Health Resources
Structural Racism, Workforce Diversity, and Mental Health Disparities: A Critical Review
Eric Kyere & Sadaaki Fukui Abstract
Objective Racial workforce diversity has been suggested as a critical pathway to address persistent racial mental health
disparities. However, structural racism has been noted to diminish such workforce diversity efforts. The purpose of this critical
review is to identify the mechanisms through which structural racism operates in organizations, including mental health
organizations, to undermine workforce diversity efforts and reinforce inequities.
Methods Using the theories of racialized organizations, the current review critically draws on literature underscoring the
racial character of organizations as mezzo-level racialized structures that may systematically activate and uphold white
privilege in the mental health workplace.
Results Findings suggest that in the context of institutionalized white dominance, workers of color within mental health
organizations may experience race-based cultural exclusion, identity threat, and racialized workplace emotional expression,
and be burdened by racialized tasks. The workers of color may also become the means for organizations to attract communities
of color due to their diverse characteristics, yet workers’ effects to address disparities in mental health are minimized
due to potential racialized organizational forces, including the whiteness of organizational leadership and color-blindness.
Conclusions and Implications for Practice Structural racism may create resistance to the efforts and effects of a racially diverse
workforce within mental health organizations. This review calls for a race-conscious framework that drastically shifts the
traditional organizational structure to an inverted hierarchy (i.e., client-centered management) to maximize diversity efforts
in the mental health organizational workforce to address racial disparities in mental health.
Eric Kyere & Sadaaki Fukui Abstract
Objective Racial workforce diversity has been suggested as a critical pathway to address persistent racial mental health
disparities. However, structural racism has been noted to diminish such workforce diversity efforts. The purpose of this critical
review is to identify the mechanisms through which structural racism operates in organizations, including mental health
organizations, to undermine workforce diversity efforts and reinforce inequities.
Methods Using the theories of racialized organizations, the current review critically draws on literature underscoring the
racial character of organizations as mezzo-level racialized structures that may systematically activate and uphold white
privilege in the mental health workplace.
Results Findings suggest that in the context of institutionalized white dominance, workers of color within mental health
organizations may experience race-based cultural exclusion, identity threat, and racialized workplace emotional expression,
and be burdened by racialized tasks. The workers of color may also become the means for organizations to attract communities
of color due to their diverse characteristics, yet workers’ effects to address disparities in mental health are minimized
due to potential racialized organizational forces, including the whiteness of organizational leadership and color-blindness.
Conclusions and Implications for Practice Structural racism may create resistance to the efforts and effects of a racially diverse
workforce within mental health organizations. This review calls for a race-conscious framework that drastically shifts the
traditional organizational structure to an inverted hierarchy (i.e., client-centered management) to maximize diversity efforts
in the mental health organizational workforce to address racial disparities in mental health.
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Advancing Behavioral Health Equity: National CLAS Standards in Action WebinarOn Tuesday, November 16, the HHS Office of Minority Health (OMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) hosted the Advancing Behavioral Health Equity: National CLAS Standards in Action webinar.
In case you missed it, a recording of the webinar is now available on OMH's YouTube channel. This webinar highlighted real world examples of behavioral health service providers using the National Standards for Culturally and Linguistically Appropriate Services (CLAS) and the Behavioral Health Implementation Guide. Presenters included:
Visit HHS's Think Cultural Health website to learn more about the National CLAS Standards. Visit OMH's website. 
Advancing Behavioral Health Equity: National CLAS Standards in Action Webinar On Tuesday, November 16, the HHS Office of Minority Health (OMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) hosted the Advancing Behavioral Health Equity: National CLAS Standards in Action webinar. In case you missed it, a recording of the webinar is now available on OMH's YouTube channel.
This webinar highlighted real world examples of behavioral health service providers using the National Standards for Culturally and Linguistically Appropriate Services (CLAS) and the Behavioral Health Implementation Guide. Presenters included:
Visit HHS's Think Cultural Health website to learn more about the National CLAS Standards. Visit OMH's website. |
Socioeconomic Disparity and Inequality Even Extend to Breathing
Health Care Triage
Individuals with higher socioeconomic status may enjoy a longer life, but we haven’t precisely pinned down all the reasons why. Disparities in lung function may help explain the lifespan gap between the poorest and richest Americans, and in today’s episode we cover a recent study on that proposed association.
Health Care Triage
Individuals with higher socioeconomic status may enjoy a longer life, but we haven’t precisely pinned down all the reasons why. Disparities in lung function may help explain the lifespan gap between the poorest and richest Americans, and in today’s episode we cover a recent study on that proposed association.
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A Collaborative Assessment of Barriers to Oral Health Care: Are Social Workers Needed?
Stephanie Lyons, Stuart Schrader, Erika Galyean, Laura Romito, Caroline Everidge, Margaret Smith, & Surendra Reddy Mandapati Abstract: Oral health disparities are pervasive. Interprofessional education and collaborative practice experiences may be a means to address this problem in oral healthcare settings. This project aimed to determine: (1) barriers involved in patients’ access to oral health care at an academic dental school clinic, (2) dental students’ perceived ability to address patients’ needs and/or care barriers, (3) the ability of current clinical operations’ to address access to care issues, and (4) the potential role of a licensed health care social worker integrated into the clinic. Investigators conducted three focus groups –one student group (n=5), one clinical staff group (n=7), and one clinical faculty group (n=5). Further, investigators administered two needs assessment surveys in the dental school – one with students, staff, and faculty (n=144) and the second with the school’s dental patients (n=150). Investigators employed descriptive and inferential statistical analyses to evaluate the survey data. Five principal barriers to oral health care for dental patients were identified from focus group and survey data, inclusive of patients, students, staff and faculty perspectives: (1) lack of financial means, (2) lack of/inadequate insurance, (3) limited/no transportation, (4) general health problems, and (5) language barriers. More female patients (38.7%) than male patients (8.1%) reported financial barriers to accessing oral care. Including licensed social workers in an academic dental clinic may help address patient barriers to care and support interprofessional collaborative practice. |
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The Last Mile: COVID-19, Telehealth, and Broadband Disparities in Rural Indiana
Kristin Funk Abstract: This critical review of literature evaluates the impact of COVID-19 on health and mental health care delivery in rural Indiana, specifically the move to increased telehealth services. Telehealth has been a mostly positive experience for patients and providers. However, many Indiana residents are without the option of telehealth due to underdeveloped infrastructure that is necessary to support broadband access. This disparity is evidence of a larger social and health justice issue and illuminates a call to action for social workers on all levels to collaborate with community members, government agencies, and local programs to push the issue towards the public health arena and to promote broadband access as a human right |
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Racism as a Public Health Threat: Putting an End to Inequity in Public Health Lecture and Panel Discussion
with Dr. Abdul El-Sayed
Created in response to the killing of George Floyd on May 25, 2020, in Minneapolis, Minnesota, this series reflects the moral and political struggle around issues of systemic racism and inequity. This lecture series seeks to demonstrate what we fiercely believe to be true: that the physical and mental health of the whole of society is negatively impacted when racist attitudes and practices are allowed to continue uncontested. The series selects speakers whose community and intellectual efforts help connect this understanding.
with Dr. Abdul El-Sayed
Created in response to the killing of George Floyd on May 25, 2020, in Minneapolis, Minnesota, this series reflects the moral and political struggle around issues of systemic racism and inequity. This lecture series seeks to demonstrate what we fiercely believe to be true: that the physical and mental health of the whole of society is negatively impacted when racist attitudes and practices are allowed to continue uncontested. The series selects speakers whose community and intellectual efforts help connect this understanding.
Enslaved people’s health was ignored from the country’s beginning, laying the groundwork for today’s health disparities
Some critics of Black Lives Matter say the movement itself is racist. Their frequent counterargument: All lives matter. Lost in that view, however, is a historical perspective. Look back to the late 18th century, to the very beginnings of the U.S., and you will see Black lives in this country did not seem to matter at all.
Foremost among the unrelenting cruelties heaped upon enslaved people was the lack of health care for them. Infants and children fared especially poorly. After childbirth, mothers were forced to return to the fields as soon as possible, often having to leave their infants without care or food. The infant mortality rate was estimated at one time to be as high as 50%. Adult people who were enslaved who showed signs of exhaustion or depression were often beaten.
As a professor of social work, I study ways to stop racism, promote social justice, and help the Black community empower itself. A relationship exists between the health of enslaved Blacks and the making of America.
Some critics of Black Lives Matter say the movement itself is racist. Their frequent counterargument: All lives matter. Lost in that view, however, is a historical perspective. Look back to the late 18th century, to the very beginnings of the U.S., and you will see Black lives in this country did not seem to matter at all.
Foremost among the unrelenting cruelties heaped upon enslaved people was the lack of health care for them. Infants and children fared especially poorly. After childbirth, mothers were forced to return to the fields as soon as possible, often having to leave their infants without care or food. The infant mortality rate was estimated at one time to be as high as 50%. Adult people who were enslaved who showed signs of exhaustion or depression were often beaten.
As a professor of social work, I study ways to stop racism, promote social justice, and help the Black community empower itself. A relationship exists between the health of enslaved Blacks and the making of America.
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Coronavirus Health Inequities in the United States Highlight Need for Continued Community Development Efforts*
Heather A. Walter-McCabe Abstract:The coronavirus (SARS-CoV-2) pandemic of 2020 has shown a spotlight on inequity in the USA. Although these inequities have long existed, the coronavirus and its disparate impact on health in different communities have raised the visibility of these deeply ingrained inequities to a level that has created a new awareness across the US population and an opportunity to use this heightened awareness of the existing conditions for change. ‘Community and social development’ efforts in the post-pandemic USA can be informed by a health justice framework, across economic, societal and cultural, environmental and social dimensions. Dimensions which have all been implicated in the coronavirus response and complement other social and community development models. Although health disparities and inequities did not begin with coronavirus and will not end in the post-pandemic USA, social and community development efforts which value health justice and concentrate on social determinants of health can provide needed policies and programmes for a more equitable US health system. |
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Four Steps to Address Racism's Impact on Maternal and Child Health
In the U.S., Black babies die at more than twice the rate of white babies. This means that if the Black-white infant mortality gap was eliminated, over 4,000 babies would be saved every year. Related, the racial gap is even worse for Black mothers: they die at over three times the rate of white mothers. Together, these facts make one thing abundantly clear: Racism, bias and oppression are affecting the health of women and children of color in the U.S.
In the U.S., Black babies die at more than twice the rate of white babies. This means that if the Black-white infant mortality gap was eliminated, over 4,000 babies would be saved every year. Related, the racial gap is even worse for Black mothers: they die at over three times the rate of white mothers. Together, these facts make one thing abundantly clear: Racism, bias and oppression are affecting the health of women and children of color in the U.S.
From Awareness to Action: Strategies for Combating Racism in Health Systems
Racism continues to adversely affect the health of families across the country. There are stark racial disparities in health outcomes for moms and babies; and families of color have shared countless stories that reveal disturbing differences in care.
Thus, the need to combat racism is undeniable, especially for those working in public health and health care. But what does this look like for an individual? This third webinar in our series on health equity focuses on providing strategies and guidance that individuals can use to identify and address racism and racial bias. After watching the webinar, viewers will be able to:
Racism continues to adversely affect the health of families across the country. There are stark racial disparities in health outcomes for moms and babies; and families of color have shared countless stories that reveal disturbing differences in care.
Thus, the need to combat racism is undeniable, especially for those working in public health and health care. But what does this look like for an individual? This third webinar in our series on health equity focuses on providing strategies and guidance that individuals can use to identify and address racism and racial bias. After watching the webinar, viewers will be able to:
- Understand and contextualize the three levels of racism: internalized, interpersonal and institutionalized/structural racism
- Apply a racial equity lens to collective impact-based health improvement initiatives using six guiding questions
- Identify key strategies for designing intentional, action-oriented, and strengths-based approaches to start and sustain an equity-focused organizational culture shift
Racism and Public Health: Seeking an Improved Approach for the New Decade
NICHQ CEO Scott D. Berns Shares Personal and Professional Goals for 2020
As a nation, we’ve erred deeply—both historically and in our inadequate efforts to counteract that history—and our mothers and babies of color are paying the ultimate price with their lives.
A little over two months ago, I attended a two-day summit organized by First Year Cleveland and the YWCA Greater Cleveland: 400 Years of Inequity: A Call to Action. The summit, which marked the 400th anniversary of the enslavement of the first Africans in North America, called on attendees to acknowledge racism as a public health crisis and advocate for change.
NICHQ CEO Scott D. Berns Shares Personal and Professional Goals for 2020
As a nation, we’ve erred deeply—both historically and in our inadequate efforts to counteract that history—and our mothers and babies of color are paying the ultimate price with their lives.
A little over two months ago, I attended a two-day summit organized by First Year Cleveland and the YWCA Greater Cleveland: 400 Years of Inequity: A Call to Action. The summit, which marked the 400th anniversary of the enslavement of the first Africans in North America, called on attendees to acknowledge racism as a public health crisis and advocate for change.
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Issue Brief: Racial and Ethnic Disparities (RED) in Treatment Courts
Dr. John R Gallagher, HD, LSW, LCAC The National Drug Court Resource Center (NDCRC) is housed at the Justice Programs Office, a center in American University’s School of Public Affairs, and is funded by the Bureau of Justice Assistance. Issue briefs such as this are created to educate and inform the treatment court field about topics of importance. For more information please visit the National Drug Court Resource Center at www.ndcrc.org |
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No More Silos: Animating Integrated Health and Behavioral Health Care Practices in the Classroom
ABSTRACT: Over the last decade, there has been increased momentum to bring the worlds of physical and behavioral health care together. Instead of social work education simply reacting to this change, it is imperative that we be proactive and prepare students to be “multilingual,” that is, be able to speak and function in both the worlds of health and mental health so they can move seamlessly into the new world of integrated care. The purpose of this article is to explore curricular and pedagogical strategies needed to prepare graduate social work students for the coming shift in practice toward integrated health and mental health care |
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Advancing Leadership in Public Health Social Work Toolkit
Welcome to the Public Health Social Work (PHSW) Education Toolkit, a project of the Boston University Advancing Leadership in Public Health Social Work Education (BU-ALPS) grant, funded by the Health Resources and Services Administration (HRSA). The PHSW Toolkit is one of three documents developed by the BU-ALPS team. In addition to the PHSW toolkit, there is an MSW/MPH Handbook to promote promising practices in the administration of MSW/MPH programs and a set of Recommendations to the Field aimed at elevating and revitalizing this important area of practice. The BU-ALPS team is passionate about public health social work education. Led by a public health social worker and longtime director of the successful Boston University MSW/MPH Program, our team is comprised of MSW/MPH and MPH graduates, all of whom have practiced at the intersection of public health and social work (SW). We are guided by the conviction that public health social work is a powerful and essential skill set for contemporary social workers who want to engage in “upstream” prevention-oriented social work, cross-sectoral efforts to improve health outcomes, and the promotion of health equity. Our goal is to promote the integration of public health social work (PHSW) into all levels of social work education and professional development. In developing the PHSW Toolkit, the BU-ALPS team engaged in a variety of efforts to better understand the current state of public health social education. We surveyed MSW deans, MSW/MPH Program faculty and directors, APHA members, and other key informants on the availability and quality of (PHSW) education. We also conducted website reviews to gather information about PHSW content in social work education and interviewed a select set of public health and social work experts and key informants. Through these efforts, we gained a better understanding of the gaps and challenges faced by those who would like to include PHSW into social work education. While no toolkit can address all of the knowledge gaps, we endeavored to develop content in response to identified needs. We hope that this toolkit will result in increased integration of PHSW into social work education and professional development. The resources we developed which will remain available on the Boston University School of Social Work Center for Innovation in Social Work and Health website. We welcome your feedback and contributions as we continue to update them. Sincerely, Betty J. Ruth, MSW, MPH, Principal Investigator, BU-ALPS Madi Wachman, MSW, MPH Alexis Marbach, MPH Jamie Wyatt Marshall, MSW, MPH Nandini S. Choudhury, |
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