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Interrupting false narratives: applying a racial equity lens to healthcare quality data
  1. Lauren Anita Arrington1,
  2. Briana Kramer2,
  3. Serena Michelle Ogunwole3,
  4. Tanay Lynn Harris4,
  5. Lois Dankwa2,
  6. SherWanda Knight5,
  7. Andreea A Creanga2,3,
  8. Kelly M Bower6
  1. 1Georgetown University School of Nursing, Washington, District of Columbia, USA
  2. 2Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  3. 3Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  4. 4The Bloom Collective, Baltimore, Maryland, USA
  5. 5MoMMA's Voices, Baltimore, Maryland, USA
  6. 6Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
  1. Correspondence to Dr Lauren A Arrington, School of Nursing, Georgetown University Medical Center, Washington, DC 20057, USA; la79{at}georgetown.edu

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Introduction

Across the globe, awareness of racial and ethnic health inequities and the need for healthcare systems to address them are growing.1 In many countries, teams working in healthcare institutions are encouraged to stratify quality metrics by race and ethnicity as part of the movement to identify and disrupt health inequities.2 The lack of standard definitions for race and ethnicity and restrictions on how and where these data can be collected make collecting high-quality data challenging. Stratifying quality metrics by race and ethnicity is further challenged by the risk of undermining the core goal of disrupting inequities.1 Although presenting patient data stratified by race and ethnicity helps identify health inequities, such data can also reinforce the belief that differences in health outcomes are caused by biological instead of social and structural factors. The myth that race is a biological construct is dangerous because it can result in apathy and inaction. Focusing on racial and ethnic identity can also misdirect change efforts towards the individuals and communities experiencing racism instead of the root causes of racism, found in systems and structures.2 3

Data presentation is a design process that can contribute to either the reproduction of inequities or their elimination.2 Advocates and scholars have long argued that antiracist data practices are needed in the movement to achieve health equity.4 5 Healthcare teams need strategies to examine and present racial and ethnic health inequities with a racial equity lens. A racial equity lens challenges the unintended consequences of a society where racism is pervasive. Using a racial equity lens for data presentation encodes the value of racial equity in data presentation.2

This viewpoint presents strategies to support teams to collect, share and use quality data to expose the effects of structural racism and other inequitable social …

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Footnotes

  • Twitter @drchellemd

  • Contributors All authors contributed substantially to the design and conception of the manuscript by sharing their ideas during meetings with said purpose. LAA is responsible for the overall content as the guarantor and drafted the abstract, introduction, background, and conclusion and revised all drafts. BK drafted the recommendations, table, and figures and revised all drafts. SMO reviewed all drafts and contributed substantial revisions to all sections of the manuscript. TLH reviewed all drafts and contributed substantially to the manuscript’s content on engagement with community partners. LD reviewed all drafts and contributed substantially to revisions of the recommendations section. SK contributed substantially to the drafting and revisions of content on partnering with patients and families. AAC offered substantial revisions to manuscript drafts with a focus on the manuscript’s audience, data-sharing platforms, tables and figures. KMB wrote content for each draft and served as the senior author providing guidance throughout each stage of the conceptualisation and writing process. All authors approved the final version of the manuscript for publication and agree to be accountable for all aspects of the work.

  • Funding This study was funded by Health Resources and Services Administration (U7AMC337170100).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.