«Dismantling Racism In Scholarly Publishing, Intentionally And Unapologetically»

Vabren Watts (@DrVabe)
Health Affairs (@Health_Affairs)

«At Health Affairs, we plan to be intentional in promoting and advancing equity via three elements—equitable participation, new voices, and introspection—which are outlined below with corresponding actions.»

Health Affairs’ plan to promote equity: elements and implementation. Source: Author’s analysis.

«During my days as a financially struggling doctoral student in Nashville, I would sometimes participate as an extra in films and country music videos to make ends meet.

»As with any institutional structure, filming had its hierarchy with respect to on-camera talent—ranging from the low-ranking extras to the high-ranking star of the production. It was customary for the star to do a quick walkthrough of the “extra waiting area,” greeting us with a quick wave, mouthing the words “thank you.”

»One day, I accepted a gig as an extra in a music video for Garth Brooks, the best-selling solo artist in U.S. history.

»On shoot day, Mr. Brooks (the star) started the customary walkthrough of the waiting area for the extras. However, this walkthrough was different—he deliberately stopped along the way to engage with groups of people. He engaged with me by shaking my hand and asking my name. When he didn’t catch the pronunciation of my name, Mr. Brooks leaned in and asked me to repeat it, and then proceeded to phonetically spell it back before he went on to greet the next person. Although our interaction was brief, I felt valued and thought that his interaction to make me and others feel valued was very intentional.

»I took away from this engagement with Mr. Brooks that infrastructures of power must be intentional in dismantling operations that are the driving forces for hierarchal dominance. This effort can be—and should be—applied to many institutional or organizational structures, in particular structures cemented in hierarchies based on race/ethnicity, whether consciously or unconsciously constructed.

»A History Of Racism And Its Present-Day Impacts

»Unfortunately, the US is rooted in a history of deliberately building structures of hierarchal dominance among races and ethnicities—legal enslavement of African people, forced displacement of Indigenous populations, prohibition of Chinese people entering and remaining in the US through the 1882 Chinese Exclusion Act, and, more recently, implementation of family separation policies that largely affected immigrant and Hispanic/Latino families. All these policies, rooted in racism, were intentional, and efforts to dismantle the policies had to be intentional.

»The impact of these and other US discriminatory policies based on race have been damaging and long-lasting. These policies have informed racially biased practices in local and state legislation, medical and health services, educational systems, and organizational structures. Overall, they have sustained power for White Americans and further marginalized Indigenous people, Black Americans, Asian Americans, Hispanics/Latino Americans, and other populations that are considered non-White by societal US standards.

»Like most institutional structures, scholarly publishing is not immune from carrying out racially biased practices—it is simply a product of its environment. Racially biased practices can transpire, consciously or unconsciously, in several forms within scholarly publishing, including:

»• Lack of diversity among authors, reviewers, and editors

»• Insufficient outreach to researchers of color and minority-affirming institutions (e.g., Historically Black Colleges and Universities, Tribal Colleges and Universities, etc.)

»• Rejection of manuscripts that use non-standard methods for interpreting research outcomes. (Different cultures have different ways of using methods and interpreting research across disciplines.), and

»• Lack of diversity of those employed by scholarly publishing firms.

»A New Emphasis On Racial Equity At Health Affairs

»Aware of these challenges, Health Affairs will be deliberately revving up its efforts to dismantle practices that perpetuate racial bias in scholarly publishing of health policy and health services research.

»As mentioned in An Editor’s View Of Race, Racism, And Equity, by Health Affairs Editor-in-Chief Alan Weil, I have been hired to help move these efforts forward as Director of the Equity Project. I bring to Health Affairs a background in research, science/health communications, and diversity, inclusion, and equity strategy. I previously served as Deputy Director of Diversity and Health Equity of the American Psychiatric Association, where I operationalized a health equity blueprint to increase the APA’s digital content and programing on health equity.

»At Health Affairs, we plan to be intentional in promoting and advancing equity via three elements: equitable participation, new voices, and introspection.

»Some work to advance equity through these strategies has been completed or is underway. This includes assessments of our content, which showed that 11 percent of Health Affairs articles over the journal’s 40-year history included reference to equity with respect to race and/or ethnicity. More recently this percentage has increased, with more than 45 percent of papers published in second half of 2020 being related to equity with respect to race. Future analyses are planned to dissect data by various periods and by populations covered in the manuscripts.

»In the coming months, we will begin asking authors and reviewers to self-identify regarding race, ethnicity, andeder. We will use these data to assess our baseline and monitor trends in diversity among these groups.

»Our Health Equity webpage has also been redesigned to help you better navigate our content.

»We have a long road ahead to advance equity through dismantling structures and practices rooted in racial bias and discrimination. However, if we are intentional and unapologetic in our efforts, we hope we can build a foundation for health services and health policy scholarly publishing that represents the perspectives of all cultures.»

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