Race & Ethnicity Pathway
This pathway complements NNLM’s resources on race and ethnicity by exploring evaluation considerations for programs that seek to improve health outcomes for people with a specific ethnicity or ethnicities.
Because of systemic inequalities present in the United States, typically, people who identify as Black, Indigenous and People of Color will be the focus of these programs.
While you are developing your evaluation plan, it is important to consider the context of your program. The context can change how your evaluation is designed and implemented because different settings and populations have different needs and abilities to participate in evaluations.
NNLM stands against racism in health. Review the following resources to learn more about health disparities, the experience of people of color, and racism in health:
- Clinical Conversations Training Program
- “Because I See What You Do”: How Microaggressions Undermine the Hope for Authenticity at Work
- Recording of Because I See What You Do": How Microaggressions Undermine the Hope for Authenticity at Work
- Please visit NNLM.gov or contact your local regional medical library for more resources
Racism
- Understand how racism can change the context of your evaluation. Racism in the United States has a complex, and often controversial, history. As the Annie E. Casey Foundation states, “the concept of racism is widely thought of as simply personal prejudice, but in fact, it is a complex system of racial hierarchies and inequities."
- NNLM has compiled common microaggressions, organized by themes that can be reinforced or minimized by the methodology and conclusions of your evaluation.
- Take a stance of anti-racism. A stance of anti-racism actively opposes racism, in all forms at all levels. It includes working against racism on a personal level and working against racism on a structural or institutional level.
- In program evaluation, this includes designing evaluations to accurately capture the lives of the program participants, and clearly calling out and communicating racism when it is encountered.
| Internalized Racism | Internalized racism describes the private racial beliefs held by and within individuals. The way we absorb social messages about race and adopt them as personal beliefs, biases and prejudices are all within the realm of internalized racism. For people of color, internalized oppression can involve believing in negative messages about oneself or one’s racial group. For white people, internalized privilege can involve feeling a sense of superiority and entitlement or holding negative beliefs about Black and people of color. |
| Interpersonal Racism | Interpersonal racism is how our private beliefs about race become public when we interact with others, such as microaggressions and tone policing. |
| Institutional Racism | Institutional racism is racial inequity within institutions and systems of power, such as places of employment, government agencies and social services. It can take the form of unfair policies and practices, discriminatory treatment, and inequitable opportunities and outcomes. |
| Structural Racism | Structural racism (or structural racialization) is the racial bias across institutions and society. It describes the cumulative and compounding effects of an array of factors that systematically privilege white people and disadvantage Black and people of color. |
| Systemic Racialization | Systemic racialization or systemic racism describes a dynamic system that produces and replicates racial ideologies, identities, and inequities. Systemic racialization is the well-institutionalized pattern of discrimination that cuts across major political, economic, and social organizations in a society. |
Equity & Equality
- Clarify the definition of success. Programs (and evaluations) can define activities and outcomes from an equity and/or an equality perspective. It is important to understand the differences between equity and equality, as they are often used interchangeably but are defined by different concepts and have correspondingly different criteria for success.
Intersectionality
- Measure multiple dimensions of discrimination. Kimberlé Crenshaw's Intersectionality framework states that people experience multiple, overlapping, and cumulative forms of discrimination, such as racism, sexism, classism, and ableism.
- Crenshaw recognized that programs have failed to address the experiences of Black women by focusing on only one dimension of their identity - either being Black or being female - rather than the intersection of those dimensions.
- These different forms, or dimensions, of oppression intersect in complex ways, so that individuals who identify with multiple dimensions of oppression experience discrimination in different ways.
- This may justify the collection of additional data related to the needs of specific communities within your group of program participants.
- More information on intersectionality
- Consult an intersectionality chart. When thinking through your evaluation, it may be beneficial to consult an intersectionality chart, like the one below, to think through how different groups may experience your program differently, and effective ways of measuring the experiences of all groups.
| Privilege/Society Normative | Oppression/Resistance | |
| White | Racism | Black, People of Color |
| Upper & Upper-Middle Class | Classism | Working Class |
| Male and Masculine, Female and Feminine | Genderism | Non-binary or transgender |
| Male | Sexism | Female |
| European heritage | Eurocentrism | Non-European origin |
| Heterosexual | Heterosexism | Lesbian, Gay, Bisexual, Queer, Asexual++ |
| Wealth | Wealthism | Poor/financially insecure |
| People with no disabilities, mental good health | Ableism | People with disabilities, people with mental illness |
| Credentialed | Educationalism | No or limited education |
| Young | Ageism | Old |
| Attractive | Politics of Appearance | Unattractive |
| Anglophone | Language Bias | English as a second language |
| Light, pale skin | Colorism | Dark Skinned |
| Gentile, Not Jewish | Anti-Semitism | Jewish |
| Fertile | Pro-natalism | Infertile |
Implicit Bias
- Consider how your unconscious behavior can change how you approach the evaluation. Implicit biases, unconscious associations between groups of people and certain characteristics or behaviors, affect how we view other races, ethnicities, genders, abilities, etc.
- In evaluation implicit biases can change how we perceive the success of outcomes, how we collect and share information, how we form conclusions, and can also inform decision making processes.
- Test for your biases. Project Implicit has a free and publicly available Implicit Association Test that can assist in identifying unconscious biases so they can be more easily recognized and addressed.
Distrust of Research
- Know why there may be resistance to evaluation. Scientific and academic institutions have not always approached research ethically and equitably.
- Some research has targeted Black, Indigenous and People of Color as research subjects or models, without considering the wellbeing or harm the study could cause.
- The findings of research have been used to incorrectly declare the superiority of Caucasians, and the results have caused significant and lasting damage to communities.
- Despite the progress the field of research ethics has made, the wide variety of research failures have, rightfully, led to the distrust of research by many communities, races, and ethnicities.
- Ensure the safety and security of the community. Your evaluation should consider the distrust of research by clearly defining the ethics and ethical processes your evaluation will take.
- Actively developing relationships will build the trust of the community you are working with.