ART-BASED RESEARCH TO ABATE RACISM/COLORISM AND IMPROVE HEALTH

As a multidisciplinary social work researcher, I have produced and published scholarly work in partnership with researchers in nursing, medicine, public health, and others. Texto e Contexto Enfermagem provides a great platform to establish the historic position of the arts in evidence-based nursing practice and research beyond the well-established concept of nursing as a combination of science and art - knowledge and skill1^,2. As early as the 1990s, nursing research introduced art-based techniques and activities-photographs, drawings/posters or collages, and mapping techniques-aimed at improving health and well-being. More recently, nursing has advanced the field of “art in research” by showing, for example, how narrative competence can be used as a strategy for understanding the facts and narratives associated with human (“patient”) existence3. Storytelling and narrative medicine have also surfaced as a strategy in nursing, medicine, and social work practices4. As a helping profession whose values include human dignity, nursing can, in partnership with allied professions, advance research on racism, perhaps the gravest threat to humanity and human health.

Nursing has risen against racism. The recent spate of police murders of unarmed Black people and the racial disparities highlighted by the COVID-19 pandemic has triggered a wave of “anti-racism research” in the United States (U.S.) and around the world posing the question, What do we know about the root causes of racism and what can we do about them? Health professionals across the globe have committed to diminish racism and improve health. For example, in 2021, leading nursing organizations in the U.S. created the National Commission to Address Racism to examine and confront individual and systemic racism by focusing on its impact on nurses, patients, communities, and healthcare systems5. The scientific community has contributed conceptual and epidemiological knowledge about the negative impact of violence toward Black, Indigenous, People of Color (BIPOC) and inequities in both prevention and treatment of disease among BIPOC6. The sociological literature shows racial disparities and their effects on housing instability, unsafe neighborhoods, economic mobility7, residential segregation, and health disparities8. This literature has serious limitations, as follows.

In the early 18^th century, Carl Linnaeus introduced a classification of four human subspecies-Americanus (Americans), Europaeus (Europeans), Asiaticus (Asians), and Afer (Africans)-characterized partly by skin colors/tones. This classification is reductionist and incomplete. For example, having light skin in the winter and brownish skin in the summer, my physical appearance never matched the colors Linnaeus had established two centuries before I was born. I am among billions of people across the globe with a wide range of skin tones. Growing up in Brazil, though we possessed various skin tones that may even change seasonally, those of us whose skins were lighter were encouraged to identify as “white.” This was my introduction to colorism-the perceived and actual privileges that I had when I was among people who were darker than I was and my lack of privilege when I was among people with skin lighter than my own.

Reductionist approaches that describe racism as a personal attitude only obscure racist social norms and policies that affect BIPOC lives. To advance current discourses, we need to organize “racism” into at least four distinct types. Internalized racism includes one’s own beliefs about the superiority or inferiority of one race over another. Interpersonal racism refers to social interactions in which people with lighter skin attack BIPOC verbally, physically, and/or socially. Institutional racism refers to discriminatory practices/norms within private and public institutions and government entities leading to inequitable outcomes, privileging people with lighter skin (e.g., better pay). Structural racism refers to policy/legislation prioritizing those with lighter skin’s health, socioeconomic privileges, and general physical safety and well-being.

I hope this editorial will serve as a call for research and autoethnographic work involving art practices as tools for undoing racism/colorism and improving health. As an immigrant to the U.S. from Brazil (“Global South”) and a multidisciplinary researcher, I am compelled to urge the scientific community in nursing and other disciplines to explore aspects of global white supremacy and the subjugation of BIPOC. We must use diverse strategies-notably the arts-to analyze the social norms that constitute white supremacy and allow the continuation of racist policies that disadvantage BIPOC. Indeed, the World Health Organization reviewed more than 3,000 studies and concluded that exposure to art can promote both health and well-being9. Another example is a review of the literature demonstrating that when exposed to certain types of music practices, incarcerated people, the majority of them BIPOC, can improve their well-being10.

The persistence of white supremacy disadvantages BIPOC and contributes to socioeconomic and health disparities11. The health literature, including epidemiological and sociological studies, on the subject of racial identity is limited and often lacks a global lens on myriad types of racism and colorism and their dire consequences to personal and community health. This literature has done little to abate racist attitudes, social norms, and behaviors. Nonetheless, emerging and innovative literature shows how arts research and ethnographic methods can help to abate racism12^-14. For example, in my installation performance, Realm of the Dead15, both the visual content and performative storytelling sparked discussions on how immigrants adapt to reductionist racial identities and learn how to build a sense of self/belonging in the U.S. How researchers from the Global South envision, understand, and fight against racism and colorism can contribute to an inclusive global knowledge base with historical, sociological, and cultural perspectives. The Global South has much to offer in terms of solutions to help the Global North address its direct involvement in and continuation of racism in its myriad forms across the globe.

Perhaps we might focus on Critical Consciousness as a tool for mitigating the effects of racism. Brazilian educator Paulo Freire affirmed that human beings have the power to take personal and collective action against oppression16. Research has shown that critical consciousness can achieve both mobilization toward anti-racism action and improvement of health (e.g., decrease drug use)17. Since the 1970s, social scientists have used “community dialogue” around works of art to improve critical consciousness among specific oppressed groups and types of oppression (e.g., racism). Community dialogue appraising a work of art taps into innate human curiosity to evaluate the sociopolitical forces perpetuating privilege and oppression. Art that confronts racism generates in the viewer empathy toward the self and others while inspiring viewers to take action to upend racist norms in institutions and society.

Figure 1 helps us to visualize how art practices can serve as an intervention that encourages and inspires audiences to engage in Content Appraisal and Personal Reflections about their racial identities and internalized racism. Community Dialogues can engage audiences in authentic discussions to identify potential sources of interpersonal racism. Interactive art can generate conversations about institutional racism and its relationship to BIPOC. Experiencing works of art may inspire individuals to engage in action (e.g., letter-writing campaigns, volunteerism) with the potential to help dismantle structural racism.

Figure 1 -
Critical Consciousness to Abate Racism and Improve Health.

The extant literature has failed to explore the nuances of racism within groups of people whose skin tones vary greatly. The conceptual framework I offer above might serve as the basis for research to unveil innovative ways of using art practices to improve critical consciousness, abate racism, and promote health and mental health. I recommend historical, autoethnographic, and descriptive research to contextualize the impact of racism in general and on colorism in particular on health, notably in countries such as those in Latin America, where miscegenation is ubiquitous and produces wide variations of skin tones. I also recommend predictive research that might elucidate the extent to which racism in general, and in the form of colorism, affects myriad health outcomes-e.g., infant mortality, maternal health, access to care, and many others. However, predictive research on racial disparities does not fully address white supremacy as a major problem nor the social norms perpetuating racism. Whereas anti-black racism and colorism are global phenomena, most current research focuses on the United States and European countries. The dissemination of this research is limited to scientific outlets inaccessible to most people across the globe, particularly in the Global South. Therefore, it behooves scientific journals in Latin America to promote anti-racism research with an eye toward health promotion and disease prevention. This type of research might benefit from two branches of arts research: Engagement and Design Research, centered on inquiry involving audiences and collaborators, and Practice-led Research, driven by performance-inspired work18. Both encourage mixing visual and performance methods to help audiences develop critical consciousness and improve their health.

REFERENCES

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Publication Dates

• Publication in this collection
  21 June 2024
• Date of issue
  2024

History

• Received
  07 Nov 2023
• Accepted
  12 Dec 2023