2021: Structural Racism

About this theme area:

Structural Racism and Community Health and Well-being

The IRL program seeks leaders who will conduct rigorous research focused on solutions to, and remedies for, racially charged policies, practices, and programs that negatively impact community health and well-being. The IRL program is specifically interested in project proposals that seek to better understand the processes and mechanisms through which policies, practices, and programs uphold structural racism in institutional systems beyond health care. Such systems include access to housing; education; employment; criminal justice; political participation; and economic systems broadly.

More research is needed on solutions to reduce and eliminate less explicit barriers, including but not limited to, systemic disenfranchisement of political and social involvement for Black, Indigenous, and other communities of color, as well as demolishing the historic and devastating impact of redlining on Black communities.

The following research projects are examples of potential research topics for this sub-theme. These examples are merely illustrative, and we welcome proposals on a range of topics and approaches, provided they are consistent with the discussion above:

• A natural experiment assessing self-reported mental health among formerly incarcerated individuals as a function of neighborhood-level voter participation and civic health (measured by the Civic Health Index) after the 2018 Florida Voting Rights Restoration for Felons Initiative.
• A study of the differences of drug sentencing based on existing drug policies in white and Latinx communities in New Mexico.
• A policy analysis assessing the relationship between hiring and promotion practices and employee benefits, programs (e.g., sick leave and worker’s compensation) and the incidence of COVID-19 in Midwestern meat processing plants.
• A study evaluating unintended mental health consequences of a jobs program among adolescents across communities of differing racial/ethnic composition.

Structural Racism and Health Care

The IRL program seeks leaders who will conduct research projects focused on solutions to eliminating structural racism and advancing equity in health care and health services delivery. We are especially interested in projects that address public health crises such as the COVID-19 pandemic. Our primary interest with this theme is in fostering community-engaged evidence for equitable approaches to improving the well-being of Black, Indigenous, and other people of color in the health care setting.

We seek projects that address priorities for the communities they serve and will generate evidence that is actionable within health care systems, broadly defined. Projects can focus on generating evidence about equitable implementation measures of accountability (e.g., for providers, for systems), safety, and well-being in health care settings. Projects can also focus on resources (both public and private) devoted to supporting health care system efforts to mitigate the impact of structural racism on patients and staff.

The following research projects are examples of topics of potential interest under this theme. These examples are
merely illustrative, and we welcome proposals on a range of topics and approaches, provided they are consistent
with the discussion above:

• A qualitative study examining the strengths and weaknesses of different approaches for community oversight and review of active and ongoing mental health initiatives focused on rural migrant workers to improve service delivery.
• A pilot study to develop accountability measures that can assess the impact of community representation in hospital governance changes on structural racism.
• A model study comparing Medicaid expansion, Medicaid buy-in, and a universal coverage system on gaps in health outcome gaps between low-income Americans, disaggregated by race and ethnicity.
• Ethnographic study or historical review of relationships between health care and communities of color. What are the underlying factors that contribute to the structures and barriers that impede quality health care?