Recognizing that "undoing racism," and embracing cultural diversity are keys to eliminating persistent health disparities in the city of Boston, the Boston Public Health Commission undertook a multi-faceted initiative that began with the simple but crucial first step of looking inward. Their "from the inside out" approach began with an institutional assessment in which the Commission asked the question, "how is racism at play here?" With the knowledge and awareness they gained from the assessment, the Commission could develop policies to dismantle institutional racism and mechanisms to assure they would be implemented, and serve as a model for the rest of the city. The core framework they adopted included: 1) building and supporting community partnerships; 2) promoting anti-racist work environments; and, 3) re-aligning external activities to address racism.

Key to this initiative were on-going workshops designed to educate, challenge and empower staff, contractors, community residents, and public health practitioners to undo institutional racism (racial justice). The Commission focused on resident participation, leadership, and decision-making in a community needs assessment process that examined issues related to racism, as well as in designing, implementing and evaluating programs and services that are culturally and linguistically accessible. This emphasis on resident involvement and leadership was critical to creating effective services, and also increased resident capacity for effecting change (participation and willingness to act for the common good). In addition, the Commission focused on assessing workforce composition, developing strategies for increasing diversity at all levels, and working with community residents, medical schools, teaching hospitals, and health centers to support "pipeline" efforts to create a more diverse workforce (jobs and local ownership).

From: THRIVE: Tool for Health and Resilience in Vulnerable Environments


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