USF College of Public Health’s Dr. Alicia Best, an assistant professor specializing in health equity and social justice, has been featured in a new Hastings Center special report calling on the field of bioethics to take on a more active role in remedying racial injustice and health inequities in the United States.

The Hastings Center is a nonpartisan, nonprofit organization and was “critical to establishing the field of bioethics,” according to its website. It’s “the oldest independent, nonpartisan, interdisciplinary research institute of its kind in the world.”

Scholars of the center produce publications on ethical issues on topics ranging from health to technology, all with the intent to inform the practice of bioethics.

Best’s article, “Anti-Black Racism and Power: Centering Black Scholars to Achieve Health Equity,” has been included in Hastings Center’s special report, “A Critical Moment in Bioethics: Reckoning with Anti-Black Racism Through Intergenerational Dialogue.”

“This special issue in Hastings is an important step on the road toward health equity as it centers and elevates the voices of recognized scholars of color, junior scholars, and other scholars actively working toward health equity,” Best said.

The special report represents a collaboration between an independent antiracism task force of bioethicists from across the United States and The Hastings Center, as part of the Center’s health equity initiative.

“I believe health equity is achieved when everyone can attain optimal health; and I believe health equity can only be achieved by addressing key social determinants of health—primarily, structural racism,” Best said.

Highlighting the intergenerational work of mostly Black scholars, the Hastings report examines structural racism—particularly anti-Black racism—in health care settings, in health equity research and practice, and in bioethics.

The report was supported by a grant from The Greenwall Foundation.

“It’s well established that Black scholars are underrepresented in positions that influence research priorities and funding decisions,” Best said. “Since many Black scholars experience structural racism, discrimination and marginalization similar to the populations that are of interest in health equity research, it is important that our perspectives are represented in all aspects of health equity research.  For example, without these critical perspectives early on when research and funding priorities are set, we run the risk of overlooking key determinants of health inequity, such as anti-Black racism and power imbalance.”

Best says that we must not ignore centuries of anti-Black racism and the effect that is has on health equity.

“The pervasive health inequities we see today were not created overnight nor in a vacuum,” she said. “They exist due to centuries of social, economic, environmental and political injustice that is embedded in American society. As such, these injustices must me understood and addressed if we are to make any meaningful progress toward health equity.”

Her article discusses how the field of scientific research is not immune to structural racism. 

“Some of the most important ways that structural racism can manifest in scientific research is underrepresentation of Black scholars in positions of power, impacting who and what gets funded, how health equity research is conducted, as well as solutions implemented to address health inequity.”

Best said that institutions play an important role in addressing this type of structural racism, specifically by actively working to identify and address power imbalances between researchers and communities, as well as within the institutions themselves, such as among researchers, staff and students.

“For example, we can look for ways to appropriately share power within research teams and provide meaningful opportunities for Black and other minoritized scholars to assume leadership roles,” she said.

Best said that the lived experiences of Black and minority researchers can be “invaluable in shaping health equity research.”

“As the priority populations in health equity research often experience marginalization and discrimination that impacts their health outcomes, understanding these experiences is critical to addressing health inequity. Given that many Black scholars experience similar (and different) forms of discrimination, our perspectives can provide valuable insight to health equity work,” she said.

Best urges that the primary goal of health equity research should be the creation of an antiracist society and awareness of how anti-Black racism manifests at each phase of the research process. But, how do we get there?

“That is a ‘big’ question that involves multiple levels. At the individual level, health equity researchers and practitioners should include antiracism as an overarching goal within our own research. Additionally, institutions and systems should actively work to identify opportunities and implement policies and practices to center the voices of and empower Black scholars and communities in health equity research,” she said.

Story by Anna Mayor, USF College of Public Health