In public health, we often talk about “closing the gap in health inequities” in order to create conditions for optimal health for all. These discussions reflect a growing consensus that health is a human right, which sets the stage for a shared vision of health justice. They also mirror ongoing efforts to achieve racial equity by addressing structural racism and its attendant injustices, in the process expanding the health focus from the individual to the collective and society. These conversations and the work they inspire position the field of public health as a major actor in helping to protect, promote, and preserve our well-being.

Health is a state of physical, mental, and social well-being, not merely the absence of disease. It is a “dynamic state of well-being emergent from conducive interactions between individuals’ potentials, life’s demands, and social and environmental determinants.” Although our collective health and well-being depend upon mutuality and our ability to heal, these critical concepts are often missing from public health discussions centered on addressing health inequities.

Focusing on mutualism and healing builds a shared understanding of our interdependence and our inherent capacity to heal. As we strive to create conditions in which everyone can thrive, we all must collectively heal from the trauma caused by structural racism and understand that our connections with one another are inextricable from our ability to improve our health. These efforts lead to new approaches that draw upon our shared strengths and shift us away from focusing on perceived deficits. As NPQ contributor Sara Horowitz notes, “mutualism is not about charity, it’s about human beings’ strengths—our powers, our magic … mutualism calls on these to be in a reciprocal relationship.”

What strategies will enable us to understand our interconnectedness, leverage our shared power, and heal from the trauma caused by structural racism?

A movement is underway to create spaces that allow for an exploration of practices to transform oppression—within our bodies, our communities, and the systems that perpetuate it. Even longtime freedom activist and scholar Angela Davis—who has more than 50 years of experience leading social justice movements—highlights such healing-based transformation in her work. Davis says, “Self-care and healing and attention to the body and the spiritual dimension—all of this is now a part of radical social justice struggles.”

In part, this shift in the social justice struggles that Davis references is the emergence of healing justice, launched in 2007 by the Kindred Southern Healing Justice Collective (The Kindred Collective). Cara Page, one of the leading architects of healing justice, defines this work as one “that identifies how we can holistically respond to and intervene on intergenerational trauma and violence.” This movement, which is quickly gaining momentum, draws upon the historic ways that communities have resisted systemic oppression and thrived.

The Kindred Collective states, “we do not seek to promote single healers as one model, nor models of healing as singular, nor to build individualized care; but to build mechanisms and systems that build collective wellness; transform generational trauma and violence; and build quality care that is accessible to all.”

Thus, healing justice work honors ancestral and indigenous wisdom in an effort to respond to generational trauma, facilitate collective healing, and transform systemic oppression. It proposes that healing and joy are essential elements of liberation.

While healing justice initially developed in the Southeast region of the US, healing justice-centered approaches are evolving and being led by a growing network of global healers and change makers who seek to forge an accessible path to our collective wellbeing, both within communities of color and across cultures.

The Kindred Collective outlines a framework for healing justice which centers on four main values—some of which are absent from both traditional public health frameworks and approaches to advancing equity:

1) Our Collective Wisdom and Memory Enables Well-Being

“We value our collective wisdom and memory towards our collective well-being”

—The Kindred Collective

A major aspect of healing justice involves naming the historic and present-day violence and oppression imposed on communities of color by government and healthcare, criminal justice, education systems, and more. According to The Kindred Collective, healing justice work acknowledges that our collective well-being is “integrally connected” to “abusive experiences based on a legacy of trauma, control, and genocide of communities.” This view uplifts the notion that individual and collective trauma are in fact linked.

Healing justice draws upon cultural wisdom that understands our individual health is dependent upon our collective well-being. Current research provides evidence that supports this understanding. Recent developments in epigenetic studies are now confirming that trauma is passed down through generations, which can shape quality of life and ultimately, life expectancy.

The longstanding history of oppression—in the form of anti-Blackness and structural racism—and its impact on our health is made visible through modalities such as community storytelling, accounts of visceral experiences, and decades of social and biomedical research. In Medical Apartheid, for example, author and medical ethicist Harriet Washington documents—in over 400 pages—stories of the multitude of traumas imposed on Black people in the name of science. One of these harrowing stories is that of Saartjie (pronounced “SART-kay,” which means “little Sara” in Afrikaans) Baartman—famously known as Sarah Baartman.

As Washington recounts, at the age of twenty-one, under the guise of promised prosperity, Baartman was forced to “enter an arena where she would become an object of unbridled medical curiosity and physical lust.” She was taken from her home by British surgeon Dr. William Dunlop and subject to years of anatomical scrutiny. “Men of science made pilgrimages to London’s academic and medical settings to sketch, measure, and endlessly analyze” her body. After years of being subjected to rape and countless supposed medical examinations—actions justified, in the name of science, by racist ideology that permeates our medical system today—Baartman “died from an infectious illness at the age of twenty-seven.”

After her death, her body was held captive by scientists and placed on public display in Paris’ Musée de l’Homme until 1985. Baartman’s story is one of many examples of the “medically exploitative display of Black people.” Widespread systemic trauma such as this creates intergenerational ripple effects that are further compounded by present day oppression.

Racial inequities persist across all social systems, not just in healthcare, and they are driven by historic and present-day oppression and violence that rely for their justification and normalization on ideologies similar to those that normalized Baartman’s subjugation. In response, healing justice honors “individual agency, and people’s right to make decisions about their own bodies.”

Healing justice sheds light on oppression and simultaneously uplifts the power of community to heal. “We see that health and healing can be achieved by returning to ancient [and] traditional healing and earth [and] nature-based modalities and creating new practices to respond to our political and social context.” In our time, where so many systems are working to remove the autonomy and agency we have over our bodies as individuals, these practices are needed.

2) Wellness is Liberation

“We value wellness as a tool for liberation”

—The Kindred Collective

Healing justice values wellness as a path to liberation. The Kindred Collective notes, these efforts work to “sustain our individual and collective wellness as a response to transform generational violence and trauma.” Healing justice addresses “racism and oppression as a public health issue and social illness that informs our physical, emotional, environmental, spiritual, and psychic well-being.” It uplifts the strength and inherent capacity of communities to harness our own power and transform oppression through healing.

In this way, healing justice pushes the existing health justice and health equity frameworks beyond what is currently considered to fall within the rubric of health. It brings attention to the inequities—the systemic injustices—that shape social determinants of health, but it also goes deeper by focusing on the traumas that have resulted from historic, intergenerational oppressive social relationships and that impact individual and community health today.

Healing is restorative and essential to our well-being. When we create the conditions for healing—an intrinsic process—to occur and actively engage in our own healing, we harness our individual and collective strength to move beyond trauma. This work creates a path for the healing of both people and systems, fostering new ways of being. Healing justice offers a way for us to reimagine how we show up for each other and how current systems dictate communities’ trajectories.

Artist and healer Londrelle notes, “The thoughts we feel create our reality. If our minds are rooted in fear, our vision becomes clouded, and it becomes difficult to see the abundance that surrounds us.” When we allow ourselves to heal from fear caused by systemic oppression, we operate from a place of power and can shift our thinking from a scarcity mindset towards abundance, creating new possibilities for ourselves and our future generations.

3) Our Interdependence Is Essential 

“We value our interdependence”

—The Kindred Collective

As noted by The Kindred Collective, healing justice values “dignity for all life” across all races and identities. This framework centers on an understanding “that the ways we live with and treat each other have direct impact on our wellness and collective well-being towards transforming our conditions.” Our wellness is reliant upon our relationships with individuals, our communities, society, and all life within earth’s ecosystem.

NPQ contributor, Shawn A. Ginwright, speaks to the need for this work in a recent article on healing-centered leadership:

The only path to reimagining the future is through healing our collective trauma and restoring a sense of possibility in our work. This can only happen when we foster a collective imagination that restores communal wisdom and sets a path toward more humane ways to show up in life.

Ginwright highlights a key aspect of healing justice—our individual healing enables a shift in how we relate to one another, co-create community, and transform systems.

The healing justice framework also values and is “conscious of the connection of our health to the environment and the healing of the earth.” As climate change affects every country across the globe, keen attention to and a shared understanding of our interdependence is needed. In Design as Politics, Tony Fry notes, “No matter the differences of our circumstances as individuals, cultures, or nations, we now share a time that is new. We all share a continual moment of the diminishment of time. The actual finite time of our life on the planet (and the life of much else) is being reduced by our own destructive actions as a species.”

4) Our Wellness Requires Honoring All Bodies  

“We value all bodies and the conditions we live in”

—The Kindred Collective

The healing justice framework provides an opportunity to expand the ways that public health examines inequities. This country’s systems are entrenched in structural racism and white supremacy, and this ideology shows up in how population health data is collected, analyzed, and utilized to develop interventions. Without an intentional effort, public health data approaches can perpetuate long-standing inequities rather than address them.

Robert Wood Johnson Foundation (RWJF) speaks to this issue by noting,

We use the category of race as a means of identifying and measuring disparities. However, race has no biological meaning; it is a social construct designed intentionally to relegate people and communities of color to second-class status and to privilege white people. It is the racism that accompanies [unfounded] racial hierarchy that has profound health consequences. The gaps and failures in our public health data systems today, in fact, stigmatize entire communities instead of doing what data can and should do: provide the roadmap and path toward systemic change.

At present, there is a tendency to compare outcomes for Black, Indigenous, and people of color to their white counterparts. Yet, in the absence of efforts to counter unfounded racial hierarchies, this approach can unintentionally uplift white supremacist ideology. The health outcomes of white people cannot serve as the gold standard that people of color strive to attain. Our ideal should be grounded in a vision of collective liberation, healing, and well-being.

Healing justice requires expansive thinking beyond limited notions of good versus bad health and honors all bodies. As noted by Adaku Utah, of Harriet’s Apothecary, this framework is “informed and grounded by economic, racial, disability and reproductive justice movements.”

Further, tracking and analyzing data through this demographic lens places the onus of health inequities on individuals and communities rather than addressing the social ills and systemic oppression that create these injustices.

 

A New Vision for Addressing Structural Racism

The US is residentially segregated by race. Public health studies show that life expectancy rates vary dramatically by neighborhood and, therefore, in conjunction with race. The Robert Wood Johnson Foundation, for example, has mapped life expectancy rates by neighborhood across the US. In some areas, there is a 30-year gap in life expectancy between neighborhoods that are positioned just a few short miles apart but have different racial makeups. Structural racism, not race, drives these stark differences.

Racism impacts everyone, inhibiting our ability to attain optimal health as a whole. Although structural racism traumatizes people of color most, studies show racial trauma also affects white people. Structural racism structures opportunity in ways that sap society’s strength by wasting human resources. It is also arguably the most significant barrier to racial and health equity.

Recognizing the debilitating impacts of structural racism across systems, local jurisdictions across the country have galvanized to formally acknowledge racism as a public health crisis and create policies and practices that aim to transform the social determinants of health (SDOH), which influence how communities live, grow, work, and play. These determinants include housing, education, economic stability, neighborhood environments, social cohesion, healthcare, food security, water access, civic engagement, incarceration, and more.

In an October 2021 report, the American Public Health Association (APHA) revealed its analysis of 198 declarations and 38 accompanying strategic actions to promote health equity. The report details the growing movement within local government to finally acknowledge that structural racism is a threat to public health. Since 2018, APHA has tracked 250 declarations issued by high-ranking government officials and adopted by entities such as city/town councils, county boards, governors and mayors, education boards, public health associations, and public health departments. The number of these declarations increased at the height of the pandemic, as COVID shed light on longstanding injustices faced by Black and Indigenous people and people of color.

APHA’s analysis revealed that nearly all the declarations include a commitment to some level of data collection, analysis, and reporting, with varied commitments to creating a taskforce to ensure accountability. More than a third of the declarations outline an obligation to forming and strengthening partnerships with community groups and organizations that are addressing racism, and almost half of those declarations include strategic action to promote an “equity in all policies” approach to future policy development along with a commitment to reviewing existing policies and programs through a racial equity lens. Leading with a racial equity lens enables examination of how policies impact people’s experiences along racial lines, shaping opportunities, outcomes, and power.

While significant efforts are underway in local jurisdictions to address systemic racism as a public health crisis, strategies that foster community healing to address the harms caused by structural racism are not at the forefront of these efforts’ strategic plans. This prompts the question: what if healing justice efforts served as a guidepost, as the foundation of a collective vision, for all government strategies to address structural racism?

What would our future look like if we all operated from a place of healing? Arguably, it would be a world where we value wellness as liberation, appreciate our interdependence, are in-tune with our inherent capacity to heal, honor the wisdom of all cultures and bodies, and are guided by a shared understanding that our collective health is inextricable from our relationship with the earth. Healing justice is critical for catalyzing the type of systems transformation that enables such as a vision to become reality.