Diversity is the representation of all our varied identities and differences—collectively and as individuals.
Equity seeks to ensure fair treatment, equality of opportunity, and parity in access to information and resources for all.
Inclusion builds a culture of belonging by actively inviting the contribution and participation of all people.
As you engage individuals, families and communities in their health and well-being, it is critical to obtain feedback from the diversity of people and families you are serving. There is diversity across personal characteristics (i.e. race, age, gender, sexual orientation, origin, income, etc.) as well as diversity of thought.
Knowing that particular groups have often been excluded from decision-making and equitable distribution of resources; inclusion requires attention and effort to make sure all voices are heard.
We must also recognize any assumptions and bias we carry into our work and interactions, and be deliberate about the power our thoughts, words and actions have to either empower or marginalize others.
Bias is the negative evaluation of one group and its members relative to another; and/or prejudice in favor of or against one thing, person, or group compared with another.
Explicit bias occurs when a person is aware of his/her evaluation of a group, believes that evaluation to be correct, and has the time and motivation to act on it.
Implicit bias is unintentional or unconscious
When it comes to understanding equity, a picture is worth a thousand words. Interaction Institute for Social Change | Artist: Angus Maguire.
WE SHALL REMAIN was created to address the effects of historical trauma in tribal communities.
Generational Effects of Trauma
Throughout history and during our present time, people have been/are subjected to long-term, mass traumas like colonialism, slavery, war, and genocide. People exposed to these traumas exhibit a higher prevalence of disease even several generations after the original trauma occurred.
Exposure to mass trauma often results in maladaptive behaviors and related social problems. Substance abuse, physical/sexual abuse, and suicide directly traumatize younger generations and can become learned behavior, perpetuating intergenerational cycles of trauma.
Traumatic events become embedded in the social memories of the population and younger generations become exposed to unresolved grief, persecution and distrust through the loss of culture and language, discrimination, injustice, poverty, and social inequality.
The cumulative effects of historical trauma on the population can produce health disparities resulting from the accumulation of diseases and social distress across generations.
Many thanks to CCWB Contributors CoNECT, Native American Community Services of Erie and Niagara Counties, and InterFaith Works of Central New York for providing content for this section.
Read more research here:
Blair, I., Steiner, J., & Havranek, E. (2011). “Unconscious (Implicit) Bias and Health Disparities: Where Do We Go From Here?” The Permanente Journal. 15(2): 71-78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140753/
Hartmann, W. E., et al. (2019). “American Indian historical trauma: Anticolonial prescriptions for healing, resilience, and survivance.” American Psychologist. 74(1): 6–19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338218/
Israel, B.A., etal. (2005). “Community-Based Participatory Research: Lessons Learned from the Centers for Children’s Environmental Health and Disease Prevention Research.” Environmental Health Perspectives. 113(10): 1463-1471. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281296/
Israel B.A., et al. (1998). “Review of community-based research: assessing partnership approaches to improve public health.” Annu Rev Public Health. 19: 173–202. https://tinyurl.com/ycm4lzyz
Jones, N., et al. (2019). “Life Course Approaches to the Cause of Health Disparities.” American Journal of Public Health. 109(S1): S48-S55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356123/
Minkler, M., et al. (2012). “Community-Based Participatory Research: A Strategy for Building Healthy Communities and Promoting Health through Policy Change.” PolicyLink. https://www.policylink.org/sites/default/files/CBPR.pdf
Minkler, M., & Wallerstein, N. (2011). Community-Based Participatory Research for health: from process to outcomes. 2nd ed. Wiley.
Sotero, M. (2009). “A Conceptual Model of Historical Trauma: Implications for Public Health Practice and Research.” Journal of Health Disparities Research and Practice. 1(1): 93-108. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1350062
Vanderbilt, A., & Wright, M. (2013). “Infant mortality: a call to action overcoming health disparities in the United States.” Med Educ Online. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772318/pdf/MEO-18-22503.pdf
Principles for Community-Based Participatory Research
Effective, authentic CBPR aspires to the following qualities:
1. Recognizes community as a unit of identity.
2. Builds on strengths and resources within the community.
3. Facilitates a collaborative, equitable partnership in all phases of research, involving an empowering and power-sharing process that attends to social inequalities.
4. Fosters co-learning and capacity building among all partners.
5. Integrates and achieves a balance between knowledge generation and intervention for the mutual benefit of all partners.
6. Focuses on the local relevance of public health problems and on ecological perspectives that attend to the multiple determinants of health.
7. Involves systems development using a cyclical and iterative process.
8. Disseminates results to all partners and involves them in the wider dissemination of results. 9. Involves a long-term process and commitment to sustainability.
10. Openly addresses issues of race, ethnicity, racism, and social class, and embodies “cultural humility.”
11. Works to ensure research rigor and validity but also seeks to ”broaden the bandwidth of validity” with respect to research relevance.
See: Israel B.A., et al. (1998). “Review of community-based research: assessing partnership approaches to improve public health.” Annu Rev Public Health. 19: 173–202. https://tinyurl.com/ycm4lzyz