How love and hate influence health and racial equity

Overcome “otherness”

Choosing love to promote health and racial equity begins with an acknowledgment of the harms that have been inflicted on some populations and a celebration of all that we have in common and how we are stronger together. Then we must move from recognition to action, confronting the structures that have undermined equity and removing barriers to opportunity. The starting point is respect and acceptance, and only then can we move towards equitable access to health and wellness opportunities.

The polar opposite of love is hate. Sometimes that is expressed overtly, through violence and cruel rhetoric, but it is often lodged in the more subtle forms of discrimination embedded in our systems, policies and practices. Racism, an antithesis of compassion, has been a pervasive form of hate in this country for centuries, marginalizing people on the basis of a single characteristic, the color of their skin. Hate is also expressed in other ways, such as when people elevate a single identity, value or point of view above all others or when institutions discriminate on the basis of gender, religion, immigration status or sexual orientation. All of that allows us to “other” people, a mindset that makes it easy to see them as less deserving and therefore justify disparities in access to health care, education, housing and much more.

The counterweight to the forces of hate must be love. By fostering compassion and reminding us of our shared humanity, love can clear a path across social, economic, and environmental inequalities. Turning to love means refusing to tolerate injustice anywhere, towards anyone, and instead embracing diversity and inclusion. When a broad mix of people with different perspectives and lived experiences are fully engaged in the process of analyzing challenges, generating ideas, and making decisions, the conditions to pursue equity are ripe. But frustration, anger, and the spread of misinformation all too often blind us to our common cause. Reluctance to listen to opinions from across the political spectrum can close doors. If we are unwilling to listen to those with whom we vehemently disagree, we not only minimize their concerns, but we also miss the opportunity to sharpen our own thinking.

My story

My own life, blessed with privileges that so many others have been denied, has taught me much about the forces of love and power. I am deeply grateful for the opportunities I have had in this country, but as an immigrant who came to Canada from Malta at the age of 14 and then moved to the United States at 20, it would be naive to pretend that my path was unburdened. . I don’t speak easily about some of the slights I encountered on that journey, and continue to encounter, in part because I know others have endured much worse. But let me share a story that speaks to the careless treatment of those who are perceived as different.

In high school, my English teacher kept grading my essays a C-minus. He couldn’t figure out why, until I realized he wasn’t actually reading them, but rather he assumed they couldn’t be spelled right because he spoke with an accent, as I do to this day.

My experience as an immigrant has allowed me to see the world through the eyes of a stranger. Those of us who are not Native Americans bring a distinctive lens to the legal, physical, and symbolic barriers that exclude some people from full participation in American society. Our personal awareness of how structures and systems are put in place to sideline certain populations easily translates into unwavering sympathy for those who cannot access power and privilege.

An imperative to advance collective healing

The COVID-19 pandemic is a perfect example of the damaging health consequences of being so locked into our mindsets that we can’t talk to each other. It’s hard not to cringe at the schisms that have allowed such a clear social benefit as vaccines to become a divisive tool. But if its safety and efficacy are clear to most of us in public health, the intensity of resistance in some quarters tells us not only that we are deeply fractured, but also that we have enormous incentive to come together. Dismissing people who are wary of vaccines undermines our ability to articulate counterarguments and change minds.

And here I think we have to consider the nature of power and its role in shaping our thoughts, desires and beliefs. Too often used to amplify and reinforce social inequalities creating a source of anger and suspicion, power can also be applied to promote the collective good, to spread love, not hate, in our communities. Properly exercised, power can be a tool to disrupt the structures that have preserved racism, intensified economic disparities, and harmed so many. For example, researchers have identified ways to target policy interventions that minimize health and economic disparities. Another study finds preliminary evidence that guaranteed income improves health and well-being in a mid-size city. We need to look for innovative opportunities to inform decision-making and catalyze the structural changes that enable health and racial equity.

A Funding Opportunity: Innovative Research to Advance Racial Equity

Mindsets of “others”, my experience as an immigrant, power dynamics – all of these have informed a lot about the ways I think about health and how I perceive the impact of marginalization and hate-fueled racism. RWJF’s Evidence for Action (E4A) program encourages and supports innovative and rigorous research on the impact of programs, policies, and practices on health and wellness, focusing on research that will help advance racial health and equity. . We already know that racism is detrimental to health and we are not looking for science to restore that unquestionable fact. Rather, we want to know exactly how structural racism expresses itself and what we can do to address it.

That’s the focus of the new Evidence for Action funding opportunity. We continually seek proposals that study how we can dismantle unfair systems and practices. We want to hear ideas from a wide range of people—researchers, practitioners, community leaders, advocates, policymakers—and we welcome multidisciplinary teams.

Together, we can move toward health and racial equity by focusing on the fundamental and structural drivers of health. Learn more and apply today.


Dr Sandro Galea is the dean of the Boston University School of Public Health. He is the former Chair of Epidemiology at Columbia University’s Mailman School of Public Health, among other leadership positions, and the author of the forthcoming book, The Contagion Next Time.

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