Privilege, power, and public health programs: a student perspective on deconstructing institutional racism in community service learning.

摘要

The Association of Schools of Public Health has identified "diversity and culture" as 1 of 7 crosscutting competencies that public health students are expected to achieve. This competency is traditionally incorporated into the curriculum through a community service-learning (CSL) component that aims to expose students to racial/ethnic health disparities. However, this model of CSL is problematic because although students are directly engaging with community members, it does not ensure long-term sustainable changes or benefits for the host community. Moreover, academic institutions have developed significant critiques of traditional CSL models where white middle-class students engage with low-income clients and communities of color, potentially reinforcing Eurocentric power and privilege. As such, public health programs require a shift in both pedagogy and curricula that more directly addresses underlying institutional racism in health disparities. Consistent with the principles of public health, a social justice framework is imperative in teaching cultural competency and should facilitate discussion of racial injustice and privilege in the students' own lives. This brief presents an autobiographical personal narrative of my experiences with CSL as a racial/ethnic minority student in a California graduate school of public health. Although autoethnography is inherently limited, this brief highlights my observations of the limitations of the service-learning model to adequately educate students on the intersection of racism and health outcomes. In addition, the brief includes suggestions for creating inclusive curricula that critically examine issues of privilege, oppression, and power dynamics related to race/ethnicity.