Five ways ‘health scholars’ are complicit in upholding health inequities, and how to stop
Health scholars have a collective responsibility for addressing health inequities
This important commentary explores how “health scholars” — those who work in education and research roles within academic institutions — actively maintain health inequities. The discussion is framed by the belief that health scholars have a shared responsibility for addressing systemic, unjust and avoidable health differences (health inequities).
Five mental models that prevent transformative systems change
Addressing the root causes of health inequities requires redistributing power and, by extension, transformative systems change. The author of this commentary emphasizes that this requires shifting deeply held beliefs, also known as mental models. She explores five mental models that tend to get in the way of transformative systems change:
- Euphemisms: Health scholars downplay the root causes of inequities by choosing milder, more comfortable words (e.g., substituting “equity, diversity and inclusion” for “racism and anti-racism”). This misdiagnoses the real problem and often results in ineffective and incomplete solutions (e.g., suggestions for more workshops or more “diverse” teams).
- Middle ground: Health scholars prioritize politeness and neutrality. They study and describe inequities without questioning and interrogating the forces and systems that distribute power and resources thus maintaining the status quo.
- Distractions: Health scholars act as if decision-makers are well meaning and, when provided with more information, will act to address institutionalized injustice. Rather than engaging in true change efforts, health scholars distract themselves with activities such as information gathering and strategic planning.
- Mystery: Health scholars believe that systemic problems are too big and mysterious to solve or perhaps tackle. They ignore their own power to do anything differently (e.g., they may say “it’s too complex” or “it’s out of my hands”).
- Capacity: Health scholars do not see that their work is (largely) publicly funded and that they have both the responsibility and the capacity to serve society. They act as if they cannot organize and advocate for change within their own institutions.
Use this resource to:
Review the deeply held beliefs that can prevent health equity action in public health organizations
Reflect about the ways in which you are complicit in upholding unjust systems (e.g., racism and colonization)
Identify concrete strategies to shift deeply held beliefs and redistribute power for health equity
Alignment with NCCDH work
Several NCCDH resources position critical self-reflection as being necessary for anti-oppressive, equity-focused action. These same resources identify opportunities to challenge the status quo and disrupt systemic inequities.
The NCCDH has published several resources understanding power dynamics and confronting systemic oppression. These include Let’s Talk: Racism and health equity (2018), Let’s Talk: Whiteness and health equity (2020), Let's Talk: Intersectionality (2022) and Let’s Talk: Redistributing power to advance health equity (2023). In 2023, the NCCDH partnered with the Black Health Education Collaborative on a series of webinars on disrupting anti-Black racism in public health.
In 2022, the NCCDH launched Mind the disruption, a podcast about people who believe and better future is possible and are working for better health for all.
Shahram, S. Z. (2023). Five ways ‘health scholars’ are complicit in upholding health inequities, and how to stop. International Journal for Equity in Health, 22(1), Article 15. https://doi.org/10.1186/s12939-022-01763-9