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Critical Anti-Racist Discourse Analysis Applied to Federally Qualified Health Center Policy.

Jennifer Jabson Tree1, Judson Laughter2, Sandra Wairimu2

  • 1Purdue University, West Lafayette, IN, USA.

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|December 26, 2024
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Summary

Federally Qualified Health Centers (FQHCs) can inadvertently perpetuate institutional racism through their policies. Analyzing policies using Critical, Anti-Racist, and Discourse Analysis (CARDA) reveals areas needing clearer accountability to dismantle racism.

Keywords:
Critical Anti-Racist Discourse AnalysisFederally Qualified Health Centerinstitutional racismpolicy analysis

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Area of Science:

  • Health Equity Research
  • Public Health Policy Analysis
  • Anti-Racism Studies

Background:

  • Federally Qualified Health Centers (FQHCs) aim to advance health equity for underserved populations.
  • Existing FQHC policies may not explicitly address or dismantle systemic racism.
  • Institutional racism can be embedded within organizational policies, impacting marginalized communities.

Purpose of the Study:

  • To analyze FQHC policies for potential reification of institutional racism.
  • To identify specific policy characteristics that may perpetuate racial inequity.
  • To advocate for racism-conscious policy development within FQHCs.

Main Methods:

  • Application of Critical, Anti-Racist, and Discourse Analysis (CARDA) to an FQHC operations manual.
  • Identification of themes related to the perpetuation of institutional racism within policy language and structure.
  • Qualitative analysis of policy text for passive voice, unspecified responsibilities, and lack of workflow delineation.

Main Results:

  • CARDA identified three key themes indicating potential for institutional racism: unspecified responsible positions for actions, use of passive voice in policies, and absence of clear workflow responsibilities.
  • These policy characteristics can obscure accountability and perpetuate racial inequity.
  • Lack of explicit delineation of responsibilities creates pathways for institutional racism.

Conclusions:

  • Dismantling institutional racism in FQHCs requires critical examination of existing policies.
  • Developing clear policies with defined responsibilities and accountability mechanisms is crucial.
  • Explicitly addressing potential harms and naming responsible parties fosters trust and strengthens community-institution relationships.