Towards health equity and social justice: an applied framework of decolonization in health promotion

Abstract

The pursuit of health equity and social justice lie at the heart of community-empowered health promotion practice. However, there is a need to address the colonial legacy and its contributions to health inequities. The process of decolonization is essential to eliminating the mechanisms that contributed to such inequities. To this end, we propose an Applied Decolonial Framework for Health Promotion that integrates decolonial processes into health promotion practice. We present characteristics of the framework, its values for health promotion transformations and considerations for using the framework in health promotion practice. The framework will help health promotion stakeholders attend to colonizing structures within the field and engage with communities to achieve social justice and health equity.

Black Lives Matter in health promotion: moving from unspoken to outspoken

“…As health promoters, it is important that we understand how the field of health promotion was ushered in along this timeline. Our field is indelibly part of a colonial history and therefore demands that we be transparent, reflective, and explicit in our attempts to actively dismantle these systems ( McPhail-Bell et al , 2013 ; Chandanabhumma and Narasimhan, 2019 ). As a profession, we must share our commitment to promote equity and dismantle racism and engage collaboratively far and wide.…”

“…Dismantling structural racism requires, among other things, linking health promotion research to decolonization efforts and equality struggles ( Chandanabhumma and Narasimhan, 2019 ). The research we do influences intersectoral structures and the social determinants of health, through our technical advice to policy makers, contributing to professional preparation, and guiding practice.…”

“…We need to build on and develop theories and models that support this work. Some promising examples that health promotion can adopt include Critical race theory ( Crenshaw et al , 1996 ; Ford and Airhihenbuwa, 2010 ; Delgado et al , 2017 ), theories of Whiteness ( Owen, 2007 ) and decolonial approaches ( Chandanabhumma and Narasimhan, 2019 ; Chilisa, 2019 ). We can also learn from the groundbreaking work of Aboriginal and Indigenous scholars who have been promoting health in diverse contexts and challenging harmful Western approaches of exclusion.…”

Exploring the Potential for the Arts to Promote Health and Social Justice

“…Thus, the influence of these factors on health must be considered from the lens of intersectionality (Crenshaw 1990), recognizing that individual people and communities might live at the intersection of a variety of these social determinants which lead to compounding marginalization and oppression-especially along the lines of race, class, gender identity, sexual orientation, disability, citizenship, age, and other characteristicsand which may exponentially complicate their experience of health (Bauer 2014;Corbin and Bonde 2012). Similarly, historic experiences also impact health (Czyzewski 2011;Menzies 2008;Chandanabhumma and Narasimhan 2019), whether that be at the individual level of previous personal trauma (van der Kolk 2015), intergenerational trauma (DeGruy 2005), or at the national level with the historic experience of colonialism (Ward 2013;Chandanabhumma and Narasimhan 2019) and/or inequitable economic policy (such as structural adjustment programs) (Spencer et al 2019). For instance, as we write this COVID-19 ravages the world and because of several overlapping facets of historic, economic, and structural oppression, the US has inequitable distributions of both the illness and access to care: for instance, 73% of the deaths in Milwaukee County, Wisconsin in the first 2 months of the pandemic-were African Americans-despite the fact that African Americans make up only 26% of the population in the county (Thebault et al 2020).…”

“…Given these deeply individualized historically and community-based experiences of health, health promotion must seek to promote not only the physical experience of health but also social justice, agency, and self-determination through empowerment, participation, collaboration, and by reducing inequity (Chandanabhumma and Narasimhan 2019). It is in these efforts that the arts have a promising role.…”