By Emmanuella Ezike
Within public health or any other sector, bias can easily sneak in and disrupt processes at every turn. It’s like that uninvited guest who just won’t leave a party. From engaging with communities to understanding their pain points, designing solutions, and putting them into action, bias can quickly throw a wrench into the works, especially when we are not paying attention. So, let’s stroll through different areas where our biases can easily creep in and see how they play their pesky part—and what we can do about it.
Community or client engagement
Community engagement is all about building trust and getting people involved. But if there’s bias, even if it’s unintentional, it can lead to some groups feeling left out or misunderstood. Let’s paint a scenario:
A city council plans a series of community engagement meetings to discuss a new public housing development in a predominantly Black neighborhood, including an out-patient clinic. The goal is to gather input from residents and ensure the project meets their needs. However, two problematic decisions were made: the panel of speakers consists entirely of city officials and developers, with no representation from local community leaders or residents, and the meetings are scheduled on weekday mornings when most residents are at work.
After six months of “laborious work” a plan is developed. The lack of genuine community input results in a development plan that does not reflect the neighborhood’s needs or preferences leading to resistance or protests.
Two types of bias are at play here:
- Implicit Bias: Unconscious attitudes and stereotypes influence the organizers’ actions and decisions, leading to exclusionary practices. The organizers might not intentionally exclude community leaders, but their implicit biases result in a lack of diverse representation and consideration of the residents’ schedules.
- Confirmation Bias: The organizers mainly listen to information that confirms their preconceptions. They favored the perspectives of city officials and developers, believing they know what is best for the community.
When communities feel unseen or unheard, it seriously undermines efforts to improve public health or development. It’s like trying to fit a square peg into a round hole. Effective community engagement requires recognizing and addressing these biases to ensure all voices are heard and respected.
Understanding the Issues
Biases can cloud our judgment and shape our perceptions, leading to a skewed understanding of what’s happening. We have a narrow view if we only listen to specific voices or rely on data that doesn’t capture the whole picture, resulting in strategies that don’t address the real problems. It’s like trying to fix a car without knowing what’s broken—you might get lucky, but chances are, you’ll miss the mark.
Scenario B: A public health organization launches a campaign to promote healthy eating habits in a predominantly Black neighborhood. The campaign includes educational materials, cooking classes, and community events to encourage residents to adopt healthier diets. However, the campaign fails to achieve its goals of improving health outcomes. Why?
The campaign failed in two keys things; acknowledging the historical context of food insecurity and the systemic barriers that have impacted the community’s access to healthy foods. This campaign has stereotype bias written all over it. It assumes that the decision to eat healthy lies solely on the residents and that all Black neighborhoods lack knowledge about cooking or eating healthy. It doesn’t account for the presence of food deserts within wards, the cost of eating healthy, or the acquired taste preferences of the community. Other seemingly “great campaigns” like this continue to fail when we do not identify and address our own biases and assumptions.
Designing and implementing solutions
Then, we have designing solutions. This is where creativity and innovation come into play, but bias can stifle both. If the people at the table all think alike, the solutions they come up with will likely be limited and, frankly, not all that creative. If decision-makers are all C-suite executives with no member having lived experience or working in communities with lived experiences. In that case, we risk developing one-size-fits-all solutions that fit no one at all. What good is a solution when designed outside of the communities that need it most? And this is not just about gathering people in a room and collecting surveys; it is about having them make the final decision on what affects them and their families. Diverse perspectives are essential for designing any and every effective intervention.
Finally, implementing solutions is where the rubber meets the road; bias can cause severe skids. If the implementation team isn’t diverse or culturally competent, they will struggle to connect with the communities they’re serving. This can lead to miscommunication, mistrust, and failure to achieve public health goals. It’s like trying to drive a car with one flat tire—you won’t get very far, and the ride will be bumpy.
So…. now that we see how bias can stymie our efforts, what can be done to reduce it?
- Acknowledge and Reflect: The first step is to recognize that bias exists. It’s crucial to reflect on our biases and how they might influence our work. This reflective process is not just a recommendation but a responsibility we all share.
- Promote Diversity:It may sound cliché, but it cannot be overstated: ensuring that your team, initiative, and engagement efforts are diverse and inclusive is crucial. This doesn’t mean just filling seats with all the residents of color in the neighborhood. This is authentic engagement. Have them at the table where decisions are made, let them champion the cause if possible, and support them as needed. Don’t just inform; engage at every step. Different perspectives can lead to better understanding and more innovative solutions.
- Build Authenticity: Build genuine relationships with communities. Listen actively and ensure that all voices are heard and valued. Authentic engagement is not just about connecting with communities but about empathizing with their experiences and appreciating their voicesand experiences.
- Stay accountable: Offer diverse ways for communities to provide feedback, such as in-person, via phone, and through accessible online platforms. This can help keep your bias in check. It separates what we think we know from what is the reality
- Educate and Train: Provide ongoing training on cultural competency and unconscious bias. Cultural competency refers to understanding, appreciating, and interacting effectively with people from different cultures. It’s a crucial skill, as it helps ensure that programs, policies etc are respectful and responsive to the culture, history and linguistic needs of the people. Medici Road developed an outstanding curriculum to support organizations in identifying and addressing bias both internally and with the communities they serve. If you would like to connectover countering bias and embedding equity in public health solutions, reach out via comms@mediciroad.org
Addressing bias isn’t easy, but it’s essential for creating effective and equitable solutions. By taking these steps, we can work towards a healthier future for everyone.
