HARVARD MEDICAL SCHOOL PRIMARY CARE REVIEW

Decentralizing Knowledge in Public Health Education, One Course at a Time

July 16th, 2021

We can see structural determinants of health all around us, like when we see factories and truck routes constructed in low-income minority neighborhoods. We also see structural determinants when quality of public schools varies vastly by neighborhood, some with after school programming, while at others, kids are left to occupy themselves. We see it when food access differs according to neighborhood socioeconomic status. If health equity existed, we would not note such obvious differences.

Now, consider that you are one who experiences these inequities regularly, wanting to learn the language of how to talk about it, or approaches to address it. Imagine being asked to pay for such information by institutions that play a role in perpetuating inequalities.

A frustrating encounter in academia, particularly in being buried in discussions about structural and environmental racism, is the ways in which this “knowledge” about social determinants of health is co-opted. It is ironic that those with firsthand experience would have to pay for a degree to be considered “competent” in these issues, or have to pay for journal access in order to obtain a critical or academic view of their lived experiences.

Epidemics of Injustice is a course at the University of Illinois Chicago (UIC) School of Public Health that is co-created by students and faculty and is open to all for free. This course is an interdisciplinary public health course that is available for credit for undergraduate, masters, and doctoral students from across campus. The lectures are open and free to all, including students and faculty from other schools as well as community members. Another key aspect of this course is that the instructor acts more like a facilitator and co-leader, rather than primarily a teacher. Traditionally, the key speakers of the session vary week to week, from interdisciplinary faculty across UIC and other universities, as well as community scholars, organizers, and activists affiliated with a variety of different organizations.

Now in its fourth year, the course was conceived and is planned by Radical Public Health, a student-led organization at the UIC School of Public Health focused on structural drivers of health inequities. The course was first developed as a solution to an observed gap in the graduate curriculum, where students desired to have coursework that recognizes contextual, politicized health behaviors rooted in systemic oppression. The course structure incorporates traditional lectures as well as action labs that give students space and tools to work on addressing injustices.

Each year, the course has a theme that is determined by a working group composed of Radical Public Health members:

  • Year 1 (2018): Understanding History to Fight for a Liberated Future
  • Year 2 (2019): Structural Violence in Chicago
  • Year 3 (2020): Debunking 500+ Years of Myth
  • Year 4 (2021): Resistance, Rebellion, and Revolution through Public Health

This course was originally taught in-person but has since transitioned online due to the COVID-19 pandemic, ultimately making it much more accessible for individuals to attend from all over the country. In Spring 2021, we had 38 enrolled credit-seeking students from across the UIC campus, but over 200+ people registered for sessions, and many more who have shared the recordings and viewed them afterwards. Given the success this semester, the Collaboratory for Health Justice at the UIC School of Public Health has established a donor fund to support making this course accessible even more accessible in audience size, languages offered, and with additional learning accommodations in the years to come.

The Spring 2021 course focused on the historical, social, cultural, and political factors related to historical and contemporary health, and the historical and contemporary resistance and rebellion through public health, as seen through interdisciplinary and cross-movement work. Sessions spanned health topics such as housing, food access, disability justice, the COVID-19 pandemic, and we discussed different avenues of social change and action through mutual aid, grassroots organizing, empowerment, policy making, direct action, and data sharing. Each week we featured guest speakers that were professors, community organizers, and scientists.

When we talk about the impact of such a course, it goes beyond the value for enrolled students as course credit. Briefly, we outline three impacts on community that this open-course format has:

  1. Decentralizes knowledge and knowledge production. One does not need to have a graduate degree to possess deep insight and knowledge about structural inequity and root causes of health inequity. While health inequity may be complex, academics tend to convey that the solutions must be complex too, clouding the essential and meaningful impact of grassroots organizing, lobbying, policy making, mutual aid, and other efforts outside of the ivory tower. By having an array of speakers with varying backgrounds, we send the message that different forms of knowledge—acquired from reading, observation, and experience—are all valid and equally meaningful, belonging in spaces within and beyond academia. Students and others who attend the course are then able to share this knowledge in the future, further centering the experiences of the community. As we write this, we also want to note the imprecise overuse of the term “decolonizing” in academia to describe this kind of work. This kind of format is anti-colonial but is still just a mark on the overall effort to decolonize.
  1. Establishes a building block for meaningful community engagement. As the disciplines of public health, medicine, nursing, planning, policy administration, and others state that they value community involvement in their efforts, it is essential to build a bridge between our academic or professional tables, and the table of the community. It is unfair to invite community members to a table where they have extra mental burden to use jargon to talk about their own experiences, such as “structural determinants of health,” “neoliberalism,” or the differences between “systemic” and “systematic.” Rather, we must establish a new, accessible table in the middle, where all groups can dialogue and engage on these issues. This course is a building block for that table.
  1. Contributes to reciprocity in our institution’s relationship to community. Public health and medicine have a dark and harmful history of helicopter research—collecting data from communities and then never returning to share results or give back, being complicit in structural violence through public health practice rooted in government. A course that is free and open to the public is a small way to tangibly show value for communities that are engaged in our work—whether it be as research partners, organizations that share information or help recruit for studies, or as research participants. Opening the course to a broader audience requires just a little extra work of posting the recording to the website and emailing registrants—a small “price” to pay for valuing essential partners in our teaching, research, and practice.

This course is just one attempt at decentralizing knowledge towards creating anti-colonial and anti-racist spaces in academic settings. By sharing what we have learned, we hope to inspire and encourage similar movements across other educational institutions.

Questions about the Epidemics of Injustice course can be directed to the Collaboratory for Health Justice at the UIC School of Public Health, SPHcollaboratory@uic.edu. We also thank our colleagues Washieka Torres (co-instructor and doctoral student), Jeni Hebert-Beirne, and Kelsey Arnold for their collaboration and support in making this past semester’s course a success.

**Feature photo obtained with standard license on Shutterstock.

 

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Alexis Grant

Alexis Grant, ScM, is a 4th year PhD candidate in Community Health Sciences at the University of Illinois Chicago (UIC) School of Public Health. She is a student, researcher, teacher, and organizer, and these paths cross often through her various roles at UIC. Alexis is also one of the founders of the Black Graduate Student Association and an organizer with the Good Trouble Coalition, both of which continue to work for the inclusion and well-being of all students at UIC. She was one of two Epidemics of Injustice co-instructors for the Spring 2021 semester.

 

Maggie AcostaMaggie Acosta, MA, is a medical anthropologist and public health researcher. She is the Coordinator for the Collaboratory for Health Justice, which was established to integrate community engagement into all aspects of research, teaching, and practice at the University of Illinois Chicago School of Public Health. She reviews policies, programs, and practices to enhance community engagement and is currently working on a program for Chicago youth to unlearn knowledge hierarchies and gather grounded knowledge for advocacy and action.

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