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Getting Grounded: Building a Foundation for Health Equity and Racial Justice Work in Health Care Teams

To effectively, collaboratively, and authentically dismantle racism in health care, equity improvement teams need a strong foundation. The authors propose three components that guide a “ getting grounded ” strategy to enable teams to center dialogue and learning around consistent language, frameworks, assumptions, values, and norms to support their pursuit of more equitable relationships, processes, and outcomes. The getting grounded efforts are designed to: (1) build a “ container ” for your team — a safe and healing space — where team members can explore and collaborate on solutions; (2) help understand and share the history of inequities and racism in your local context; and (3) assess the current state of health equity in your system. The aim of these efforts is for health care teams to counter white supremacy culture, to center historically oppressed voices, and to address their own institutional histories in a process of truth, reconciliation, improvement, and healing. The inequities on display in the Covid-19 pandemic; the murder of George Floyd and the police killings of Breonna Taylor and others; the Capitol insurrection — these and other national events have increased awareness among leaders of historically and predominantly white health care organizations of the ubiquity of racism and other root causes of health inequities. Our current context has forced a reckoning and demanded action. The existence of racism in health care and other root causes of inequity underlying the social and structural drivers of health have been well established. 1 – 4 Inequities in access, treatment, and outcomes, as well as in policies and practices