Centering Systemic Oppression in Prevention Research and Practice to Address Health Inequities

Systemic discrimination on the basis of race, gender, sexuality, class, and ability has been foundational to the development of health disparities and plays an undeniable role in their maintenance. Accordingly, challenging these systems is pertinent to preventing disparate health outcomes. Yet, many preventive interventions favor individual, family, or proximal community-level efforts and may not sufficiently address the oppressive structures that underlie health inequities. This approach may place the onus on marginalized individuals, their families, schools, and communities to address products of deep-rooted systemic problems. An individual-level prevention focus also reinforces individualistic mainstream discourse around systemic problems, resulting in an emphasis on the prevention of symptoms of larger systems rather than an examination of the systems themselves. This approach also promotes mere survival in the face of oppressive systems, and values success within their confines instead of reimagining them structurally. Given these implications, prevention scientists should be encouraged to explore systemic factors and target larger structures by prioritizing social change work.

This roundtable brings together individuals representing multiple prevention science perspectives, including research, translation, practice, and policy to consider how systemic oppression maintains health disparities and may bias prevention science research and practice toward individual-level targets. How might training programs challenge emerging prevention scientists to better examine and account for systems of oppression as determinants of health in their research? Can the prevention science field reimagine individual-level prevention efforts to broaden their depth and scope and account for multilevel factors in accordance with the ecological theories that characterize our understanding of health disparities? Moving forward, in what ways can research, preventive intervention design, and implementation prioritize and target systemic factors that contribute to health inequities? This discussion aims to encourage prevention scientists in academic, community, and public sector settings to explore how prevention science might better understand and integrate the systemic bases of health disparities into its scholarship and practice.