"This Work Belongs to Everyone": Understanding Health Equity Practitioners' Approaches to Addressing Structural...

Structural racism-which encompasses discriminatory laws/policies, institutional practices, and social norms-is a driver of racialized health inequities in the U.S. Notably, laws/policies at the federal, state, and local levels perpetuate structural racism across all societal domains and are key structural determinants of racial health equity. Health equity practitioners play a critical role in mitigating the impacts of structural racism-related laws/policies through their legal, policy, and community-based work at state and local health departments, community-based organizations, and health policy organizations. While the broad professional experiences of health equity practitioners have previously been documented, research specifically examining their approaches to addressing structural racism in the context of racial health equity practice is limited. Hence, we conducted a qualitative study interviewing practitioners (n = 21) employed at organizations seeking to advance racial health equity across the U.S.; interviews were conducted between December 2023-February 2024. We applied template-style thematic analysis, identifying practitioners' four key approaches to addressing structural racism: (1) documenting racialized health inequities; (2) policy monitoring, evaluation, and analysis to understand the impacts of structural racism-related laws/policies; (3) establishing multisectoral collaborations among academic, community, and government partners; and (4) fostering anti-racism within health equity organizations. Health equity practitioners can address structural racism in the context of racial health equity practice by not only documenting its impacts on racialized health inequities but also developing sustainable partnerships among health departments, community-based organizations, and health policy organizations and meaningfully supporting and aligning with the needs, priorities, and community organizing efforts of marginalized racialized communities.