Using Community-Based System Dynamics to Address Structural Racism in Community Health Improvement.

Autor:	Gullett HL; Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, Ohio (Drs Gullett, Stange, and Hovmand, Mr Brown, and Ms Gotler); PolicyBridge, Cleveland, Ohio (Mr Brown); A Vision of Change, Cleveland, Ohio (Ms Collins); and Cuyahoga County Board of Health, Parma, Ohio (Dr Gullett and Ms Halko)., Brown GL, Collins D, Halko M, Gotler RS, Stange KC, Hovmand PS
Jazyk:	angličtina
Zdroj:	Journal of public health management and practice : JPHMP [J Public Health Manag Pract] 2022 Jul-Aug 01; Vol. 28 (4 Suppl 4), pp. S130-S137.
DOI:	10.1097/PHH.0000000000001492
Abstrakt:	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. Competing Interests: The authors declare that they have no conflicts of interest. (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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