Necessary Conversations: Understanding Racism as a Barrier to Achieving Health Equity
We need to talk about race.
The story of our nation is one of justice and freedom, but the unspoken truth is too many people are shut out of equal opportunities because of the color of their skin. Civil Rights laws and advocacy movements have brought racial inequities to light, but have not solved urgent problems caused by structural racism. This inequity has led to wide-scale poorer health outcomes and shorter life spans.
Structural racism refers to the persistence of inequity in communities of color while others benefit from a disproportionately larger share of the nation’s resources. There is indisputable evidence that the impacts of this inequity are generational. Structural racism has led to a lack of basic healthcare, education, housing, and other needs for too many in our nation.
Authentic conversations about racial inequities are essential, difficult, and urgent. There are many forces that prevent people from talking about racism. Without honest reflections on race and the history of this nation, conversation and narratives often generate unproductive fear, shame, guilt, avoidance, and denial. We need to move past that to a place of healing and action. A book by RWJF’s chief science officer, Dr. Alonzo Plough, shows us how.
Editor's Note: We incorrectly named the Central Park bird watcher George Cooper. His name is Christian Cooper.
Live Webinar—Book Talk: Necessary Conversations
Participants joined Dr. Alonzo Plough as he modeled how to talk about structural racism. The webinar offered insight into health equity as the operational focus on the Foundation’s work. Watch the webinar recording to understand how:
- RWJF is embracing new research and evaluation strategies to measure solutions
- Important it is to elevate the importance of narrative change
- To create space for those with lived experiences to drive decision making
This webinar will be available in Spanish and English, and will be recorded for on-demand use through RWJF’s Communications Toolbox.
Necessary Conversations: Talking Frankly About Race
Engaging in honest dialogue about race sometimes means lowering our defenses and acknowledging our feelings so we can walk together toward racial equity.
Necessary Conversations: Understanding Racism as a Barrier to Advancing Health Equity is edited by Alonzo L. Plough, PhD, MPH, VP, Research-Evaluation-Learning and Chief Science Officer, Robert Wood Johnson Foundation.
The book, published by Oxford University Press, features a diverse set of voices, including Nikole Hannah-Jones, a Pulitzer Prize winning journalist, Derrick Johnson, president and CEO of NAACP, Crystal Echo Hawk of IllumiNative, Gail Christopher, executive director, National Collaborative for Health Equity, among many other esteemed thinkers and doers.
Dolores Acevedo-Garcia, PhD, Professor of Human Development and Social Policy
Director, Institute for Child, Youth and Family Policy, Heller School for Social Policy and Management, Brandeis University
Shana Bartley, MSPH, Director of Community Partnerships, Income Security and Child Care/Early Learning, National Women’s Law Center
Susan Beane, MD, Executive Medical Director, Healthfirst
Robert D. Bullard, PhD, Distinguished Professor of Urban Planning and Environmental Policy and Director of Bullard Center for Environmental and Climate Justice Barbara Jordan-Mickey Leland School of Public Affairs, Texas Southern University
Beneta D. Burt, MPPA, President and CEO, Mississippi Urban League, Inc.
Nakeitra Burse, DrPH, CHES, CEO, Six Dimensions, LLC
Juan Cartagena, President and General Counsel, LatinoJustice
Ronda Lee Chapman, Director of Equity, The Trust for Public Land; former Senior Associate, PolicyLink
Shelby Chestnut, MS, Director of Policy and Programs, Transgender Law Center
Gail C. Christopher, DN, Executive Director, National Collaborative for Health Equity (NCHE); Founder of Ntianu Garden: Center for Healing and Nature; Senior Scholar, Center for the Advancement of Well-Being, George Mason University
Joia Crear-Perry, MD, FACOG, Founder & President, National Birth Equity Collaborative
Byron D’Andra Orey, PhD, Professor of Political Science, Jackson State University
Jara Dean-Coffey, MPH, Founder and Director, Equitable Evaluation Initiative; Founder and Principal, Luminare Group
Crystal Echo Hawk, MA, Executive Director, IllumiNative
An educator who requested anonymity, An American Public School District
Madeline England, MIA, Former Community Health Director, Mississippi State Department of Health
Sherry Glied, PhD, Dean, Professor of Public Service, Robert F. Wagner Graduate School of Public Service, New York University
Solomon Greene, JD, MCP, Senior Fellow, Research to Action Lab and Metropolitan Housing and Communities Policy Center, Urban Institute
Derek M. Griffith, PhD, Co-Founder and Director, Racial Justice Institute; Founder and Director, Center for Men’s Health Equity; Professor of Health Systems Administration and Oncology, Georgetown University
Jennifer Gunter, PhD, Director, South Carolina Collaborative on Race, University of South Carolina
Charon Gwynn, PhD, Deputy Commissioner, Division of Epidemiology, New York City Department of Health and Mental Hygiene
Mark Hall, JD, Director of Health Law and Policy Program, Professor of Law, Wake Forest University
Iyanrick John, JD, MPH, Adjunct Professor, California State University, East Bay
Nikole Hannah-Jones, MA, Domestic correspondent, The New York Times
Derrick Johnson, JD, President and Chief Executive Officer, NAACP
Cristy Johnston Limón, MBA, Former Executive Director, Youth Speaks
Alesha Judkins, Mississippi State Director, Criminal Justice Reform, FWD.us
Pamela Junior, Executive Director, Two Museums Mississippi
Chris M. Kabel, Senior Fellow, The Kresge Foundation
Donna Ladd, Founding Editor, Mississippi Free Press and Jackson Free Press
Nsombi Lambright-Haynes, MPPA, Executive Director, One Voice
Alana M.W. LeBrón, PhD, Assistant Professor, Department of Health, Society, and Behavior, Program in Public Health and Department of Chicano/Latino Studies, School of Social Sciences, University of California, Irvine
Rukia Lumumba, JD, Founding Executive Director, People’s Advocacy Institute and Electoral Justice CoDirector, Movement for Black Lives
Nyiesha Mallett, Climate Justice Youth Organizer, UPROSE
Demetria McCain, Esq., President, Inclusive Communities Project
Donna M. Mertens, PhD, Transformative Research and Evaluation; Professor Emeritus, Gallaudet University
Milena A. Melo, PhD, Assistant Professor, Department of Anthropology, University of Texas Rio Grande Valley
Nick Mitchell-Bennett, MA, Executive Director, come dream. come build.
Sean Morales-Doyle, JD, Deputy Director, Voting Rights & Elections, Brennan Center for Justice at New York University School of Law
Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation
Alfredo Ortiz Aragón, PhD, Associate Professor, Dreeben School of Education, University of the Incarnate Word
Mariana Osoria, MA, Senior Vice President, Partnerships & Engagement, Family Focus
Jackie Qataliña Schaeffer, Senior Project Manager, Alaska Native Tribal Health Consortium
Jason Reece, PhD, Assistant Professor, City and Regional Planning, Ohio State University
Residents of Cicero, Illinois
Ed Sivak, Executive Vice President of Policy and Communications, Hope Enterprise Corporation/HOPE Credit Union (HOPE)
Linda Villarosa, MA, Assistant Professor of Media Communication & Arts and Black Studies at the City College of New York and contributing writer to The New York Times Magazine
Geoff K. Ward, PhD, Professor of African and African-American Studies, Washington University in St. Louis
Teneasha Washington, PhD, MPH, Assistant Professor, Health Behavior, School of Public Health, University of Alabama at Birmingham
Jamal R. Watkins, Senior Vice President for Strategy and Advancement, NAACP
Primus Wheeler, MS, Executive Director, Jackson Medical Mall Foundation
Thea Williams-Black, PhD, Founder and CEO, GEMS: Growing Educational Minds for Success Consulting LLC and Former Dean of Education, Supervision, and Instruction / Professor of Education, Tougaloo College
Necessary Conversations
Dolores Acevedo-Garcia, PhD, Professor of Human Development and Social Policy
Director, Institute for Child, Youth and Family Policy, Heller School for Social Policy and Management, Brandeis University
Shana Bartley, MSPH, Director of Community Partnerships, Income Security and Child Care/Early Learning, National Women’s Law Center
Susan Beane, MD, Executive Medical Director, Healthfirst
Robert D. Bullard, PhD, Distinguished Professor of Urban Planning and Environmental Policy and Director of Bullard Center for Environmental and Climate Justice Barbara Jordan-Mickey Leland School of Public Affairs, Texas Southern University
Beneta D. Burt, MPPA, President and CEO, Mississippi Urban League, Inc.
Nakeitra Burse, DrPH, CHES, CEO, Six Dimensions, LLC
Juan Cartagena, President and General Counsel, LatinoJustice
Ronda Lee Chapman, Director of Equity, The Trust for Public Land; former Senior Associate, PolicyLink
Shelby Chestnut, MS, Director of Policy and Programs, Transgender Law Center
Gail C. Christopher, DN, Executive Director, National Collaborative for Health Equity (NCHE); Founder of Ntianu Garden: Center for Healing and Nature; Senior Scholar, Center for the Advancement of Well-Being, George Mason University
Joia Crear-Perry, MD, FACOG, Founder & President, National Birth Equity Collaborative
Byron D’Andra Orey, PhD, Professor of Political Science, Jackson State University
Jara Dean-Coffey, MPH, Founder and Director, Equitable Evaluation Initiative; Founder and Principal, Luminare Group
Crystal Echo Hawk, MA, Executive Director, IllumiNative
An educator who requested anonymity, An American Public School District
Madeline England, MIA, Former Community Health Director, Mississippi State Department of Health
Sherry Glied, PhD, Dean, Professor of Public Service, Robert F. Wagner Graduate School of Public Service, New York University
Solomon Greene, JD, MCP, Senior Fellow, Research to Action Lab and Metropolitan Housing and Communities Policy Center, Urban Institute
Derek M. Griffith, PhD, Co-Founder and Director, Racial Justice Institute; Founder and Director, Center for Men’s Health Equity; Professor of Health Systems Administration and Oncology, Georgetown University
Jennifer Gunter, PhD, Director, South Carolina Collaborative on Race, University of South Carolina
Charon Gwynn, PhD, Deputy Commissioner, Division of Epidemiology, New York City Department of Health and Mental Hygiene
Mark Hall, JD, Director of Health Law and Policy Program, Professor of Law, Wake Forest University
Iyanrick John, JD, MPH, Adjunct Professor, California State University, East Bay
Nikole Hannah-Jones, MA, Domestic correspondent, The New York Times
Derrick Johnson, JD, President and Chief Executive Officer, NAACP
Cristy Johnston Limón, MBA, Former Executive Director, Youth Speaks
Alesha Judkins, Mississippi State Director, Criminal Justice Reform, FWD.us
Pamela Junior, Executive Director, Two Museums Mississippi
Chris M. Kabel, Senior Fellow, The Kresge Foundation
Donna Ladd, Founding Editor, Mississippi Free Press and Jackson Free Press
Nsombi Lambright-Haynes, MPPA, Executive Director, One Voice
Alana M.W. LeBrón, PhD, Assistant Professor, Department of Health, Society, and Behavior, Program in Public Health and Department of Chicano/Latino Studies, School of Social Sciences, University of California, Irvine
Rukia Lumumba, JD, Founding Executive Director, People’s Advocacy Institute and Electoral Justice CoDirector, Movement for Black Lives
Nyiesha Mallett, Climate Justice Youth Organizer, UPROSE
Demetria McCain, Esq., President, Inclusive Communities Project
Donna M. Mertens, PhD, Transformative Research and Evaluation; Professor Emeritus, Gallaudet University
Milena A. Melo, PhD, Assistant Professor, Department of Anthropology, University of Texas Rio Grande Valley
Nick Mitchell-Bennett, MA, Executive Director, come dream. come build.
Sean Morales-Doyle, JD, Deputy Director, Voting Rights & Elections, Brennan Center for Justice at New York University School of Law
Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation
Alfredo Ortiz Aragón, PhD, Associate Professor, Dreeben School of Education, University of the Incarnate Word
Mariana Osoria, MA, Senior Vice President, Partnerships & Engagement, Family Focus
Jackie Qataliña Schaeffer, Senior Project Manager, Alaska Native Tribal Health Consortium
Jason Reece, PhD, Assistant Professor, City and Regional Planning, Ohio State University
Residents of Cicero, Illinois
Ed Sivak, Executive Vice President of Policy and Communications, Hope Enterprise Corporation/HOPE Credit Union (HOPE)
Linda Villarosa, MA, Assistant Professor of Media Communication & Arts and Black Studies at the City College of New York and contributing writer to The New York Times Magazine
Geoff K. Ward, PhD, Professor of African and African-American Studies, Washington University in St. Louis
Teneasha Washington, PhD, MPH, Assistant Professor, Health Behavior, School of Public Health, University of Alabama at Birmingham
Jamal R. Watkins, Senior Vice President for Strategy and Advancement, NAACP
Primus Wheeler, MS, Executive Director, Jackson Medical Mall Foundation
Thea Williams-Black, PhD, Founder and CEO, GEMS: Growing Educational Minds for Success Consulting LLC and Former Dean of Education, Supervision, and Instruction / Professor of Education, Tougaloo College
This book is organized in three sections:
Reckoning with racism offers a cohesive framework for recognizing and redressing structural racism. Only by exposing racial hierarchy for what it is—deeply embedded systems and structures that position some people as inherently more valuable than others—can we clear a path for equity.
Chapter 1—Racial Hierarchy, Race Narrative, and the Structures that Sustain Them
Chapter 2—Beyond the Black/White Binary: Confronting Invisibility and the Harms of “Othering”
Chapter 3—Keeping it Real: Pathways to Authentic Connections
The harms of racial injustice examine ways people of color are affected by inequity and its accompanying harms. Data and stories bring comparable revelations—from the Black maternal mortality crises to the incarceration epidemic to challenges faced by immigrants, and the dangers that climate change pose—these realities speak to the urgency of dismantling discriminatory systems.
Chapter 4—Structural Racism in Black Maternal Healthcare
Chapter 5—The Health Harms of Incarceration and Punishment
Chapter 6—Immigrant Health: Inequity and Fear
Chapter 7—Climate Crisis, Environmental Justice, and Racial Justice
Strategies to advance health equity suggests what is possible when we acknowledge and learn from the past, embrace new research and evaluation strategies to measure solutions, elevate the importance of narrative change, and create space for those with lived experiences to drive decisionmaking.
Chapter 8—Learning the Lessons of History
Chapter 9—Fair Housing, Equitable Communities
Chapter 10—Transforming Research and Evaluation
Chapter 11—Racial Justice Through Civic Engagement: A Look at Voting and the Census
Other books in the series include:
Knowledge to Action: Accelerating Progress in Health, Well-Being, and Equity
1-min read
Advancing Health and Well-Being: Using Evidence and Collaboration to Achieve Health Equity
1-min read
Well-Being: Expanding the Definition of Progress
4-min read
Culture of Health in Practice: Innovations in Research, Community Engagement, and Action
1-min read
Community Resilience: Innovation, Engagement, and Equity
1-min read