Healthcare Institutions
The IARA Project investigates new and existing strategies for antiracist transformation in the healthcare sector. This research focuses on the organizational practices and institutional policy changes that directly address the racial gap in health outcomes. This work aims to support healthcare sector decision-makers and practitioners in achieving lasting and sustainable change at the institutional level.
What do healthcare organizations need right now?
In the wake of George Floyd’s murder, which ignited global racial justice protests, many healthcare organizations set new antiracist goals. However, many of these commitments lacked effective strategies and accountability mechanisms. Healthcare organizations need support to identify, implement, and measure antiracist interventions at the institutional level.
What does antiracist research offer?
Systemic racism is deeply embedded in U.S. healthcare and economic systems, and it remains pervasive throughout social policies and organizational practices alike.
Finding effective antiracist interventions is as challenging as it is essential. Much of the current research on systemic racism in healthcare focuses on how racism shapes social determinants of health and economic well-being. The IARA Project, however, is dedicated to exploring and developing solutions to these systemic inequities.
Keep scrolling to learn more about IARA’s ongoing research, including our examination of the American Medical Association’s archives and our previous report on accountability in healthcare institutions.
Meet the researchers
Angel Rodriguez
Research Fellow
Examining the American Medical Association Archives
To facilitate a landmark research project, the American Medical Association (AMA) is opening its archival collections to researchers from the Institutional Antiracism and Accountability (IARA) Project beginning in the summer of 2024. The groundbreaking initiative, called the Truth, Reconciliation, Healing, and Transformation (TRHT) Archival Research Project, will examine the historical roots of racial disparities in American healthcare to develop actionable strategies for restorative justice and health equity.
The TRHT Archival Research Project will conduct in-depth archival analysis and historical research to understand the organizational practices and decision-making processes that have caused racial harm to patients, physicians, and populations.
This project is made possible through an historic partnership between the AMA, the Robert Wood Johnson Foundation, and the AMA Foundation. Research findings, set to be publicly available in 2026, will provide a historical baseline and offer learnings that the AMA and other U.S. healthcare institutions may use to consider policy recommendations and programs.
2023 Report on Accountability & Transformation
Supported by a grant from the Robert Wood Johnson Foundation, IARA conducted a one-year study of existing antiracist interventions in healthcare organizations and a review of authoritative evidence for institutional accountability. The report titled ‘From Words to Action: Institutional Accountability and Transformation‘ was published in March 2023.
IARA’s pioneering case studies identifies five organizational levers necessary to close racial disparities in healthcare outcomes and produce long-term sustainable institutional transformation:
1. Buy-in and continued engagement from leadership
2. A shared understanding and use of explicit language to define structural racism
3. Effective organizational infrastructure
4. Clearly defined metrics
5. Building internal capacity and professional development
Read the report to discover the five essential strategies for driving institutional change, along with additional recommendations for healthcare organizations committed to antiracist transformation.
Talk: Obstacles & opportunities
In this discussion, Dr. Vabren Watts, Director of Equity at Health Affairs, sits down with Ángel Rodríguez, IARA Research Fellow and co-author of the above report Antiracist Institutional Change in American Healthcare Organizations.
Press play for a discussion on the opportunities and obstacles in implementing antiracist change initiatives in healthcare organizations and other key findings from the report.
Related articles on healthcare
Implementing Anti-Racism Interventions in Healthcare Settings
2021
In the years following the murder of George Floyd, many health organizations declared anti-racism commitments and shifted their core values in an attempt to reform hospital-based interventions to implement antiracist change. To date, however, there remains a gap in providing a systematic review of these efforts to understand which interventions actually worked. In this paper, authors conducted an international systematic review for anti-racist interventions in healthcare to: (1) increase understanding of these efforts for the sector and (2) analyze the anti-racist interventions’ potential to influence policy and patient care.
Association Between Racial Wealth Inequities and Racial Disparities in Longevity Among US Adults and Role of Reparations Payments, 1992 to 2018
2022
This cohort study aims to identify, address and quantify the relationship between longevity ( “all cause mortality”) and wealth as it relates to Black individuals versus white individuals. Furthermore, the study then models how reparations payments to the black community could potentially affect the longevity ( “all cause mortality”) gap between Blacks and whites. By further exploring the direct connection between reparations and health outcomes, the authors attempt to specifically describe the role of monetary resources in determining health inequities across racial groups.
How Structural Racism Works — Racist Policies as a Root Cause of U.S. Racial Health Inequities
2021
Racism is not ahistorical and neither are U.S. health care and public health institutions and practices. Drs. Bailey, Feldman and Bassett argue that structural racism is a legacy of African enslavement and affects both population and individual health. They offer three examples of structural domains that continue to lead to poorer health outcomes for Black Americans: (1) redlining and racialized residential segregation, (2) police violence and the carceral state, and (3) unequal health care.
3 Principles for an Antiracist, Equitable State Response to COVID-19 — and a Stronger Recovery
2021
Historically, at times of economic crises, governmental leaders often cut funding for social programs and create tax cuts for the wealthy, worsening social conditions for marginalized populations, in particular the racial wealth gap. At the peak of the pandemic in 2021, the federal government’s American Rescue Plan unprecedentedly offered state governments the opportunity to address systemically racist policies, the root cause of racial disparities caused by Covid-19. In this paper, the authors provide an antiracist framework for state officials to craft policies that promote equity and racial justice.