Perspective Transformation: Learning to See Racism

by Sheryl Monks


Racism is an urgent public health threat. We at the Journal of Public Health Management and Practice and JPHMP Direct have seen the evidence that systemic racism leads to shorter life spans among blacks and other people of color (POC) brought on by disease, violence, and accidents; greater socioeconomic disparities that result in fewer opportunities to gain an education, secure safe housing, or obtain competitive employment; unfair disadvantages that lead to greater risks of incarceration and police brutality; among many other inequities that contribute to an overall disadvantaged and poorer quality of life. JPHMP supports racial justice and those calling for changes in policies at all levels to end racism and police brutality. Black lives matter, and we are committed to publishing evidence-based research that continues to illuminate the harmful effects of white privilege and racism on the health and well-being of black people and communities of color and are firmly focused on disseminating fact-based evidence that will help to change the harmful policies and practices entrenched in American society.

To bring about such changes will require a national shift in values and attitudes. A new article published in JPHMP highlights a concept known as perspective transformation. Perspective transformation centers on “the idea that once a person knows, think[s], and believes something different, they will make different decisions, engage in different behaviors, and take different actions.” The article examines how participants in a health equity initiative in Greater Cleveland, Ohio, have experienced perspective transformation on structural racism. The initiative, known as Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga), makes perspective transformation an explicit part of its work aimed at eliminating structural racism.

The article aims to “show public health advocates, in clear and compelling ways, the deeply embedded realities of structural racism, the origins and consequences of these realities, and their deleterious impact on the health and well-being of individuals, communities, and the nation as a whole” and “to introduce new terms, concepts, and frameworks to health leaders and professionals; clarify action steps and best practices; and evaluate the impact of such efforts.”

Four Key Catalysts

Researchers found that when health equity stakeholders experience a shift in perspective regarding racial understanding and attitudes, it’s often as a result of experiencing at least one but usually a combination of the following:

  1. Witnessing the impact of racism on others,
  2. Learning about racism,
  3. Personal experience of racism,
  4. Getting uncomfortable and/or seeing others get uncomfortable during discussions of racism and its effects

Watching racism unfold with our own eyes, as we have seen in the graphic videos of the deaths of George Floyd, Ahmaud Arbrey, and others, evokes empathy and compassion. Education and training increases awareness of the impacts of racism. Personal experience is felt far more deeply and is usually experienced more often by blacks and people of color. These are the three primary catalysts for perspective transformation, but the authors of the study found another important catalyst that involves “getting and being uncomfortable in conversations about race and racism.” The study found that 60% of white participants in the health equity initiative reported that getting into difficult conversations about race that made them wrestle with their thoughts and feelings helped to change their perspectives.

As one white participant noted, “That’s the point. Like, you gotta wrestle. At some point you stop wrestling and move to action, but you have to have the period of wrestling.”

Four Primary Outcomes

The study found that perspective transformation led to changes in participants’ understanding and a willingness to take action themselves, in the following ways:

  1. They had new terms, concepts, and frameworks for understanding and talking about racism;
  2. they were compelled to carry the conversation forward in substantive ways;
  3. they felt energized and motivated to confront racism and its impact; and
  4. they wanted to find fellow travelers on a journey of perspective transformation.

Witnessing the impact of racism firsthand, learning more about the history of racial discrimination, and talking to people of color about their personal experiences, while it may be difficult and even uncomfortable, can lead to new understanding and equip all people, blacks and whites, with new skills for carrying conversations forward in ways that help bring about change that results in social justice and health equity for all Americans.

Read the Report in the Journal of Public Health Management and Practice

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Sheryl Monks is the editorial associate of the Journal of Public Health Management and Practice. She manages JPHMP Direct.