Undoing Unjust Systems

One of the treasures of Johns Hopkins is the richness of the city it calls home. Baltimore is vibrant in its neighborhoods, culture, and educational offerings.  

Yet the legacy of historical federal, state, and local policies that for decades promoted redlining and segregation and encouraged economic disinvestment in thriving urban neighborhoods endures. Evidence of the damage is painfully clear in disparities and inequities across health and socioeconomic determinants between Black and white city residents: in infant mortality, life expectancy, digital connectivity, financial security, housing, and access—access to critical resources and to those who hold power, make decisions, and influence policy, shaping the health and quality of life for many in Baltimore.

The ongoing social, racial, health, and economic justice crises—ignited by the pandemic and rage over the deaths of Black individuals at the hands of law enforcement—have highlighted the need for systems-level change—change that requires intentional action that is often uncomfortable and, at times, uncharted.

It goes beyond creating more programs: The focus must be on dismantling frameworks that support and perpetuate inequities. It means changing mindsets, policies, norms, behaviors, and culture. It requires intentionally developing practices, policies, and processes that align with the statements we expound.  

We need only look to the words of Frederick Douglass, from an 1857 speech, for guidance. "If there is no struggle, there is no progress. Those who profess to favor freedom, and yet depreciate agitation, are men who want crops without plowing up the ground."

To change the system, we must not only acknowledge our histories, but also question long-standing institutional policies and practices. 

An essential element of systems change is consideration of perspectives that differ from our own, but that in and of itself is not enough. Inviting diverse opinions and then silencing those voices is not inclusion but rather a manifestation of the fears of transformational change. There must be space for continuous dialogue, learning, and reimagining; a willingness to grow through conflict; and a commitment to embrace our truths, histories, limitations, and differing views. System-level changes include an awareness and acknowledgement of the fundamental structures that are in place that limit transformation. 

I find myself navigating the challenges of established systems through the prism of all that I am—my perspectives, experiences, knowledge, gender, and race—yet the system does not fully see me. I am constantly reminding others of place and privilege, of power dynamics and instances of microaggressions, of bias and judgement. 

While the resolve to drive systems change toward racial equity has been newly energized by the death of George Floyd and the disproportionate impact of the COVID-19 pandemic on BIPOC communities, we are also exhausted—by our role as “educators,” by the need to be measured in our words, by the emotional toll of explaining our reality to those who hear only what they believe to be petty complaints or indignities. We are exhausted in recognizing our own place of privilege, fighting for change and yet, unable to realize the positive community impacts we are striving to achieve, know are possible, and yet somehow inexplicably escape us.

To change the system, we must not only acknowledge our histories, but also question long-standing institutional policies and practices. The Bloomberg School’s newly created Office of Inclusion, Diversity, Anti-Racism, and Equity (IDARE) is a critical step in support of accountability for this work. To ensure meaningful change in these entrenched systems and structures, sustained fiscal and human resources are needed.

The IDARE leadership positions that now exist within each department—including my own as associate chair for IDARE in the Department of Health Policy and Management—have a mission to advance the principles of IDARE and identify specific steps and innovative approaches to that end. 

Moreover, in this role I am called to be an agitator to ensure equality and progress are top priorities that guide the way toward a more equitable, just, and inclusive system, and that IDARE efforts are realized in concrete and meaningful ways.