triumph of community activism, a victory for residents who struggled for years against food apartheid. In a neighborhood that had long lacked a full-service supermarket, the store became a symbol of local empowerment in one of the nation’s most segregated cities.

This segregation is a contributing factor in why White people in Buffalo have a longer life expectancy than their Black neighbors living on the East Side. To counter these conditions, residents persevered in efforts to shape a healthier, more equitable neighborhood—residents like 67-year-old Church Deacon Heyward Patterson. Deacon Patterson volunteered at a soup kitchen and even drove his neighbors to Tops Friendly Market to access nutritious food when they didn't have transportation of their own. He was murdered while helping load groceries into someone's car.

The murder of Deacon Patterson and others sparked outrage across the nation. But when the initial shock fades away, we need to look harder at the role of racist systems and structures that endure in the United States and how they contribute to unbridled violence and lives that are cut short.

It is long past time to reckon with this nation’s dark, shameful history of white supremacy. 

Until we recognize how present-day inequities—in all their forms—root back to a deeply flawed past, we will see more East Buffalos, more mainstreaming of “replacement theory,” and less willingness to do the hard work of advancing racial justice. 

This is the subject of my new book, Necessary Conversations published by Oxford University Press. I suggest that having meaningful conversations about race is a step towards that reckoning. Dozens of leading thinkers and doers—activists, policymakers, researchers, educators, and journalists—contributed their provocative ideas. As editor of these important chapters about understanding racism as a barrier to health and wellbeing, I am honored to highlight some of their thoughts here.

“There is a structure and an architecture that created inequality, and those exist whether individuals operate with racial animus or not.” —Nikole Hannah-Jones

The prevailing American narrative builds on the premise that, as the Declaration of Independence states, “all men are created equal” and that we have progressed steadily towards that ideal. In reality, believes Nikole Hannah-Jones, the racial hierarchy that spawned the inception of human bondage has defined this country ever since. Her 1619 Project challenges common assumptions about slavery and race and lifts up the pivotal contributions of enslaved people in building the American economy.

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在东布法罗的Tops Friendly市场的开业是一个社区行动主义的胜利这是多年来与食品隔离制度抗争的居民的胜利。在一个长期缺乏全方位服务超市的社区，这家商店成为了美国最具影响力的地区之一的地方赋权的象征种族隔离的城市．

这种族隔离是一个促成因素为什么布法罗的白人有预期寿命延长和住在东区的黑人邻居相比为了应对这些状况，居民们坚持不懈地努力塑造一个更健康、更公平的社区67岁的教会执事海沃德·帕特森．迪肯·帕特森(Deacon Patterson)在施粥所做志愿者，当邻居们没有交通工具时，他甚至开车带他们去Tops Friendly Market买营养食品。他是在帮别人把杂货装上车时被杀的。

迪康·帕特森等人被杀一事在全国引发了愤怒。但是，当最初的震惊逐渐消退时，我们需要更加认真地审视种族主义制度和结构在美国所起的作用，以及它们是如何促成肆无忌惮的暴力和生命的缩短。

早就该正视这个国家黑暗、可耻的白人至上主义历史了。

在我们认识到当今各种形式的不平等是如何根源于有严重缺陷的过去之前，我们将看到更多的“东水牛”，更多的“替代理论”主流化，以及更少的愿意为促进种族公正而努力工作。

这是我新书的主题，必要的对话牛津大学出版社出版。我认为，就种族问题展开有意义的对话是迈向这一目标的一步。几十位杰出的思想家和实干家——活动家、政策制定者、研究人员、教育工作者和记者——提出了他们具有挑衅性的观点。作为这些关于理解种族主义是健康和幸福的障碍的重要章节的编辑，我很荣幸在这里强调他们的一些想法。

“存在一种造成不平等的结构和架构，无论个人是否怀有种族敌意，这种结构和架构都是存在的。”-Nikole汉娜琼斯

主流的美国叙事建立在这样一个前提之上，即《独立宣言》(Declaration of Independence)所述“人人生而平等”，而且我们已经朝着这一理想稳步前进。事实上，他相信Nikole汉娜琼斯从那以后，种族等级制度就定义了这个国家。她的1619项目挑战了关于奴隶制和种族的普遍假设，并提升了被奴役者对建设美国经济的关键贡献。

Beneta Burt facilitates dialogue in safe spaces “that allow people in the room to be uncomfortable,” and then to work through their discomfort together. And at the University of South Carolina, the Welcome Table uses storytelling to enable intimate conversations that build trust, uncover hidden biases, and encourage honest, personal exchanges about race.

“To move forward, this nation must heal the wounds of our past and learn to work together with civility, and indeed, with love... We must build the capacity to see ourselves in the face of the other.” —Gail Christopher

Gail Christopher believes that empathy and compassion are skills that can be taught—and that hearts and minds must be changed before it is possible to change institutions. Her Rx Racial Healing Circles™ bring together small groups to foster appreciation, belonging, and consciousness change, assets that she believes are necessary to move past “otherness” and enable people to recognize their shared humanity.

The health harms of racial injustice are reflected in maternal mortality, the incarceration experience, immigrant health, climate change, and so much else. 

Stories and data about specific populations reveal the harsh results of racial disparities. In her shocking New York Times cover story, “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis," Linda Villarosa tracks the tragedy of Black maternal and infant mortality across class lines. She lays much of the blame on the structural racism that is embedded “in the lived experience of being a Black woman in America,” coupled with the often-unconscious but pervasive racial bias of a medical system that is still dominated by White physicians.

Likewise, the impact of serving jail or prison time hits Blacks hardest. In Mississippi, 75 percent of those serving prison sentences of 20 years or more are Black men. Alesha Judkins describes barbaric conditions at Parchman, the notorious state penitentiary, including black mold, food infested with rat feces, and bed shortages that force imprisoned people to sleep on the floor. More hopefully, she also talks about the efforts of her advocacy organization, FWD.us, to end cash bail, reduce extreme sentences, restore family connections, and redirect investments from criminal justice to community development. 

The power to retool societal structures so that they elevate equity, rather than undermine it, rests with all of us.

Informed by historical and contemporary realities, Necessary Conversations concludes hopefully, emphasizing the power to end structural racism through narrative change, innovative approaches to knowledge-building, inclusive decision-making, and coalition-building.

Our contributors remind us that centering actionable research on equity allows us to think more broadly about how we measure what works, gives pride of place to community engagement, and respects complexity in study designs. By acknowledging that our beliefs, assumptions, and values influence what data we collect, and how we use it, we can move beyond what Jara Dean-Coffey calls the traditional “Western-centric, White-dominant frame.” Dean-Coffey offers the Equitable Evaluation Framework as an alternative tool for reimagining the purpose and practice of evaluation.“

"The stakes are too high for evaluation not to be an instrument of change and in service of equity and liberation.” —Jara Dean-Coffey

Read my book, Necessary Conversations and listen to my book discussion where I share ideas and strategies to make real change to create health equity. Together, we can dislodge structural racism at its roots and work toward equity. 

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在重构历史的过程中，汉纳-琼斯打开了行动的大门。她说:“我发现有用的是对我们每天做出的选择的愤怒感，这些选择认为有些人有价值，而有些人没有。”“我不希望我们抱有希望，认为有一天我们会改变它。我想我们现在就做点什么。

“讨论种族问题不是要把奴隶制及其后果归咎于所有白人，而是要承认奴隶制的存在及其后果。”- - -Beneta伯特

分享关于种族主义的真实故事对于帮助白人认识到自己的特权，以及让有色人种感到他们被倾听和尊重至关重要。在密西西比城市联盟，Beneta伯特促进在安全空间的对话，“允许房间里的人感到不舒服”，然后一起克服他们的不舒服。在南卡罗来纳大学欢迎表通过讲故事实现亲密对话，建立信任，发现隐藏的偏见，并鼓励关于种族的诚实、个人交流。

“要向前迈进，这个国家必须治愈我们过去的创伤，学会礼貌地合作，事实上，还有爱……我们必须建立站在他人的角度看待自己的能力。”盖尔·克里斯托弗

盖尔·克里斯托弗他相信，同理心和同情心是可以传授的技能——在改变制度之前，必须先改变人心和思想。她的Rx种族治疗圈™将小组聚集在一起，以培养欣赏、归属感和意识变化，她认为这些资产对于超越“他者性”并使人们认识到他们共同的人性是必要的。

种族不公正对健康的危害反映在孕产妇死亡率、监禁经历、移民健康、气候变化等等方面。

关于特定人群的故事和数据揭示了种族差异的严重后果。在她令人震惊的《纽约时报》封面故事中为什么美国黑人母亲和婴儿处于生死危机，"琳达维拉罗萨追踪黑人孕产妇和婴儿死亡率的悲剧。她把大部分责任归咎于结构性种族主义，这种种族主义“根植于作为一名美国黑人女性的生活经历中”，再加上仍然由白人医生主导的医疗系统中往往无意识但普遍存在的种族偏见。

同样，在监狱服刑对黑人的影响最大。在密西西比州，被判20年或20年以上监禁的人中，75%是黑人。Alesha Judkins描述了臭名昭著的帕尔奇曼州立监狱的野蛮条件，包括黑霉，充斥着老鼠粪便的食物，以及床位短缺迫使囚犯睡在地板上。更有希望的是，她还谈到了她的倡导组织的努力，FWD.us例如，废除现金保释，减少极端判决，恢复家庭联系，并将投资从刑事司法转向社区发展。

我们所有人都有能力重组社会结构，提高而不是破坏公平。

《必要的对话》以历史和当代现实为依据，充满希望地总结，强调了通过叙事变化、知识建设的创新方法、包容性决策和联盟建设来终结结构性种族主义的力量。

我们的撰稿人提醒我们，把可操作的研究集中在公平上，可以让我们更广泛地思考我们如何衡量有效的方法是把社区参与放在首位，并尊重研究设计的复杂性。通过承认我们的信念、假设和价值观会影响我们收集的数据，以及我们如何使用它，我们可以超越这些数据hara Dean-Coffey称之为传统的“以西方为中心，白人主导的框架”。迪恩-科菲提供了公平评估框架作为重新构想评估目的和实践的替代工具。”

“评估的风险太大了，不能不成为变革的工具，为公平和解放服务。”hara Dean-Coffey

读一读我的书《必要的对话》听我的书讨论在那里，我分享一些想法和策略，以做出真正的改变，创造卫生公平。团结起来，我们就能从根源上消除结构性种族主义，为实现公平而努力。