Making Injustice Visible: How a Health Department Can Demonstrate the Connection Between Structural Racism and the Health of Whole Neighborhoods.

CONTEXT: The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has built a presence in Tremont, a historically redlined neighborhood located in Bronx, NYC. As part of an agency-wide commitment to explicitly name racism as a threat to healthy communities, DOHMH has sought opportunities to educate and engage in discussion about historical and current structural racism. PROGRAM: Between January and September 2018, DOHMH exhibited Undesign the Redline, a pictorial timeline and historical analysis of redlining, in its Tremont office. The exhibit exposed neglected history, making concrete the concept of structural racism. IMPLEMENTATION: DOHMH staff led 101 tours for 950 visitors, including employees, community partners, and residents. Tours were given in English and Spanish in three 2-month cycles over 8 months. Tour guides also facilitated interactive workshops with youth groups, community-based organizations, and teams from city agencies to engage participants in the design and ownership of new systems intended to "undesign" the consequences of redlining. EVALUATION: Immediate feedback was requested from all participants at the conclusion of each tour and was collected on a bulletin board. Longer-term impact was assessed through an electronic survey sent to all participants who provided valid contact information to better understand ways that the exhibit impacted personal and professional actions. Participants reported talking with family, friends, and coworkers, seeking more information, and applying an equity lens to professional projects after experiencing the exhibit. DISCUSSION: Hosting the exhibit in a local health department building offered a concrete opportunity to learn about and discuss structural racism. Exhibit tours had immediate- and long-term impacts on participants and contributed to sustainable changes internal to DOHMH work. This work presents a concrete practice to make injustice visible and engage in open conversation about structural racism to build community trust.