Antiracist Institutional Change in Healthcare

Abstract

Systemic racism is deeply embedded in U.S. healthcare and economic systems and remains pervasive in social policies and organizational practices that perpetuate oppression of Black, Indigenous, and people of color (BIPOC) and produce disparate quality of life outcomes.1 In 2020, the outbreak of coronavirus disease (COVID-19) and the rising wave of racial justice demonstrations exposed these deeply embed- ded inequities in a new light and moved many organizations, including those in healthcare, to commit to racial equity and embark on a journey to become antiracist. Yet, few studies exist that address the impact of antiracist change in healthcare organizations and, more importantly, evaluate the evidence used to measure the progress of long-term transformation.

The Institutional Antiracism and Accountability (IARA) team conducted a one-year research study to examine antiracist interventions in healthcare and evaluate institutional change initiatives originating before 2020. The team’s scope also included a comprehensive review of over 50 articles and publications to assess the landscape of research literature on health equity. IARA’s qualitative case study analysis included 25 interviews at three separate healthcare organizations—the New York City Department of Health and Mental Hygiene, the Mount Sinai Health System, and the Southern Jamaica Plain Commu- nity Health Center—to evaluate evidence of antiracist change in three distinctly different healthcare settings.