COVID-19 has generated renewed attention to the stark racial disparities in health that persist in the United States. The cause of these disparities is racism that manifests in individual behaviors, in laws and policies and in the current and historical structures of almost every aspect of U.S. society.
Specific to COVID, racism contributes to workplace inequality that disproportionately exposes Black Americans to the virus. A long history of racist housing policy constrains housing access for Black Americans, creating crowded and unstable conditions that inhibit social distancing. A racist criminal justice system disproportionately exposes Black Americans to the risk of infection in prisons and jails. Furthermore, repeated exposure to racism in its many forms, including, for example, daily microaggressions and the pervasive threat of police violence, acts as a form of toxic stress that chips away at the body. This process of “weathering” results in health deterioration, the onset of chronic conditions and, premature aging at the cellular level. Weathering is thought to be the primary cause of pronounced inequalities in morbidity and mortality between Black and White individuals, and likely plays a prominent role in COVID-19 disparities.
Given the toll that racism takes on our nation’s health, racial justice must be central to our mission as a school of public health. While the Yale School of Public Health has strong programs in global health and global health justice, over the last few years our students and faculty have called for more courses that focus on domestic health equity and in particular racial justice. In response to this need, a group of faculty and students from across YSPH worked collaboratively throughout 2019 to develop and launch a new concentration in U.S. Health and Justice.
This cross-departmental YSPH concentration, which will welcome its first cohort this spring, will prepare students to analyze and address systems and processes that perpetuate racial injustice and health injustice in the United States. Students will examine how historical and current systems of privilege and power, related to race, as well as class, gender and sexual orientation, create unequal burdens on health that are avoidable and unjust. Students will also develop organizing, advocacy and policy skills that prepare them to advance health justice. Finally, students will develop tools to analyze public health research methods, discourse, and practice using a health justice framework. In doing so, students will also reflect on the ways public health itself can contribute to racism. Indeed, some scholars have raised concerns that the focus on racial disparities in COVID-19, without appropriate contextual framing, may give rise to behavioral and biologic explanations that reinforce harmful racial stereotypes and White supremacy.
Central to the concentration is a new YSPH course titled Advocacy and Activism taught by Tekisha Everette, Ph.D., executive director of the non-profit Health Equity Solutions and a new faculty member in the Department of Social and Behavioral Sciences. As Assistant Clinical Professor Everette notes, “This course will provide students with the theoretical frameworks and the practical applications of community organizing and advocacy as a means of subverting traditional systems of power and advancing health justice. Employing an intersectional lens, students will analyze and discuss how they can facilitate collective action for health equity through the exploration of historical and contemporary contexts of political activism among marginalized communities in the United States.”
In addition to this central course, students will select elective courses from across YSPH and Yale University to further examine the roles of history, power, government and law in both constraining and advancing health equity and justice. Finally, one objective of the concentration is to redefine how students interact with the New Haven community and to encourage sustained partnerships that benefit our community partners and students as well. In partnership with the YSPH Office of Public Health Practice, the concentration will support local internships and practicum experiences to address local health justice needs.
Danya Keene, Ph.D., is an associate professor at the Yale School of Public Health and director of its U.S. Health and Justice Concentration.
This is part of a series of essays by Yale School of Public Health faculty, alumni and students on the issues of race and racism in the United States following the killing of George Floyd and the ensuing protests against police brutality throughout the United States. We remember, too, Ahmaud Arbery, Breonna Taylor, Rayshard Brooks and countless Americans who came before.
See other essays in this series and related material in the Public Health Crisis of Racism section on the YSPH website.