Table 3.

Summary of recommendations for achieving health equity through anti-racism practices.

Address Structural Determinants of Equity SDoE focus on structural or root causes, recognizing that addressing health disparities requires a holistic perspective. Authentic processes in mitigating inequity require addressing the unequal allocation of power and resources	•Care over control Replace increased surveillance and restrictive funding with direct community partnerships. Resourcing medically underserved communities allows for self- determination of healthy futures. •Anti-racism analysis Acknowledging and reconciling that mechanisms, systems, and employees within public health institutions, medical schools, hospitals, and other health care and educational settings are rooted in racism. •Meaningful community building Integrating within existing health systems a Black and Indigenous community health approach to reducing health disparities along racialized lines. Addressing specific barriers that interfere with access to medical and public health recommendations.
Reparations The case for reparations has never been clearer considering the obvious result of decades of policies leading to persistent modern day racial inequities in wealth, home ownership, and health, as examples. Avoidable racial differences in COVID-19 spread and transmission might have been decreased by up to sixty percent if reparations had previously been enacted	•Financial accountability Reparations for Black descendents of enslaved persons as a solution for racial health inequities. Financial responsibility includes reparations as a solution to disrupting the seeming permanence of racism in our society. •Truth and reconciliation Healing justice is a framework that allows for analysis of power, profit, control, exploitation, ableism, oppression, violence, and trauma across health systems with a focus on addressing harm and generational healing. Centering healing justice principles and practices can serve to evaluate process and self-reflexive practice in the spirit of truth and reconciliation.
Address Indigenous Erasure An example of Indigenous Erasure within public health is continued genocide through data erasure and misclassification. Lack of data directly limits the ability tribal health authorities and policy makers' ability to make data-driven decisions for equitable policy and resource allocation	•Honoring treaty rights The continued violation of treaty rights is a legacy of the colonial control of genocidal intent foundational to America. Decolonization is rooted in the repatriation of land and the rematriation of cultural practices and lifeways. •Decolonizing data Decolonizing data includes methods of collecting, analyzing, and interpreting data using anti-oppression and Indigenous frameworks and value systems. •Anti-blackness and indigenous erasure Addressing anti-Blackness within Indigenous communities and Indigenous erasure within Black communities needs to be addressed in dismantling racism. True accountability will not be accomplished by only addressing one without the other.
Abolitionist Praxis Acknowledging the ways in which the prison industrial complex interacts and works with the medical industrial complex (MIC) is a step in changing the landscape of what is possible. Abolition requires the development of alternative solutions toward social problems; abolition is both a process and a goal.	•BREATHE Act A project of the Movement for Black Lives that calls for decriminalization, elimination of police enforcement, and diversion of funding from law enforcement agencies to community-based programs that address violence and harm. •Decriminalization and decarceration From a public health and health justice critical lens, decriminalization, and decarceration are required in redefining what health, healing, and safety are without punitive measures and punishments. •Incarceration as a Public health crisis ncarceration is considered a SDoE by Healthy People 2030. Reform alone will not solve the longstanding human rights abuses and violence committed by the prison industrial complex.