The Green Shoots of The Equity Movement

You don’t have time to read this. 

The unwritten social contract of the moment is that you have to be obsessed with the news. And then dutybound to ‘discuss’ it with your friends, family and colleagues, preferably through media that is ‘social’. You must consume tweetable* content and create tweetable content. 

A hamster in a wheel. 

But what if you climbed out of that wheel and thought about what is happening? How have hard-fought gains in diversity, equity and inclusion been so easily halted? Economists talk about the “headwinds” businesses are enduring as new, democratically elected governments shape the world into what their voters were sold. How easily those headwinds have ripped out the green shoots of the equity movement. 

What does that say about the roots of that movement? 

I spent early January going through my files to pull out every peer-reviewed article I’ve amassed in exploring the link between community, power and health equity. I have 440 (and counting). It seems an impressive haul but, collectively, they tell a less than impressive story. 

The idea of inequities in health might have been proposed in 1992 but it needed ‘clarifying’ in 2014. What was happening in the intervening 22 years? General confusion? The prevailing theory on power was described in 1974 but a 2018 review found most research into power and health was “under theorized”. How does it take 44 years to get that right? 

Against that backdrop, I turn to my work. I have collaborators that have put their article on racial equity on hold for fear it will “put a target on their back”. I have seen much-respected leaders ‘tweak’ their bios to soften any mention of equity. And I’m witnessing a previously powerful national nonprofit struggle to find anyone willing to share their equity practice for an article that until January 20^th was considered “essential” to build the field. 

I’m not blaming any of them for their reaction. They are, to be frank, right to be doing what they’re doing. They have work to protect, teams to take care of and families to feed. But what it shines a light on is how much opportunity was wastedduring calmer times. 

What might we have done with that opportunity? I think of all the foundations that have funded work into community, health and equity, and how their ‘results’ sit in grant reports that no one can find. I think of all the nonprofits that have done such work often refusing to write it up as it was “not what they do”. I think of all that knowledge that has been lost, undocumented and now unretrievable. A field unable to make its case. Green shoots with shallow roots. 

In my policy work, I find myself in a frustrating (and tedious) search for knowledge. People have done stuff. It has apparently worked. You should talk to Tom. You should talk to Dick. You should talk to Harry. I email them. They may or may not answer. I get second-hand accounts, people trying to help by sharing what they know – or think they heard. I triangulate. Try to sound confident. Add citations to half-baked reports. But why wasn’t this stuff written down properly?

Say what you want about pharmaceutical companies (and RFK Jr very much will) but they understand the importance of knowledge. They collect data assiduously, analyse it into information rigorously, and combine it into knowledge persuasively. They’re a machine. They understand that at their core they’re a knowledge business. By the time they’re seeking a license for a drug, they have citations at the ready – the best built bullets in business. 

By contrast, I’m a detective. Columbo. Dishevelled. Constantly asking the same questions. I connect dots, see similarities. Might it be, for instance, that the so-called ecosystem needed for community power is the same – or same enough – as so-called social infrastructure? And could it be that what they’re describing is also what people and communities need to be resilient? Is there a core truth there around which to build a set of national policies? 

I’m actually convinced there is. But I’m also clear that I don’t have the citations to make the case. Of course, in the policy world it’s not necessarily about the citations, it’s about having the right stories to tell into the right ears. But the citations are needed. The work has to be written up, debated, and refined. It’s unacceptable to be confused for 22 years or just inept for 44. 

All of which is to say that looking across the 440 articles in my haul I’m not remotely surprised about what’s happening to DEI. The field – such that it was – was high on rhetoric and low on data, information and knowledge, especially with regards to practice. And even where there was all three, it was largely organised to persuade the persuaded. People furiously agreeing with each other is only useful when those people are a majority. That’s democracy. 

Like European leaders belatedly realising they need to actually pay for their own defence, leaders in health and racial equity will soon realise they need to get their house in order. I’m sure there’ll be numerous strands to that but getting clear on what we think we know and communicating it (beyond the echo chamber) is going to be key. 

We hamsters need to get out of the wheel and think. 

Pritpal S Tamber

* I know; we don’t ‘tweet’ anymore, we post. But I miss tweeting.