sadly, there are many signs that the coming year(s) will be tumultuous and dangerous. Even so, this is not a time for us to cower. It is a time to get involved with ongoing struggles. To prioritize deep understandings over buzzword-based chatter. To witness. To speak. To act—boldly, but not recklessly for health justice. To preserve our humanity.

For those who may feel discouraged or overwhelmed, here are several additional reminders.

• Celebrate. Remember, dear sojourners, this work is extensive and difficult, but you are indeed doing it! Much of the labor is not readily perceived or acknowledged by others. Your peers or institutions may not value it beyond whatever immediate gains it affords them. However, we are motivated to do the work by a commitment to our community. Or, because we dream of a better world and know that world is possible. Those who benefit from your work may never know how much effort you expend doing it. You must find ways to recognize and celebrate each important milestone yourself. Perhaps the day will come when we can sit down and recount them together.

• Rest. Carve out the time you need for rest. The best models of health justice do not ignore our own rights to physical, mental and spiritual well-being. You deserve the space and time to care for yourself, your team members and your loved ones while doing the work. There is no need to apologize for that.

• On Saviors. The emerging challenges will not be solved because a public health savior developed a cure. They will be solved because a movement toward health justice demanded something different and worked to make it happen. Efforts to achieve health justice require the collective efforts of many people. This orientation is at odds with academia, which promotes a single academic “star” who operates in isolation from others. Surround yourself with other collectivist-oriented colleagues.

• On isolation. Do not isolate yourself. Threats to the attainment of “optimal health for all”. include various forms of racism, climate change, attacks on reproductive rights, etc. Therefore, it is important to build coalitions to synergistically achieve shared goals.

• On the evolution of racism. Be aware that racism is evolving in the early 21st century. It is both subtler and more complex. Realign your intellectual work to reflect this.

Some of you are feeling discouraged or overwhelmed. You are important. And so, too, is your work. Keep your head up. Take one small step at a time. And, be sure to get the professional support needed to thrive.

Yours in struggle,

Chandra

… ever committed to impactful movement toward health justice in the early 21st century…

“Hey sis, rest is not a reward": Exploring ways to advance reproductive justice through joy, rest and liberation

Reproductive Justice in the time of COVID

“Hey sis, rest is not a reward”: Exploring ways to advance reproductive justice through joy, rest and liberation

We recently published qualitative findings from interviews we conducted as part of the COVID-19 Storytelling Project in a paper titled “A Qualitative Analysis on Sexual and Reproductive Health Needs and Issues During COVID -19 Using a Reproductive Justice Framework”[1]. The findings we published are a continuation of reproductive justice work that communities have been leading long before the pandemic. These findings have inspired me to seek out those who have been doing this hard work for decades. The paper also highlights the relationship between rest and joy as pathways to reproductive justice, particularly in the context of covid where existing disparities have only worsened. I want to explore the ways in which we center our joy, rest, and liberation in reproductive justice work, especially when working within a culture that continues to show us they do not value our lived experience.

So often throughout different spaces, be it nonprofit, tech, medical or research, Black folks, and other communities of color are charged with leading discussions, interventions and other initiatives to advance health and reproductive justice. And this is how it should be, right? Nothing about us without us! No doubt. The leaders of the reproductive justice movement defined it as “...a human right to maintain personal bodily autonomy, have children, not have children, and parent the children in safe and sustainable communities [2]. And as the reproductive justice framework promotes, we absolutely should be up front and center, leading, demanding power, taking up space, and in turn receiving agency, resources, and adequate compensation for our efforts. But what happens when we go home? Or close our laptops, and try to shake off the day, are we able to come home to ourselves? Is our value defined by what we do for the movement? How is our rest connected to the larger movement?

Here in Los Angeles, the movement has been sustained by many organizations such as Black Women for Wellness and California Latinas for Reproductive Justice. These impactful groups have locked arms with the community and have been fighting for equity for decades. Black Women for Wellness (BWW), a nonprofit formed in 1997 to support the well-being and health of Black babies, support systems change and policy and advocacy [3]. BWW provides health and reproductive health education to the community as well as advocate for policies and research that support environmental justice. This intersection of reproductive justice and environmental justice is critical to the work of centering joy and liberation. We know that Black people have been denied access to green space through divestment and redlining [4]. Personally, access to parks where I can walk around, lay out under some trees, and just experience life is so vital to my well-being, allowing me to restore so that I may continue doing this work.

California Latinas for Reproductive Justice (CLRJ) is another well-known and appreciated organization that centers the experiences of Latina/xs by employing a reproductive framework to promote the human rights of Latinx community [5]. CLRJ focuses on supporting access to quality education, living wages, and violence prevention as pathways to reproductive health. Both of these organizations center their priority population and provide resources and leadership opportunities for both Black and Latinx folks to advocate for reproductive justice.

These organizations remind us that this work requires stamina, yet, have we thought enough about what we need to maintain that stamina? We cannot keep pouring from an empty cup. As Tricia Hersey promotes through her “Nap Ministry” work, “rest is resistance” [6]. Choosing to step away, or literally lie down for a nap, when the world would rather see you work until you die is itself a revolutionary act for us Black folk. But not just individual rest, a collective rest where we encourage and hold space for one another to take the time we need to fill our cups. One where we can extend grace and allow one another to be.

Reproductive justice movements have advanced community-based demands by taking to the streets. Protesting. Being loud and proud. But how do we take care of ourselves in ways that allow us to be able to be our best when we show up? White supremacist capitalist culture teaches us that we must cope with our struggles by working harder, pulling ourselves up by our bootstraps, but as Audre Lorde says “the master's tools will never dismantle the master's house.” Is there a way to imagine a different way of being as we do this work. One that allows us to focus on our individual and collective healing so that it benefits ourselves and the movement? One that allows us to prioritize our joy, liberation and pleasure as pathways to deep healing. We acknowledge that rest and joy may look differently depending on the community, and that we can hold both joy and grief at the same time.

Resting and doing less, unapologetically, is the move for us Black folks, taking our time, saying no to carrying the burden of advocacy and education of the masses. Going where we are celebrated, not just tolerated. This newly popularized movement of “quiet quitting” is old news for us as we have been doing this for generations…holding onto our dignity and quietly leaving spaces where we have not been valued, seen or heard, returning to our chosen families and communities. Our quiet strength is firmly rooted in our collectivism, the reality that many of us thrive because we exist in an ecosystem of caregivers, mentors, play cousins, aunties, grandmothers, and best friends. They are the soil that nourishes us.

Rest is also the soil that sustains us. Science provides evidence of this as stress reduction is clinically proven to reduce the possibility of adverse birth outcomes for Black people [7]. Safely planted, we can reflect, restore and grow. Beyond simply surviving to thrive. As a childfree woman who wants to have children eventually, I want them to come into a body that is well rested and nourished.

For me this looks like going to the ocean, crying and writing, releasing, laying under my favorite trees at my local park, saying no to requests that I do additional work and not feeling badly about it, moving my body, taking mental health days, and really just shifting from doing more to being more. It is hard to make this shift, as it goes against everything I have been taught to be as a Black woman working in predominantly white institutions. But I am enough, we are enough.

In the famous words of Congresswoman Maxine Waters, I am “reclaiming my time.” Reclaiming time that was taken away from my ancestors who were forced to care for everyone else but not afforded the time needed to care for themselves. Advancing the right to bodily autonomy and self-determination includes finding out what rest looks like for you. I hope you will read the article [1] published in the fall 2022 installment of the RACE Series in Ethnicity & Disease and are inspired to continue on our collective journey toward reproductive justice. And to my beautiful Black folk, put your phone on silent mode and find out what brings your spirit peace and joy. It is our time to be still. To breathe. To come home to ourselves. Just to be.

About the Author

Nicole V. Jones is a researcher, health equity strategist and healer of systems whose work focuses on improving health outcomes through dismantling systemic racism, particularly in the healthcare system. Nicole advocates for philanthropic investments in Black community-lead strategies and organizations whose work centers Black joy, healing and safety, with a focus on birth equity. Nicole is a recent MPH graduate of the UCLA Fielding School of Public Health where she worked closely with the Center for the Study of Racism, Social Justice and Public Health as a qualitative researcher. Currently, Nicole is a Program Officer at First 5 LA and serves on the management team of the African American Infant and Maternal Mortality (AAIMM) Initiative which seeks to reduce Black infant and maternal mortality by disrupting the pathway to physiological stress through promoting safe and joyous births. Nicole has worked on a number of racial equity-based health initiatives including doulas, anti-racism trainings for hospitals and guaranteed basic income pilots to improve Black maternal and child health outcomes. She is a proud, third generation Los Angeles native who loves to travel the world, particularly the African Diaspora and learn about the richness and nuances of dance, food, birthing and healing from different cultural lenses.

You can contact Nicole at her LinkedIn page.

Reference

1. de la Rocha P, Sudhinaraset M, Jones N, Kim C, Cabral, Amani B. A qualitative analysis on reproductive health needs and issues during COVID-19 using a reproductive justice framework. Ethn Dis. 2022;32(4):357-372; 10.18865/ed.32.4.357

2. Reproductive Justice. (n.d.). Sister Song. Retrieved September 25, 2022, from https://www.sistersong.net/reproductive-justice

3. About Us—Black Women for Wellness. (n.d.). Retrieved September 25, 2022, from https://bwwla.org/about-us/

4. Lewis, J. (n.d.). Walking on a Redline: Did Discriminatory U.S. Housing Policies Affect Greenspace Development? Environmental Health Perspectives, 129(3), 034004. https://doi.org/10.1289/EHP9033

5. What We Do | California Latinas for Reproductive Justice. (n.d.). Retrieved September 25, 2022, from https://californialatinas.org/about-us/what-we-do/

6. The Nap Ministry. (n.d.). The Nap Ministry. Retrieved September 25, 2022, from https://thenapministry.wordpress.com/

7. Liu, S. R., & Glynn, L. M. (2022). The contribution of racism-related stress and adversity to disparities in birth outcomes: Evidence and research recommendations. F&S Reports, 3(2, Supplement), 5–13. https://doi.org/10.1016/j.xfre.2021.10.003

From the Director...

June 30, 2023

From the Director

These reflections have been difficult to write.

Like so many of you, I am deeply troubled by the efficiency with which racial capitalism and white supremacy are reconfiguring society. I am deeply saddened by the ease with which people dismiss the humanity of those perceived as other. What troubles me most, however, is that in rushing to act quickly, health justice advocates may find ourselves drifting into this new phase of the battle with little understanding of the terrain on which it is being fought. (1)

The early 21st century is clearly a pivotal moment in the US. (2,3) In my assessment, it marks a new era of racial capitalism—one that critical race theorists and others have yet to fully understand. (4) In order to be able to continue to serve in a leading role in this new era, the center will take an intentional hiatus from our externally facing activities to focus intensively on distilling lessons from the past five years and charting a bold new course to confront the emerging national and global contexts of racialization on their terms. This is the last newsletter you will receive from us in this configuration of the Center for the Study of Racism, Social Justice & Health.

With seed funding from the Fielding School of Public Health and the support of many colleagues, I was thrilled to launch the Center for the Study of Racism, Social Justice & Health on the inaugural Indigenous People’s Day in 2017. My goal was for it to serve as a leader in advancing a bold movement for racial justice within the field of public health and beyond it. I feel humbled that the Center has been far more influential than I had planned for at the time. In recent years, many new centers have popped up in schools and programs of public health in response to racism intersecting the COVID pandemic. Some of them are thoughtfully designed, others are merely opportunistically pursuing the resources now available to conduct work on the health implications of racism. The hiatus this Center is about to embark on will help to ensure it cannot be conflated with the latter.

The work of the Center would not have been possible without the support of so many people. It is impossible to name all of you. Still, I thank you. It has been a privilege to struggle together toward a shared vision of beloved community.

The fierce team of Rebekah Israel Cross, Natalie Bradford, Ale Cabral and Porchia Toussaint launched this center. Each of you is precious to me. Thank you for your willingness to join me on what may have seemed like a wild journey at the time. That first year was magical. James Huynh and Millicent Robinson each served briefly as staff around the tumultuous beginning of the COVID-19 pandemic. Terence Keel, Kia Skrine Jeffers and Bita Amani graciously served as faculty leaders. As Associate Director for the Arts, Kia reminded us that the work cannot be reduced to empirical knowledge production. She hosted public-facing programs that centered the well-being of black women and communities, and reached broad audiences, including nurse scientists and community-based researchers. Bita has served as the lead co-chair of the COVID-19 Task Force on Racism & Equity. She has been my partner in fundraising, policy- and community-facing outreach, research, translation and dissemination of findings for use by community partners. Mienah Sharif and Paris “AJ” Adkins-Jackson completed postdoctoral fellowships and then went on to begin tenure track appointments where they are launching careers that challenge the field of public health from within. Mienah has continued to collaborate with the center and play a role in shaping the development of an anti-racism center at her new academic home. No one has sustained a core role longer than Consuela Abotsi-Kowu. She has been a student volunteer, center coordinator, data specialist on the COVID-19 Task Force on Racism & Equity, as well as the project assistant and project manager for the multi-million dollar intervention, Project REFOCUS. Consuela, you are an exemplary colleague from whom I have learned a lot. Thank you for continuing on this adventure with me. To the members of the Center’s Executive Board: Robin D.G. Kelley, Margaret Prescod, Barbara Krimgold, Collins Airhihenbuwa, Keith Norris, Gil Gee and Camara Jones, thank you for helping me to navigate the kinds of challenges that emerge when trying to carry out this work with integrity. Faculty, student, staff and community affiliates of the center whether based at UCLA or elsewhere, you are sources of inspiration and models of courage. Continue to forge ahead knowing others are working in solidarity with you. We are fortunate to have the generosity of many donors and advocates, including Vic Schoenbach and Phyllis Chestang, who generously shared financial support, recent publications and other materials with the center on a recurring basis. Your contributions that all of you have made are incredibly valuable, not only because of the resources they provide (for instance, to be able to hire students and staff), but also because you are letting us know that you value the work we are doing. My sincerest gratitude to you. Janet E. Dandridge donated a provocative work of installation art, one large component of which still hangs on the Center wall. Many, many volunteers, including but certainly not limited to Taylor Rogers, Ezinne Nwankwo, Anna Hing, Erin Manalo-Pedro, Adrian Bacong, and Anna-Michelle McSorley, who is continuing the Anti-Colonialism Collective from her new home at New York University, hosted events or participated in activities that sustained our relationships with community partners. The UCLA Fielding School of Public Health’s dean’s office shared our work with donors and the stellar team in the Office of Marketing and Communications championed our activities and affiliates in various publications. If you participated in any of our many activities, you also benefited from conversations we regularly had with our closest community partners. Particularly warm thanks go to Felica Jones and Healthy African American Families, the Black Coalition Fighting Back Serial Murders, Black Alliance for Just Immigration and Stop LAPD Spying Coalition. Over the last two years, I have relied heavily on my center coordinator extraordinaire, E. Minelle David, whose ideas are valuable to me and whose thoughtfulness and love come through in how she curates our weekly newsletter, interacts with others, and addresses the many requests that come across her desk. Minelle, it is a blessing to work with you.

Folks (i.e., everyone who has supported us whether named or not), together we built a home and a community; that will continue. Together, we established the feasibility of using Critical Race Theory/Public Health Critical Race Practice (PHCRP) (5) to conduct anti-racist, community-engaged health equity work. That will continue. I am incredibly proud of the foundation we built. Yes. It was difficult to build it. I am extraordinarily grateful for your commitment to the work; I know that you were still fighting the good fight even when doing so came at great personal or professional cost. Please be encouraged as we move into this next phase knowing that your efforts have provided the institution (UCLA and the Fielding School of Public Health), our communities and the field with much more on which to draw as they forge ahead for health justice.

Thank you everyone for the privilege and the responsibility of this work. I look forward to reconnecting when we get to the other side.

With love and for health justice,

Chandra

1.         Bowleg L. "The Master's Tools Will Never Dismantle the Master's House": Ten Critical Lessons for Black and Other Health Equity Researchers of Color. Health Educ Behav. 2021;48(3):237-249.

2.         Jung M-K, Costa Vargas JH, Bonilla-Silva E, eds. State of White Supremacy: Racism, Governance, and the United States. Stanford, CA: Stanford University Press; 2011.

3.         Bonilla-Silva E, Glover KS. "We are all Americans": The Latin Americanization of race relations in the United States. In: Krysan M, Lewis AE, eds. The changing terrain of race and ethnicity. New York: Russell Sage Foundation; 2004:149-183.

4.         Krieger N. Got Theory? On the 21st c. CE Rise of Explicit use of Epidemiologic Theories of Disease Distribution: A Review and Ecosocial Analysis. Current Epidemiology Reports. 2014;1:45-56.

5.         Ford CL, Airhihenbuwa CO. Commentary: Just What is Critical Race Theory and What's it Doing in a Progressive Field like Public Health? - PMC (nih.gov) Ethn Dis. 2018;28(Suppl 1):223-230.

Congratulations to Dr. Ezinne Nwankwo & Dr. Taylor Rogers!

On Friday, June 16, 2023, two anchors among the student affiliates of the Center for the Study of Racism, Social Justice and Health received their doctorates. Their paths and interests are different, and each honored her own unique path in remaining steadfast contributors to the vision of the Center.

Dr. Taylor Rogers was the inaugural student chair of UCLA’s partnership with the annual UNC minority health conference featured in a documentary short about the work of the center’s COVID Task Force on Racism & Equity, a collaboration with Charles R. Drew University of Medicine & Science. It highlights Dr. Rogers’ role writing press releases, identifying grant opportunities and generally supporting the advocacy work of one of the Center’s closest partners, the Black Coalition Fighting Back Serial Murders. Since her arrival to UCLA, Dr. Rogers has fought to bring institutional change to the Fielding School of Public Health, UCLA and the field of Health Policy and Management. This has often been isolating, difficult work. We recognize your courage and salute you for your vision and persistence.

Dr. Nwankwo has been a dedicated grant writer and graduate student researcher at the Center since her arrival to the department of Community Health Sciences. She worked not only on behalf of the center, but also sometimes on behalf of our community partners. In addition to your eagerness to assist with center projects requiring support, you will be missed for your amazing humor, candor and team spirit, which you lavish upon us at every gathering large or small.

CONGRATULATIONS TO BOTH OF YOU!!! WE ARE SO PROUD OF YOU. May your new academic homes recognize and celebrate the gift you are. May you feel like you belong. And, may the foundation you laid and the support you received enable you to thrive!

So much respect and pride.

In struggle for justice,

Chandra

From the Director...

From the Director:

Since joining the UCLA faculty in 2008, I have personally hosted a viewing of the UNC Minority Health Conference or sponsored a partnership conference at UCLA nearly every year. This practice continued through the Center, beginning in 2017 when the Center was launched. Student affiliate Taylor Rogers, a healthcrit and doctoral candidate in Health Policy & Management, agreed to serve as the inaugural student chair of the UCLA partner site for the conference. Since then, Millicent Robinson, Ale Cabral and Adrian Bacong have served in this role exceptionally.

This year, in lieu of a separate UCLA partner conference, we urge you to participate in one or both of the activities below, which both occur Friday, February 24, 2023. Participating is important not only to learn, but also to feel and to connect. Certainly, connecting with one another now—a period of continued violence and turbulence—is as important as ever.

“Practicing Health as a Human Right: Policy, Ethics and Law,” 44th Annual UNC Minority Health Conference

*which remains my favorite health equity-focused conference in the nation!*

For the conference schedule and to register, please visit the conference site.

“Transforming Research: Feminist Methods for Times of Crisis and Possibility,” 33rd Annual Thinking Gender Student Conference

Friday, February 24, 2023, at the Grand Horizon Ballroom at UCLA Covel Commons. For the conference schedule and to register, please visit the conference website.

Wishing you a wonderful weekend.

In struggle for health justice,

Chandra

From the Director...

From the Director

January 13, 2023

Happy new year and welcome to 2023! Certainly, 2022 turned out to be quite a tumultuous year socially, politically, globally, financially, climactically, and, for many people, personally; therefore, it may be tempting to want to put 2022 behind us altogether. But, like every year, 2022 also held promise at the beginning. My hope is not that we enter 2023 as an escape from the turmoil of 2022, but that we learn from 2022 in order to move through 2023 with both optimism and clear-eyed vision.

Some of you are new to the Center for the Study of Racism, Social Justice & Health. The Center was launched five years ago on the inaugural Indigenous People’s Day in Los Angeles, October 9, 2017. It serves as a hub for researchers, students, staff and community members based at UCLA and elsewhere to collectively study and address the public health implications of various forms of racism. Founded based on the principles of Public Health Critical Race Praxis (PHCRP), Center affiliates are involved in rigorous research, innovative teaching and community engagement all focused on racial and social justice. You can find some of our publications and a video highlighting our activities during the COVID pandemic below:

• Racism: Science & Tools for the Public Health Professional – selected as an academic title for 2020 by the American Library Association

• Applying Critical Race Theory in Health Equity Research  – a special issue of Ethnicity & Disease

• The Rapid Assessment of COVID Evidence (RACE) Series - a special collection of papers currently being published in Ethnicity & Disease

• The COVID Task Force on Racism & Equity – video aired at the 2021 annual meeting of the American Public Health Association showcasing the work of the Task Force, which is a collaboration between UCLA and Charles R. Drew University of Medicine & Science

Last June, I introduced you to the Center’s first major cohort of PhD graduates, who had been deeply entrenched in antiracism scholarship, research, teaching and community engagement over the course of their doctoral programs. They represent a critical mass of emerging racism researchers. For instance, they constituted two-thirds of all doctorates earned in Community Health Sciences at UCLA in 2022. They have studied Critical Race Theory extensively, which is rare among public health programs. And, each of them is now completing postdoctoral fellowships, which will position them to shape the field through their research and future teaching. It will be exciting to see how collectively they will significantly bolster the capacity of public health to respond effectively to emergent threats to health equity.

The new year is a perfect time to introduce current student affiliates and their wide-ranging backgrounds and interests. So, I highlight just several of them here: Ale Cabral, Aisha Fletcher, James Huynh, Cindy Le, Erin Manalo, Ezinne Nwankwo, Dillon Rodriguez, and Taylor Rogers.

The most senior of these students--James, Ezinne and Taylor--are doctoral candidates, which means they have successfully defended their dissertation proposals and are now actively conducting the proposed dissertation research.

This group of eight students is poised to influence policy, which is essential for responding to health inequities. Aisha is a current Robert Wood Johnson Foundation Health Policy Research Scholar (HPRS); James and Ezinne are recent alumni of the program. The program prepares students to become leaders advancing policy solutions to health inequities.

UCLA public health doctoral students complete a minor program of study while earning the doctorate. Cindy Le, who is a Robert and Melinda Gates Foundation Scholar, may be the first student whose minor is in information sciences. This will make her work extremely timely and relevant. Most importantly, it will provide her with the substance knowledge and skills needed not only to use emerging information science and data science technologies, but to create them and ensure they reflect core social justice principles.

Issues of immigration—its intersectionality with racism and other structural injustices—is a theme in the dissertation work and other activities of these students. Erin Manalo proudly draws on her identity in advancing anticolonial work that centers the people of the Philippines and recognizes salient gender dynamics. James Huynh’s focus on LGBT activism in Orange County, CA centers the experiences of the Vietnamese refugee communities there. Drawing on Queer and Trans of Color Critique as well as Public Health Critical Race Praxis (PHCRP) and traditional socio-behavioral theory, this work has the potential to inform future scholarship in queer studies, ethnic/area/American studies, and public health.

Ale Cabral has earned an impressive reputation for her selfless leadership roles in community-engaged research and community service. Her longstanding areas of interest include social determinants of HIV inequities, HIV and aging, substance use, and LGBTQ+ health. She coordinates the RACE Series being published in Ethnicity & Disease. It is remarkable that her grants portfolio as a doctoral student in Community Health Sciences exceeds that of some junior faculty.

Aisha and Dillon are the newest PhD students at the Center. Their broad areas of interest are tied to specific populations whose humanity continues to undervalued in society. Aisha is interested in improving the life expectancy and quality of life of African American men. Her interest in structural racism stems from the fact that so many of them die prematurely due to conditions that could have been prevented. Dillon’s work serves as a reminder that despite all of the pharmaceutical advances that have been made since the first cases of what is now known as AIDS were diagnosed, HIV continues to have a significant impact on the lives people of color, especially gay and bisexual men as well as transgender women. These populations experience the compounded impacts of intersecting factors tied to poverty and economic injustice, mass incarceration, homophobia and transphobia, nativism, limited access to care, stigma, mistrust of the public health sector, and racism. Through their work Aisha and Dillon seek not only to identify key determinants of the disparities, but also to center, value and show love for members of these populations.

To address the myriad of ways social injustices evolve over time, many Center affiliates are developing novel concepts and methods for research or interventions targeting racism. Among these students, for instance, Ezinne’s research is raising new questions about the need to understand differences, similarities and overlap between residential segregation imposed on recent immigrants of color vs their voluntary decisions to reside in ethnic enclaves.

Attention to healthcare is an increasingly important part of the nation’s public health agenda. Several of the students are focused on this in some way. Taylor has been working as an “outsider within” the field of health services research to identify institutional drivers of inequities in healthcare and document factors influencing the diversity of the workforce.

In addition to their research and scholarship, these students are actively engaged in service to the field and community. For instance, Ale co-designed and led an innovative, interactive online version of the annual Minority Health Conference at UCLA that incorporated yoga, mindfulness, exercise as well as an amazing soundtrack into a research conference program. Participants were so engaged that participation was still high at the end of the day-long event.

This is the final year of the center in its current format. You will have to stay tuned for the next phase of our work, which builds on all we have learned thus far in a new home and format.

If you have not had an opportunity to get involved yet, you do still have time to participate in the journal clubs, book club and formal presentations. As people who run track know, it is important to round the final bend of the race with a strong kick. We will continue to expand the movement for health justice through the remainder of the academic year by engaging with leaders of the next generation of public health centers on racism and health and by amplifying the work of the historically black colleges and universities (HBCUs) with whom we most closely collaborate, Charles R. Drew University of Medicine & Science and Howard University. I do hope you’ll join us.

Thank you for supporting this work. Your support is invaluable. Looking forward to continuing the journey with you and with new partners.

In struggle for health equity,

Chandra

From the Director (regarding the strike)

From the Director:

The Center for the Study of Racism, Social Justice & Health stands in solidarity with UC students who are on strike for fairer wages. Like UC Berkeley, UCLA is located in one of the nation’s most prohibitively expensive cities in which to reside. Both the cost and availability of housing matter; even wealthy people looking for places to live in LA may have difficulty finding it. To live and work in Los Angeles requires reliable transportation, especially for people who cannot afford to live in Westwood, the neighborhood in which UCLA is located. The neighborhoods among which the campus is nestled are among the most expensive in the country and in Los Angeles: Beverly Hills, Bel Air, Brentwood, Pacific Palisades, Culver City, Santa Monica, etc.  (See the Los Angeles City Historical Society’s online almanac). According to the LA Times’ Mapping LA Project, it is also one of the county’s whitest areas (Figure 1). It is remarkable—and not in a complimentary way--that only 7.0% of the population of Westwood is Latinx given Latinx people account for 48.9% of the population of Los Angeles and 40.2% of the state population according to the census.

Source: LA Times

Employment is one of the social determinants of health, which are known to create the conditions that drive health inequities. To address them is necessary to achieve the goal of public health: to promote optimal health for all.

All workers deserve fair and safe working conditions. The strike by student workers (e.g., research assistants, teaching assistants) and postdoctoral scholars, therefore, serves not only as a call to improve the working conditions for certain classes of workers, but as a reminder of the need to do so for all workers. This includes the university staff. Their contributions hold academic departments and the entire university together. Although they provide direct material and emotional support for students, faculty, administrators and others (e.g., patients), their needs, interests and perspectives are often overlooked, too.

Thank you, students and postdoctoral scholars, for reminding us that all workers deserve fair, safe working conditions and a living wage.

Let us see the student strike as an opportunity to learn more about the actual conditions of workers in the UC system and to work collectively toward creating optimal working conditions.

Resources that students and former students have shared with me are below.

A list provided by a UCLA student (name not disclosed intentionally here):

Read about the strike and workers' core demands

https://www.fairucnow.org

Join a picket line in California
https://www.fairucnow.org/picket/

Donate to the UAW-UC Academic Workers Strike Support and Hardship Fund
https://givebutter.com/uc-uaw

Review the UAW 2865 Bargaining Survey Results
https://uaw2865.org/2022-bargaining-campaign/bargaining-survey-results/

Host a teach-in about the strike
https://docs.google.com/presentation/d/1HTuvtm9TNj6NhbCFVM66enHYdVtS8ZoF/edit#slide=id.p1

Follow UAW Twitter (and Instagram) accounts for live updates
@uaw2865 @UAW5810 @sruuaw

In struggle for health equity,

 Chandra

From the Director on the Center's 5th Anniversary

From the Director…

Monday, October 10, 2022 marks the five-year anniversary of the Center for the Study of Racism, Social Justice & Health (Center), which was launched on the inaugural Indigenous People’s Day in Los Angeles, October 9, 2017. I am deeply grateful for the warriors for health justice who have been leading our antiracism work through rigorous research, innovative teaching, community engagement, outreach and education as well as generous levels of service at UCLA, in the field of public health, in our local communities and beyond.

The founding core staff on graduation day, year 1. From left: Rebekah Israel Cross, Natalie J. Bradford, Chandra L. Ford, Porchia Toussaint

The level of impact on the field has exceeded my expectations. It was a privilege to publish Racism, Science & Tools for the Public Health Professional, and for it to be named a 2020 academic title by the American Library Association. I am particularly proud of the first large cohort of core doctoral students—Rebekah Israel Cross, Natalie J. Bradford, Anna Hing, Anna-Michelle McSorley, Millicent Robinson and Adrian Bacong—to graduate with their doctorates in June of this year. Each is conducting groundbreaking work rooted in very extensive work in racism, anti-racism, Public Health Critical Race Praxis, Critical Race Theory, anticolonialism, and health equity. They are already beginning to shape the national landscape of antiracism research, teaching and service in public health.

Book signing for Racism: Science & Tools for the Public Health Professional. American Public Health Association (APHA) Press Booth, APHA annual meeting 2019. From left to right: Derek Griffith, Keon Gilbert, Georges Benjamin (APHA Executive Director), Chandra Ford, Natalie Bradford, Marino Bruce.

One should not conflate having a center and with the effort entailed in building a center. For more than five years, we have been building a center. We have been fostering an institutional home for an expanding movement toward health justice. Many people have contributed to this work. I extend my deepest gratitude to everyone who has contributed in any way to its growth. THANK YOU. Your bold and innovative contributions as well as your practical ones have been helping to institutionalize anti-racism in the field of public health even before the field or the nation fully recognized the need for this work.

Graduation 2022 newly conferred PhDs: Rebekah Israel Cross, Adrian Bacong, Anna-Michelle McSorley, Anna Hing, Millicent Robinson. Not shown: Natalie J. Bradford

To agitate for justice within one’s own institution, profession or community can be isolating. To speak truth to power requires courage. So, I am particularly indebted to the core team of mostly BIPOC people with whom I have worked most closely over the last five years to forge an institutional home rooted in Public Health Critical Race Praxis (PHCRP). The particularly significant efforts of Rebekah Israel Cross, Natalie Bradford, Bita Amani, E. Minelle David, Ale Cabral, Consuela Abotsi-Kowu, Mienah Z. Sharif, James T. Huỳnh, Ezinne Nwankwo, Taylor Rogers, Kia Skrine Jeffers and Porchia Toussaint are immeasurable. I am extremely blessed to be able to draw on the wisdom of the Center’s Executive Board: Collins Airhihenbuwa, Keith Norris, Margaret Prescod, Barbara Krimgold, Camara Phyllis Jones, Gilbert Gee and Robin DG Kelley, Thank you for the opportunities and wisdom you have been sharing with me since before the Center was established. Finally, in addition to an extremely close relationship with the Charles R. Drew University of Medicine and Science, we are fortunate to have extraordinary community-based organizations with whom to partner. They include (but are not limited to) the Association of Black Women Physicians, Black Coalition Fighting Back Serial Murders and Healthy African American Families. If you like the work of the Center, please support the work of our partners.

The Center is located in beautiful southern California on the campus of the University of California at Los Angeles. The United States secured California as its 30th state in 1850, two years after the Mexican American war ended with the treaty of Guadalupe Hidalgo; however, the original inhabitants and caretakers of this land were the Gabrieliño Tongva peoples. Though recognized as a nation more recently, the expansion of Los Angeles displaced this nation and helped facilitate the establishment of UCLA. However justice-oriented our work may be, the Center inherently benefits from the spoils of settler colonialism. We at the Center remain humbled and motivated by this knowledge. I am grateful to Rey Soto for steadfastly reminding us and our invited guests to remain attentive to this truth.

Equity has been defined in a variety of ways. Former president of the American Public Health Association, Camara Phyllis Jones,  defines it as “assurance of the conditions for optimal health for all people.”1 She further explains that health equity can only be achieved if we

• value all individuals and populations equally,

• recognize and rectifying historical injustices, and

• provide resources according to need.

This definition underscores that equity can only be achieved through the decolonization of public health. We will mark the 2022 Indigenous People’s Day in support of the UCLA Department of American Indian Studies and the American Indian Studies Center. We encourage everyone form learning circles to study your own indigenous communities.

This is a critical moment in the history of our nation, our communities and our world. And, there is much to do. I invite you to join us in whatever ways you can as we continue the struggle toward our dreams of a more just world in which there is optimal health for all. We are eager to lean into the next phase of our movement building work as we continue to:

lead the nation in conducting, rigorous community-engaged research to identify, investigate and explain how racism and other social inequalities influence the health of diverse local, national and global populations.

I extend my deepest gratitude to Center friends. Thank you. The past five years have been both rewarding and challenging.

Today we celebrate all that we have been able to achieve. Tomorrow, we return to the struggle.

For more information or to get involved, click here.

In struggle and with deepest gratitude,

Chandra

The Center for the Study of Racism, Social Justice & Health at UCLA acknowledges the Tongva peoples as the traditional land caretakers of Tovaangar (Los Angeles basin, So. Channel Islands) and are grateful to have the opportunity to work for the taraaxatom (indigenous peoples) in this place. As a land grant institution, we pay our respects to Honuukvetam (Ancestors), 'Ahiihirom (Elders), and 'eyoohiinkem (our relatives/relations) past, present and emerging.

References

1. Jones CP. Systems of Power, Axes of Inequity: Parallels, intersections, braiding the strands. Med Care. 2014;52:S71-S75.

2. Tuck E, Yang KW. Decolonization is not a metaphor. Decolonization: Indigeneity, Education & Society. 2012;1(1):1-40.

Hurricane Fiona Exposes More Than Crumbling Infrastructure in Puerto Rico

Hurricane Fiona Exposes More Than Crumbling Infrastructure in Puerto Rico

By: Anna-Michelle Marie McSorley, PhD, MPH

Hurricane Fiona is the latest natural disaster to strike Puerto Rico, which has been a territory of the United States (U.S.) since 1898 [1]. While this storm has substantially and uniquely devastated the archipelago’s infrastructure, Fiona made landfall within a territory that has recently been navigating a multitude of consecutive natural disasters amidst a historically complex socio-political context; one that has been over a century in the making. This blog provides details on the events of Hurricane Fiona, background on Puerto Rico’s territorial status, and resources for how you can help Puerto Rican recovery efforts.

The Natural Disaster

Hurricane Fiona and the Aftermath in Puerto Rico

Hurricane Fiona made landfall in Puerto Rico on September 18, 2022 [2]. Although a seemingly less severe category-1 hurricane compared to Hurricanes Irma (category-5) and Maria (category-4), which wreaked havoc in Puerto Rico in 2017 [3], Fiona’s forces still managed to dump as much as 30 inches of rain in some areas of Puerto Rico [4,5]. These torrential rains, coupled with the damage that remained from the prior hurricanes, led to mass flooding and decimated many parts of the already compromised infrastructure. This resulted in disruptions to water services and territory-wide power outages that left 3.2 million residents weathering the storm in the dark. 

These interruptions in power and water services permeated across all sectors and contributed to the U.S. Department of Health and Human Services’ decision to declare a state of public health emergency in Puerto Rico [6]. Six days after the storm, over 37% of hospitals were still relying on unstable energy from generators as the restoration of power had only been confirmed for 94 of the 150 hospitals in Puerto Rico [7]. In some areas, the local health facilities had reopened, but flooding and landslides left people living in rural municipalities cutoff from the bridges and roads needed to access these facilities [8,9], which provide crucial medical treatment for pre-existing and hurricane-related ailments and injuries. Similarly, many residents continue to be unable to access other basic needs, such as food and bottled water, as well as the gasoline needed to power generators. Tragically, as residents continue to rely on candle-light and generator power, fires have increased, partially contributing to the estimated 16 hurricane-related deaths that have been reported, thus far [10].

More than a week later…

By Monday, September 26, 2022, over a week after the hurricane made landfall, data from the Puerto Rico Emergency Portal System managed by the Government of Puerto Rico, reported that over 41.5% (608,739/1,468,005) of customers were still without power and over 16% (212,439/1,327,740) of customers did not have water services [11,12]. Moreover, residents remain under a boil-water advisory [13], as water services are restored, and Puerto Ricans in the municipalities hardest hit by the storm are still largely without power. In Mayaguez, a municipality on the west coast of the main island, only 23% of customers had power restored to their homes as of 9/26/22 [7]. As Puerto Ricans move into the second week without these essential services, many residents can’t help but flashback to the events of Hurricane Maria and recall the poor federal response that left some Puerto Ricans living in the dark for as long as 9 months [14]. 

The Socio-Political Context

Puerto Rico is a U.S. Territory who’s 3.2 million residents are U.S. Citizens

The United States Commonwealth of Puerto Rico, as it is named in the U.S. Constitution, became a territory after the Spanish-American War of 1898 [1]. This magnificent collection of islands and islets in the Caribbean, including the main island of Puerto Rico, and the smaller inhabited islands of Vieques and Culebra, are home to an estimated 3.2 million Puerto Ricans who predominantly speak Spanish. In 1917, Puerto Ricans residing within the territory were granted U.S. citizenship [15]. In 1952, Puerto Rico was granted self-governing commonwealth status by the U.S. Congress [16]. However, as neither a state nor a sovereign nation, Puerto Rico remains under U.S. constitutional control. Similarly, while Puerto Ricans are U.S. citizens, those residing in the territory cannot vote in U.S. federal elections and their congressional representatives do not have voting power in the U.S. Congress [17]. In this sense, Puerto Ricans have limited power to influence the federal government that they rely on for aid during natural disasters.

U.S. Government Response to Latest Natural Disaster

On September 22, 2022, President Biden, in his remarks on the Hurricane Fiona Recovery Efforts, assured the residents of Puerto Rico that the U.S. federal government would be there to help. President Biden guaranteed “100 percent funding for debris removal, search and rescue, power and water restoration, and shelter and food for the month.” [18] This is vital federal support needed for Puerto Rico to recover from this latest natural disaster. However, the long-term plan for investment in shoring up the archipelago’s infrastructure recovery is unclear. Again, Puerto Rican residents have limited political power to influence these federal response efforts but those of us in the States do have the ability to help in several ways.

How you can help…

1. Vote in the upcoming midterm elections on Tuesday, November 8, 2022

   This year, all 435 seats in the U.S. House of Representatives and 35 of the 100 seats in the U.S. Senate will be contested. These seats represent the federal governing bodies that influence the socio-political context of the States and Puerto Rico. This November, exercise your right to vote in honor of those who do not have a voice in this upcoming election.

   Visit vote.org to find your local polling place.

2. Donate to local community organizations in Puerto Rico

• Fiona Community Response Fund - “The Fiona Community Response Fund is led by a coalition of community-led organizations working on immediate response to fulfill needs over the short- and long-term. It is a partnership of approximately 25 organizations.”

• Taller Salud - “Taller Salud is a community-based feminist organization dedicated to improving women’s access to health care, to reducing violence within the community and to encourage economic growth through education and activism.”

• Comedores Sociales - “Created in 2013, Comedores Sociales de Puerto Rico is a nonprofit organization that seeks to eradicate hunger in Puerto Rico through strategies of collective work and socialization of resources in favor of the majority of our people.”

• Techos Pa’ Mi Gente - “A non-profit organization dedicated to the construction of decent roofs and the rehabilitation of homes in communities affected by natural disasters. It contributes to improving the quality of life of the individuals that make up these communities. Promotes self-management and provides training in basic construction skills to build resilience.”

Please note: Websites in Spanish can be translated to English using the translation function within the Google Chrome browser.

Dedication: He escrito este artículo en honor de las mujeres Puertorriqueñas que me criaron y que siempre me han amado con todo su corazón.

Translation: I have written this piece in honor of the Puerto Rican women who raised me and who have always loved me with all of their hearts.

About the Author: Dra. Anna-Michelle McSorley (she/ella) is a Postdoctoral Scholar at the New York University (NYU) School of Global Public Health within the Center for Anti-racism, Social Justice, and Public Health. She received her MPH and PhD from the Fielding School of Public Health at UCLA. She is also a Faculty Affiliate of the UCLA Center for the Study of Racism, Social Justice and Health and a Co-Founder of the Anti-Colonialism Collective. Dra. McSorley is a health inequities researcher who studies the social determinants of health that act upon the life chances of marginalized communities, with a particular focus on the Puerto Rican population living in the States and Puerto Rico. Although she is a Brooklyn-born Nuyorican, her formative years were shaped by her experiences living a back-and-forth life between New York City and Puerto Rico. Today, most of her extended family lives in Añasco, one of the coastal municipalities that was most impacted by Hurricane Fiona.

You can find Dra. McSorley at the virtual sessions of the Anti-Colonialism Collective Book Club on the last Tuesday of every month. To learn more about Dra. McSorley and her work, visit amcsorley.com.

Acknowledgements: Thank you to Chandra Ford, Minelle David, and the Center for the Study of Racism, Social Justice and Health for welcoming this important commentary and for the mentorship I have received throughout the years. Also, a big thank you to Alexandra Rivera-González, MPH for her advocacy in Puerto Rico and for elevating the work of many of the community organizations that are listed in this piece.

References

1. Morales E. Fantasy Island: Colonialism, Exploitation, and the Betrayal of Puerto Rico. Bold Type Books; 2019.

2. Hurricane Fiona Makes Landfall in Puerto Rico, ABC News, World News Tonight.; 2022. Accessed September 24, 2022. https://www.youtube.com/watch?v=9BwEavDBUw0

3. RAND Corporation. Hurricanes Irma and Maria: Impact and Aftermath. Accessed September 26, 2022. https://www.rand.org/hsrd/hsoac/projects/puerto-rico-recovery/hurricanes-irma-and-maria.html

4. Finch A. Rainfall from deadly Hurricane Fiona tops 30 inches in Puerto Rico.https://www.accuweather.com/en/hurricane/hurricane-fiona-devastates-puerto-rico-with-heavy-rain-flooding-and-mudslides/1249326. Published Spetember 2022. Accessed September 24, 2022.

5. Hernandez A. Hurricane Fiona hit Puerto Rico as a Category 1 storm. Flooding still wrought havoc. Washington Post. https://www.washingtonpost.com/nation/2022/09/23/hurricane-fiona-puerto-rico-floods/. Published September 23, 2022. Accessed September 24, 2022.

6. HHS Press Office. HHS Secretary Becerra Declares Public Health Emergency for Puerto Rico after Hurricane Fiona. HHS.gov. Published September 21, 2022. Accessed September 24, 2022. https://www.hhs.gov/about/news/2022/09/21/hhs-secretary-becerra-declares-public-health-emergency-puerto-rico-after-hurricane-fiona.html

7. Government of Puerto Rico. Puerto Rico Emergency Portal System (PREPS). Accessed September 24, 2022. https://www.preps.pr.gov/

8. The Associated Press. In Puerto Rico, rescuers struggle to reach areas cut off by Hurricane Fiona. NPR. https://www.npr.org/2022/09/22/1124523267/puerto-rico-hurricane-fiona-people-stranded. Published September 22, 2022. Accessed September 26, 2022.

9. Andrews H. Public health emergency declared in Puerto Rico where most still without power, water after Hurricane Fiona. FOX Weather. https://www.foxweather.com/weather-news/public-health-emergency-puerto-rico-power-water-hurricane-fiona. Published September 22, 2022. Accessed September 26, 2022.

10. Sánchez LNP. Puerto Ricans Fear Extended Blackout After Hurricane Fiona. The New York Times. https://www.nytimes.com/2022/09/24/us/puerto-rico-power-outages.html. Published September 24, 2022. Accessed September 26, 2022.

11. Government of Puerto Rico. Puerto Rico Emergency Portal System (PREPS). Accessed September 26, 2022. https://www.preps.pr.gov/

12. Romo V. Puerto Rico has lost more than power. The vast majority of people have no clean water. NPR. https://www.npr.org/2022/09/20/1123984002/hurricane-fiona-puerto-rico-lost-more-than-power-vast-majority-no-clean-water. Published September 20, 2022. Accessed September 24, 2022.

13. Comunicaciones AAA (@ACUEDUCTOSPR) / Twitter. Twitter. Accessed September 24, 2022. https://twitter.com/ACUEDUCTOSPR

14. Willison CE, Singer PM, Creary MS, Greer SL. Quantifying Inequities in US Federal Response to Hurricane Disaster in Texas and Florida Compared with Puerto Rico. BMJ Glob Health. 2019;4(1):1-6. doi:10.1136/bmjgh-2018-001191

15. Library of Congress Hispanic Division. Jones Act - The World of 1898: The Spanish-American War. Accessed July 16, 2021. https://www.loc.gov/rr/hispanic/1898/jonesact.html

16. Foreign Relations of the United States, 1952–1954, United Nations Affairs, Volume III - Office of the Historian. Accessed September 27, 2022. https://history.state.gov/historicaldocuments/frus1952-54v03/d902

17. Deibert M. Puerto Rico’s Colonial Model Doesn’t Serve Its People. Foreign Policy. Accessed August 25, 2021. https://foreignpolicy.com/2020/07/31/puerto-rico-united-states-colonial-model-ricardo-rossello-wanda-vazquez-statehood-referendum/

18. House TW. Remarks by President Biden on Hurricane Fiona Recovery Efforts. The White House. Published September 22, 2022. Accessed September 24, 2022. https://www.whitehouse.gov/briefing-room/speeches-remarks/2022/09/22/remarks-by-president-biden-on-hurricane-fiona-recovery-efforts/

From the Director...

Warmest greetings, everyone! Welcome to the 2022-2023 academic year. At least for now, we are meeting in person. It is wonderful to see friends and colleagues whom I've missed over the months. To all new students, welcome! Please explore opportunities to push yourselves beyond your comfort zone as you embark on this next phase of your life.

It has been a long and busy summer for our COVID-19 Taskforce on Racism & Equity, which has been focusing social injustices in the COVID pandemic.

There is plenty to do! We look forward to involving you in upcoming activities: journal clubs, sponsored talks, etc.

Please look for our special collection of papers in the Rapid Assessment of COVID Evidence (RACE Series), which is being published in Ethnicity & Disease. The next issue, which is scheduled for release the week of October 20th, responds to the health equity implications of the Supreme Court's recent decision restricting reproductive rights.

Do keep us posted on news on your organizations and communities!

In struggle for health equity,

Chandra

Chandra L. Ford, PhD, MPH, MLIS

Professor and Founding Director

Center for the Study of Racism, Social Justice & Health

Department of Community Health Sciences

UCLA Fielding School of Public Health

Guest Blog: “Lessons Learned: Preparing Racial Unrest and Mental Health Educational Materials”

Lessons Learned: Preparing Racial Unrest and Mental Health Educational Materials

Jennifer Duan, B.A. (1), Kimberlye E. Dean, Ph.D. (2)

(1) Massachusetts General Hospital

(2) Massachusetts General Hospital/Harvard Medical School

Amid the COVID-19 pandemic, we have seen a rise in targeted, racially motivated violence and open aggression towards people of marginalized groups (FBI Uniform Crime Reporting Program, 2022). To illustrate, race and ethnicity-based hate incidences increased by 16% from 2019 to 2020, along with an increased rate of hate incidents in Asian Americans[i], Black Americans[ii], and Hispanic[iii] individuals from 2018 to 2020. Individuals across racial groups have thus experienced a growing trend of negative mental health consequences (Twenge, J. M. et al., 2021). Furthermore, these events have contributed to an exacerbation of previously unmet mental health needs across racial groups (Conroy, J. et al., 2021). Given these significant challenges, it is imperative that the current clinical workforce be equipped to manage symptoms exacerbated by racially motivated violence.

To equip the clinical workforce with actionable tools to mitigate lasting impact of racially motivated violence, we prepared a presentation highlighting the rise of mental health issues among racially and culturally diverse communities due to growing racial unrest. Our audience included clinicians working in an urban teaching hospital. To accommodate various background levels of understanding race, we were intentional in creating materials for this topic. Thus, we created the following guidelines to inform interested scholars of our process on navigating racial health disparities and to serve as a resource for anyone interested in diving deeper.

This decision was made following input from all coauthors including: (1) first author, a Chinese American woman with research interest in mental health disparities and cultural psychology; (2) second author, a Black American woman with a research focus on equity in mental health care accessibility and the intersection of trauma, substance use, and racism.

Our Objectives

In preparation for this presentation, our team consisted of three women of color from diverse educational backgrounds (one BA, two PhDs). This presentation focused on historically underserved communities, which includes Asian Americans, Black Americans, Hispanic people, and Indigenous people[iv]. Our presentation links the current political climate of increased racial hate incidences to poor mental health outcomes and then establish steps for clinicians to better serve their clients/patients of color. While the presentation was prepared for clinicians, this guide is intended for everyone interested in learning more about race and health disparities.

Our responsibilities were divided into three categories: (1) the first author was responsible for researching statistical trends of hate incidences, mental health outcomes, and access to mental health resources for minority groups; (2) the second author was responsible for establishing how providers can take actionable steps to approach client experience of racism at the clinic; (3) another researcher in our team provided overarching expertise in implementation science, community work, and planning support, but unfortunately had to step back due to other time commitments and responsibilities.

Our Approach

When initially developing our content, we used the following theories as part of our foundational framework: Bronfenbrenner’s ecological systems theory (Bronfenbrenner, 1992) and the minority stress theory (Meyer, 2003). Bronfenbrenner’s theory brought in the framework that an individual’s development from an early age is affected by multi-level systems (ex., family, access to healthcare, culture). While the minority stress theory was originally established for the LGBTQ+ community, this framework can examine how stress affects people of color and historically underserved communities (Shagani et al., 2019). By utilizing these frameworks, we made sure that our source materials aligned with viewing racial identity and health disparities as multifaceted and nuanced.

Challenges

1.      Tailoring an interdisciplinary topic to a specific audience

Research can be inaccessible to a general audience, especially with complex jargon. Since we did not know our audience’s background on racial health disparities, we ensured that our presentation covered a baseline of foundational material and minimized jargon. The presentation had a 30-minute time limit, which was challenging for an extensive topic like racial health inequity. Therefore, we carefully considered which concepts to expand upon and omit. When speaking or writing about race, it is important to acknowledge the definition of race[1] and its nuances, as well as the difference in how race is interpreted and utilized in different fields, such as within public health, psychology, and ethnic studies. When working together, we also had to be mindful of balancing the presentation. The presentation started by establishing a background of current events, which involved headlines of racially motivated hate incidents scattering 2019 to early 2022 across underserved groups. To prioritize our time, we emphasized microaggressions and functional health outcomes, while cutting down material on differentiating race and ethnicity, as well as racial traumatic stress theory.

2.      Scattered data

Pulling data from multiple reputable sources is a tedious but necessary part of the literature search. Since there was no centralized open-source database that encompasses health disparities from all racial groups, we encountered the issue of scattered data and having to create our own graphs from multiple sources (Figures 1 & 2). As we include multiple racial groups in our presentation, being intentional about sourcing from inclusive research articles is a must. We had to be mindful of other external factors increasing mental health disorders, such as the ongoing COVID-19 pandemic affecting disadvantaged communities. We also recognized that not all statistics will match the claims we are looking for – and that is okay. In this case, we found that there was not an increase in reported racial hate incidents for Indigenous people, according to the FBI. To be true to the literature search, including data that may counter our initial claims is just as important.

3.      Importance of actionable steps

Actionable steps are especially important in educational materials. Based on our team’s presentation feedback, we noticed that participants (clinicians) found it helpful to identify actionable ways to address one’s own racial bias in a patient-provider setting.

Actionable steps for our audience included:

1.      Navigating discussions of race in treatment instead of avoiding it – self-reviewing pros and cons

2.      Interacting with patients from diverse backgrounds with empathy and an open mind

3.      Developing and implementing trainings in racially and culturally based frameworks

4.      Reviewing books that discuss the history and current events of race-based stressors

Tips Before Researching and Writing

Finally, we want to introduce actionable steps before exploring your own curiosity towards racial health disparities, which can aid your writing process as well.

1.      Know your audience

We recognize that our audience for this piece may already be interested in racial disparities. While there is potentially a range of knowledge and educational backgrounds, this audience has a commonality of genuine interest and curiosity. In contrast, presenting information to an audience with little knowledge of racial health disparities requires a different approach. For a newer audience, there may not be enough time to explore the depth of your findings. Consider what fundamental frameworks can guide your team and support your goals (ex., Bronfenbrenner, Critical Race Theory).

Talking about race can elicit different emotional responses depending on an individual’s comfort, identity, and cultural background. Depending on the racial group, recognizing and connecting to one’s racial identity has been shown to have varied effects on one’s mental health (Woo, et al. 2019). Be prepared to expect a range of emotional reactions when presenting your work; do not be discouraged by fear and dampen the message of your work.

2.      Recognize your own biases

Even in a diverse team, personal biases may guide us towards a specific research direction outside of inclusivity, and it is important to hold each other accountable. However, different perspectives can yield nuanced discussions, as well as opportunities to fill in any gaps, such as carefully representing different racial groups and making sure all voices are heard.

Additional Readings

As navigating racial disparities can be daunting, we hope these resources can provide a steppingstone in learning about this interdisciplinary and growing field:

• Crenshaw, ‎K., Gotanda, N., ‎and Peller, G. (1995). Critical Race Theory: the key writings that formed the movement. The New Press.

• Kendi, I. X. (2019). How to Be an Antiracist. One World.

• DiAngelo, R. (2018). White Fragility: Why It's So Hard for White People to Talk About Racism. Beacon Press.

Having a foundational framework to drive one’s research or presentation is crucial to grounding one’s own understanding of the topic and communicating with an audience. We hope this guide can aid future readers and presenters in navigating race and health. 

References

Bronfenbrenner, U. (1992). Ecological systems theory. Jessica Kingsley Publishers.

Bird, M. Y. (1999). What we want to be called: indigenous peoples’ perspectives on racial and ethnic identity Labels. American Indian Quarterly, 23(2), 1–21.

Crime Data Explorer. https://crime-data-explorer.fr.cloud.gov/pages/explorer/crime/hate-crime

FBI Uniform Crime Reporting Program (2022).  Federal Bureau of Investigation

Conroy, J., Lin, L., & Stamm, K. (2021, April). The demographics of unmet need for mental health services. Monitor on Psychology, 52(3). http://www.apa.org/monitor/2021/04/datapoint-mental

Junn, J., & Masuoka, N. (2008). Asian American Identity: Shared Racial Status and Political Context. Perspectives on Politics, 6(4), 729–740. http://www.jstor.org/stable/20446825

Lopez, M. H. (2020). Three-Fourths of Hispanics Say Their Community Needs a Leader. Pew Research Center. Retrieved June 29, 2022, from https://www.pewresearch.org/hispanic/2013/10/22/3-hispanic-identity/

Meyer I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological bulletin, 129(5), 674–697.

Shangani, S., Gamarel, K. E., Ogunbajo, A., Cai, J., & Operario, D. (2020). Intersectional minority stress disparities among sexual minority adults in the USA: the role of race/ethnicity and socioeconomic status. Culture, health & sexuality, 22(4), 398–412.

Twenge, J. M., McAllister, C., & Joiner, T. E. (2021). Anxiety and depressive symptoms in U.S. Census Bureau assessments of adults: Trends from 2019 to fall 2020 across demographic groups. Journal of Anxiety Disorders, 83, 102455.

Woo, B., Fan, W., Tran, T. V., & Takeuchi, D. T. (2019). The role of racial/ethnic identity in the association between racial discrimination and psychiatric disorders: A buffer or exacerbator?. SSM - population health, 7, 100378.

Notes

[1] The American Psychological Association defines race as "a socially defined concept sometimes used to designate a portion, or “subdivision,” of the human population with common physical characteristics, ancestry, or language.

[i] "Asian American" was coined in 1968 by Yuji Ichioka and Emma Gee, UC Berkeley students and founders of the Asian American Political Alliance, who wanted to encourage pan-Asian amongst political turmoil (Junn & Masuoka 2008). "Asian American" now encompasses all Asian ethnicities, including East Asian, South Asian, and Southeast Asian groups. While our sources and the U.S. census have used “Asian” to describe this demographic, we wanted to specifically note that this population is within the U.S.

[ii] "Black Americans" includes individuals with ancestry tied to enslaved Americans, immigrants from Africa or the Caribbean to the U.S, and other individuals from the African diaspora. The term has been used to be inclusive of the Black experience in America.

[iii] "Hispanic" refers to individuals who are "a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race," according to the U.S census. While this is a more cultural term, we decided to include this due to our sources using this term. According to Pew Research Center (2013), "Hispanic" was the most popular preference for the community to describe themselves.

[iv] “Indigenous people” refers to the descendants of culturally distinct ethnic groups who first inhabited a specific land, in this case the United States. According to the Smithsonian National Museum of the American Indian, Indigenous people prefer being called by their tribe's name. While "American Indian" is used in the U.S. census and "Native American" has been used throughout our sources, we intentionally researched opinions of scholars with this identity, where most participants (Yellow Bird, 1999) preferred another term other than “American Indian” or “Native American.” "American Indian" was coined during a period of colonialism, and "Native American" has been used by people who are not indigenous to the United States. Since “Indigenous” is the more inclusive of all tribes, we decided on this term.

Disclaimer: The opinions expressed in this guest blog are those of the authors. The authors do not purport to reflect the opinions or views of the Center.

From the Director...

From the Director

June 10, 2022

The academic year at UCLA comes to a close today. I feel a deep sense of gratitude to everyone who has helped in some way to advance the mission of the Center during the pandemic. Our mission is to promote health equity through rigorous research, innovative teaching, and community engagement. The last few years have been devastating on multiple fronts for so many people. We offer prayers and condolences while we continue to target the root causes of health inequities.

Alongside the difficulties of this period there have been many notable accomplishments. Below are just a few of the Center’s activities of this academic year:

• The brilliant distinguished quarterly lectures delivered by Dr. Monica McLemore and Dr. Ugo Edu

• A COVID justice panel with community partners Black Alliance for Just Immigration (BAJI) and Youth Justice Coalition (YJC) organized by the COVID Task Force on Racism & Equity (Chair, Bita Amani)

• A national workshop on racial healing organized by Kia Skrine Jeffers, Associate Director for the Arts, on behalf of the American Public Health Association’s Public Health Nurses caucus

• Monthly journal club and book club meetings (see ACC book club below)

• Co-sponsorship of the 2022 Thinking Gender Conference, which focused on Transgender Studies at the Intersections this year

• Co-sponsorship of the UCLA Thurgood Marshall Lecture delivered by the honorable Keith Ellison

Please check out our current projects, which include:

• Project REFOCUS - through which we are developing a novel set of technology-based interventions to promote pandemic equity. This project, which is funded by the CDC Foundation and CDC, is a collaboration between the Center and Howard University (Monica L. Ponder, co-lead).

• COVID Storytelling Project – A two-part study that involves the rapid collection and analysis of social media (e.g., Twitter) and focus group data regarding injustices occurring over the course of the pandemic.

• The RACE Series – A special collection of articles published open access (i.e., freely available to the public) in the journal Ethnicity & Disease. The series is supported with funding from the Robert Wood Johnson Foundation. The papers in the collection report key research findings as they are produced (i.e., hot off the press) from research conducted over the course of the pandemic. Much of this research is ongoing. You can learn more about both Project REFOCUS and the COVID Storytelling Project from papers published in this series.

Celebrating Students

As shared in 2020 in opening remarks at the book launch for Racism: Science & Tools for the Public Health Professional (American Public Health Association [APHA] Press, 2019), I believe our graduate students represent the vanguard of the field and I predicted they would lead the field of public health in advancing health equity work that engages Critical Race Theory (CRT), sustains participation in community-engaged social justice efforts and develops novel methods for conceptualizing and investigate the myriad of ways racialized oppressions harm health. I feel even more confident making that assertion today. Those who are graduating this year will arrive at their new appointments in many ways already prepared to lead the field in this area. They follow our inaugural cohort of postdoctoral fellows, Dr. Paris Adkins-Jackson, now at the Columbia University Mailman School of Public Health, and Dr. Mienah Sharif, now at the University of Washington which recently launched ARCH: the Antiracism & Community Health Center, as well as Anna Hing (now at the recently launched Center for Antiracism Research for Health Equity at the University of Minnesota), John Pamplin (Columbia University Mailman School of Public Health), and Brittney Butler (Harvard FXB Center Health & Human Rights Fellow).

Rebekah Israel Cross and Natalie Bradford were the Center’s founding student affiliates and two of its core staff members. They each contributed a section to Racism, and Rebekah published the first (and perhaps still the only) student perspective on advancing CRT-based approaches in public health. Having successfully defended innovative, policy-relevant dissertations, they will now head off to postdoctoral fellowships at the University of North Carolina Gillings School of Global Public Health and University of Texas at San Antonio College for Health, Community and Policy, respectively. What were they studying? Here are their dissertation titles:

•  Gentrification, Residential Mobility, and Preterm Birth among Black Women: A Mixed Methods Study of Racial Resegregation in Northern California by Rebekah Israel Cross

• This Ain’t Yo Laboratory: Centering Home to Examine the Relationship Between Racial Residential Segregation, Medical Underservice, and Community Health Center Expansion Nationally and Locally by Natalie J. Bradford

Congratulations Dr. Israel Cross and Dr. Bradford! We are inspired by you and excited for the next phase in your journey.

Other student affiliates who have completed dissertations and are moving forward include Anna-Michelle McSorley, who first approached the Center about how to study anti-colonialism within public health . After several thoughtful conversations, she came up with the idea of the Anti-Colonialism Collective (ACC). This book club has become a vital source of connection for center affiliates and for people not otherwise connected to it. We thank the donors who appreciated the topics being covered and Anna-Michelle’s anti-hierarchical approach to facilitating the book club. Having successfully defended her dissertation, Dr. McSorley will join the Center for Anti-racism, Social Justice, & Public Health that is in development at New York University.

Millicent Robinson and Adrian Bacong served as chair and co-chair (with Ale Cabral), respectively of our annual Minority Health Conference in prior years, and Millicent also served as center coordinator during the stormy early months of the COVID pandemic. Her role then was critical and invaluable given how destabilizing, uncertain and exhausting that period was for everyone. They, too, have successfully defended their dissertations and accepted postdoctoral appointments at Stanford University (Dr. Bacong) and the University of North Carolina (Dr. Robinson). Thank you and congratulations to each of you! And, congratulations to all graduating students!

Celebrating our Partners

If you appreciate our work, we urge you to support our partners who are leading critical social justice work often with limited resources. Five of our key partners include:

• Black Alliance for Just Immigration (BAJI) - https://baji.org/

• Black Coalition Fighting Back Serial Murders - https://www.blackcoalitionfightingbackserialmurders.net/

• Healthy African American Families - https://www.haafii.org/

• Stop LA Police Department (LAPD) Spying - https://stoplapdspying.org/

• Youth Justice Coalition - https://youthjusticela.org/

I thank the many others of you who continue to support our work through donations of time, information or resources. There are many to name, so allow me to highlight just two examples of the kind of support for which we are grateful.

• The 2022 Minority Health Conference, which as always was in partnership with the UNC Gillings School of Global Public Health, featured archival video and audio recordings of health equity champions and elders from the personal archives of Dr. Victor J. Schoenbach. This digital media project would not have been possible without the generous support and assistance of Dr. Schoenbach.

• So that people could participate in the ACC book club meetings even if they could not afford the books, forward-thinking donors reached out and made donations so that the center could make the books available to participants for free.

Expressing Gratitude

I am deeply grateful for the dedicated staff, graduate students, postdoctoral scholars, executive board members, faculty and staff on whom the center relies. Thank you for your commitment, vision and enthusiasm. Thank you for your insights. Thank you for your service.

I thank the leadership of the center, including Bita Amani, under whose leadership the COVID Task Force on Racism & Equity, which is a collaboration between Charles R. Drew University (CDU) has been tirelessly engaged in research, community organizing and information sharing with community partners. You can learn about some of this work in a short video about it here. I also thank E. Minelle David, who has been an extraordinary Center Coordinator. Her commitment to health equity is palpable. I appreciate her attention to detail and all the ways she quietly holds so much together on behalf of the Center in order to advance our mission. Thank you, Minelle! You are seen and loved. :)

Finally, the work of the center would not be possible without the material support we receive from people like you. Thank you to our volunteers. Thank you to our donors. Your donations primarily support the education and training of our students and postdoctoral scholars. They also cover some of the activities with partners—both community partners and academic partners—that research grants typically do not support (e.g., co-sponsored talks). Thank you to those of you who participate in our activities. A special thanks to the very supportive staffs of the UCLA Department of Community Health Sciences—especially Melba Tolbert, Jamie Raiss and Kathy Yi—and the Fielding School of Public Health’s office of the dean. We appreciate being able to draw on your expertise. We also celebrate executive board member, Gilbert C. Gee, on becoming the next chair of the department.

Sadly, remarks from 2020 resonate still. So, I close with those remarks here.

The circumstances of the present—the hostile political climate, the deadly COVID-19 pandemic, and the persistence of “state-sanctioned and extra-legal” killings of black, indigenous and other people of color—have made this an extraordinarily difficult time. I am particularly concerned about its impact on our students.

The students involved with this center are phenomenal. Their brilliant analyses connect dots intellectually across disciplines, theories, and methods. These students are bold, courageous, introspective and creative. They insist a better world is possible, and they work toward manifesting it. They are generous with one another and with me, modeling what it is they wish to see in the world. They are the next generation of leaders. Faculty, are we doing all we can to help them become their very best?

To my students, you inspire me, and you touch the lives of many others. This is an extraordinarily difficult time, especially for those of us who come from the margins of society. Today you are nearing the finish line of another academic year. It may not feel like much of a victory, but it is. Each day that you get up and choose to keep moving forward is a victory. It is a victory not only for you, but also for everyone who loves you and for those who draw inspiration from you. As much as I admire you for your strength, please remember that you are also human. You deserve the compassion you so generously share with others. You need to rest. You need to laugh and to have fun. You need a break from peers who exclude you and faculty who underestimate or overlook you, while at the same time “picking your brain” on matters of diversity. You need trustworthy friends who will challenge you when it is appropriate to do so. You need your families even if you also need space from your families. Finally, you need to know that faculty and senior scholars stand with you. We are sharing this journey with you. We see you. We appreciate you. We celebrate you.

 With humility and gratitude,

 Chandra L. Ford