Document Type
Article
Publication Date
7-1-2022
Abstract
Context: Structural racism is a profound determinant of health resulting in pervasive health inequities for people of color. Despite the recognition of structural racism as a complex, dynamic system, we lack a shared vision of the system that would enable identification of solutions for equitable systems transformation. Policy: Through a public health–led community health improvement planning process, a cross-sector consortium implemented community-based system dynamics to provide a systems science lens to guide efforts to eliminate structural racism. Implementation: In group model building sessions involving diverse stakeholders, community-based system dynamics was used to bring together cross-sector stakeholders to create causal loop diagrams of the system of structural racism. Participants identified potential leverage points for actionable focus to eliminate structural racism. Evaluation: Causal loop diagrams of structural racism generated through group model building demonstrate complex dynamics in the areas of criminal justice, education and economic opportunity, health and health care, quality of life, racial trauma and healing, and a promising system transformative solution through perspective transformation. Discussion: Community-based system dynamics, employed in the context of local community health improvement planning, engages stakeholders in systems thinking through sharing lived experience to create system maps of structural racism and identify leverage points and transportable solutions that foster health equity. These informal maps serve as the foundation for formal computer simulation models that will guide systemic action on high-yield, community-driven solutions to eliminate structural racism.
Keywords
group model building, health equity, structural racism, system dynamics
Language
English
Publication Title
Journal of Public Health Management and Practice
Grant
KL2TR002547
Rights
© 2022 The Authors. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/), which permits non-commercial copying and redistribution of the material in any medium or format, provided the original work is not changed in any way and is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Gullett, Heidi L. MD, MPH; Brown, Gregory L. MS; Collins, Delores AAS, C-CHW; Halko, Martha MA; Gotler, Robin S. MA; Stange, Kurt C. MD, PhD; Hovmand, Peter S. PhD, MSW. Using Community-Based System Dynamics to Address Structural Racism in Community Health Improvement. Journal of Public Health Management and Practice 28(Supplement 4):p S130-S137, July/August 2022. | DOI: 10.1097/PHH.0000000000001492
Manuscript Version
Final Publisher Version