Australasian Epidemiological Association News

AEA position on race, racism and epidemiology

The Australasian Epidemiology Association (AEA) recognises that racism is an important public health issue. Institutional racism is a driving force behind multiple social determinants that structure individuals’ and communities’ opportunities for health. Epidemiology and public health research, more broadly, can play a crucial role in understanding what institutional racism is, how it operates and manifests, and its impact on people’s lives.

As an association we wish to reflect on the ways in which we can commit, and support our discipline to commit, to anti-racism action. The AEA Council will be in contact with our membership to work with you to identify and implement such improvements. This will include, but will not be limited to, examining and refining our existing mechanisms to support the professional development of Pasifika, Māori, and Aboriginal and Torres Strait Islander members. We are also committed to increasing the cultural diversity of our membership and representation from Pasifika, Māori, and Aboriginal and Torres Strait members on Council. We will ask members at the AGM this year to support a change to the AEA constitution to permit more positions on Council for this purpose.

We recognise that it is important for our discipline to reflect on the ways in which racism can be perpetuated through our work. For example, Epidemiology has historically reduced racialised health inequalities down to biological explanations, leading to interventions aimed at changing individual health behaviour (e.g. smoking, alcohol consumption), rather than acknowledging, researching and changing the healthcare system and wider social and political structures which shape individual behaviour and health outcomes. Because of this, any reduction in health inequalities resulting from individual-focused interventions are unlikely to be sustained and where there is an absence of change there is risk for this to be incorrectly framed as deviance or deficiency on the part of the individual. If our discipline desires to embrace anti-racism research, we need to change the research questions we ask, the approaches we take, and the structure of the teams we work in. This, in turn, requires an epidemiology workforce that can intellectually engage with the concepts of race and racism as they pertain to equitable population health.

The AEA calls on universities to re-assess their epidemiology curricular, through engagement with their anti-racism and critical race scholars, to ensure the development of this future workforce. We also call on the governments and other funding bodies across New Zealand, Australia, and the Pacific Island nations to name institutional racism and critical race scholarship as research priorities and commit to supporting the development of research programs and leaders in this area to ensure that the evidence required to drive policy and systems reforms to eliminate racialised health inequalities is developed.

Our research institutes also need to consider the way in which they can take anti-racism actions. The AEA recognises that Indigenous and ethnic minority staff and students are likely to carry an unequal burden of the intellectual and emotional labour required to ensure that our projects are conducted appropriately, to answer meaningful questions, and translate into improved health outcomes. On top of their own research programs, these scholars are often asked to contribute their expertise and leadership to other projects, committees, or for media reports. While it is important to engage Indigenous and ethnic minority scholars in research that affects their communities, we recognise that this often occurs as the expense of their own track record and may even lead to burn-out. This situation can reinforce the existing power imbalances.

The AEA calls on all research institutes to reflect on how their performance metrics can be improved to reflect the unique and necessary expertise and leadership of their Indigenous and ethnic minority staff that may not necessarily translate into increased publication counts. Institutes must also examine the ways in which they are supporting and ensuring the safety and wellbeing of these staff and student who take on these additional workloads. Within institutes, it is the responsibility of each Pākehā (non-Indigenous/White) researcher – as division heads, team leads, and researchers at each career stage – to ensure that we are honouring the spirit of collaboration and working in partnership with Indigenous and ethnic minority colleagues and communities.

Finally, we believe that one of the first steps of addressing racism is through listening to the communities that are affected by it. As a start, we recommend these readings to all our members:

1 https://www.lowitja.org.au/content/Document/Lowitja-Publishing/Racism-Report.pdf

2 https://healthcentral.nz/opinion-ricci-harris-is-your-unconscious-ethnic-bias-impacting-on-maori-patient-care/

3 https://www.pantograph-punch.com/posts/dear-epidemiology

4 https://www.lowitja.org.au/content/Image/Canada_Australia_Discussion_Paper-web_hi_res.pdf

5 http://www.limenetwork.net.au/wp-content/uploads/2017/10/Bond.C-GPCS-V4.pdf

6 https://www.mja.com.au/journal/2020/212/5/more-refresh-required-closing-gap-indigenous-health-inequality

7 https://croakey.org/peter-yu-delivers-powerful-calls-to-action-at-lowitjaconf2019/

8 https://croakey.org/the-inala-manifesto-a-call-to-arms-for-indigenous-health-researchers/

9 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724931/

10 https://www.sciencedirect.com/science/article/pii/S1047279717310682

11 https://academic.oup.com/aje/article/154/4/299/61900

12 https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/discrimination

13 https://oxfordmedicine.com/view/10.1093/med/9780195377903.001.0001/med-9780195377903-chapter-3

14 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724931/

15 https://www.healthaffairs.org/do/10.1377/hblog20200220.518458/full/

These are only a short list. If you find other useful readings, we encourage you to share them on Twitter and tag in @AustralasianEpi.

Sincerely,
AEA Council