Transformative Consciousness of Health Inequities: Oppression Is a Virus and Critical Consciousness Is the Antidote
- 101 Downloads
Oppression has been identified as a fundamental cause of disease. Like a self-replicating virus, it infects systems from the biological to the political, contributing to personal (e.g., substance use, low self-esteem) and social (e.g., community violence, mass incarceration) dysfunction. Paulo Freire’s critical consciousness (CC) is a philosophical, theoretical, and practice-based framework that has been identified as an antidote to oppression. Critical consciousness constitutes an awareness of, and action against, institutional, historical, and systemic forces that limit or promote opportunities for certain groups. Although the CC theory has been used to address inequity, very few scholars have attempted to conceptualize, operationalize, and describe the development process of CC. In response to the conceptual inconsistencies widely noted in the CC literature, this paper presents a new construct, transformative consciousness (TC), composed of three domains: awareness, behavioral-response, and consequence, for each level of the socio-ecosystem. The staged process of TC development is also described. The theoretical framework of TC can be applied to various social issues, such as violence, targeted incarceration, homelessness, HIV/STI infection, and substance use—all of which have tremendous implications for health and well-being as a human right. With further research, transformative consciousness may prove necessary to move persons in the direction of anti-oppressive, individual, and collective action to overcome and dismantle oppression, creating a healthier and more just and liberated society.
KeywordsCritical consciousness Oppression Inequity Social justice Liberation health
- Androff, D., & McPherson, J. (2014). Can human rights-based social work practice bridge the micro/macro divide? In K. R. Libal, S. M. Berthold, R. L. Thomas, & L. M. Healy (Eds.), Advancing human rights in social work education. Washington, DC: Council on Social Work Education.Google Scholar
- Alexander, M. (2010). The new Jim Crow: Mass incarceration in the age of colorblindness. New York, NY: The New Press.Google Scholar
- Barr, D. (2014). Health disparities in the United States: social class, race, ethnicity, and health (2nd ed.). Baltimore: The John Hopkins University Press.Google Scholar
- Barrett, J. (2011). Multicultural social justice and human rights: strategic professional development for social work and counseling practitioners. Journal for Social Action in Counseling and Psychology, 3, 116–122.Google Scholar
- Borrell, L. N., Kiefe, C. I., Williams, D. R., Diez-Roux, A. V., & Gordon-Larsen, P. (2006). Self-reported health, perceived racial discrimination, and skin color in African Americans in the CARDIA study. Social Science & Medicine, 63(6), 1415–1427. https://doi.org/10.1016/j.socscimed.2006.04.008.CrossRefGoogle Scholar
- Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist, 32(7), 513–531. Retrieved 12/21/15 from http://cac.dept.uncg.edu/hdf/facultystaff/Tudge/Bronfenbrenner%201977.pdf.CrossRefGoogle Scholar
- Bronfenbrenner, U. (1994). Ecological models of human development. In International Encyclopedia of Education, Vol. 3, 2nd Ed. Oxford: Elsevier. Retrieved from http://www.psy.cmu.edu/~siegler/35bronfebrenner94.pdf.
- Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54(10), 805–816 http://dx.doi.org.proxy.wexler.hunter.cuny.edu/10.1037/0003-066X.54.10.805.CrossRefGoogle Scholar
- Council on Social Work Education (2015). Educational policy and accreditation standards. Retrieved from https://www.cswe.org/getattachment/Accreditation/Accreditation-Process/2015-EPAS/2015EPAS_Web_FINAL.pdf.aspx.
- DiAngelo, R. (2011). White fragility. International Journal of Critical Pedagogy, 3(3), 54–70.Google Scholar
- Diemer, M. A., Kauffman, A., Koenig, N., Trahan, E., & Hsieh, C. A. (2006). Challenging racism, sexism, and social injustice: support for urban adolescents’ critical consciousness development. Cultural Diversity and Ethnic Minority Psychology, 12(3), 444–460. https://doi.org/10.1037/1099-9809.12.3.444.CrossRefGoogle Scholar
- Flynn, A., Holmberg, S., Warren, D., & Wong, F. (2016). Rewrite the racial Rules: building an inclusive American economy (p. 92). Roosevelt Institute. Retrieved from http://rooseveltinstitute.org/wp-content/uploads/2016/06/Structural-Discrimination-Final.pdf.
- Freire, P. (1973). Education for critical consciousness. NY: Continuum.Google Scholar
- Freire, P. (1975). Cultural action for freedom. Retrieved from http://www.thinkingtogether.org/rcream/archive/110/CulturalAction.pdf Harvard.
- Freire, P. (2000). Pedagogy of the oppressed (30th anniversary ed). New York: Continuum (original work published 1970).Google Scholar
- Friedman, S. R., Sandoval, M., Mateue-Gelabert, P., Rossi, D., Gwadz, M., Dombrowski, K., Smyrnov, P., Vasylyeva, T., Pouget, E. R., & Perlman, D. (2013). Theory, measurement and hard times: some issues for HIV/AIDS research. AIDS and Behavior, 17(6), 1915–1925. https://doi.org/10.1007/s10461-013-0475-3.CrossRefGoogle Scholar
- Gebo, K. A., Fleishman, J. A., Conviser, R., Reilly, E. D., Korthuis, P. T., Moore, R. D., Hellinger, J….HIV Research Network (2005). Racial and gender disparities in receipt of highly active antiretroviral therapy persists in a multistate sample of HIV patients in 2001. Journal of Acquired Immune Deficiency Syndromes, 38(1), 96–103. doi: https://doi.org/10.1097/00126334-200501010-00017.CrossRefGoogle Scholar
- Ginwright, S., & James, T. (2002). From assets to agents of change: Social justice, organizing, and youth development. New Directions for Youth Development, (96), 27–46. https://doi.org/10.1002/yd.25.
- Green, B. H. (2009). Exploring the relationship between racial factors and critical social analysis among a group of African American youth. Psychology Theses. Paper 67. Retrieved from http://digitalarchive.gsu.edu/cgi/viewcontent.cgi?article=1063&context=psych_theses.
- Haight, W., Gibson, P. A., Kayama, M., Marshall, J. M., & Wilson, R. (2014). An ecological-systems inquiry into racial disproportionalities in out-of-school suspensions from youth, caregiver and educator perspectives. Children and Youth Services, 46, 128–138. https://doi.org/10.1016/j.childyouth.2014.08.003.CrossRefGoogle Scholar
- Hatcher, A., de Wet, J., Bonnell, C. P., Strange, V., Phetla, G., Proynk, P. M., Kim, J. C., et al. (2010). Promoting critical consciousness and social mobilization in HIV/AIDS programmes: lessons and curricular tools from a South African intervention. Health Education Research, 26(3), 542–555.CrossRefGoogle Scholar
- Ho, K. (2007). Structural violence as a human rights violation. Retrieved from http://projects.essex.ac.uk/ehrr/V4N2/ho.pdf.
- Jemal, A. D. (2016). Transformative consciousness: conceptualization, scale development and testing (unpublished doctoral dissertation). Rutgers University, NJ.Google Scholar
- Jutte, D. P., Miller, J. L., & Erickson, D. J. (2015). Neighborhood adversity, child health, and the role of community development. Pediatrics, 135(Supplement, S57), 48–57. Retrieved 9/20/16 http://pediatrics.aappublications.org/content/135/Supplement_2/S48.full.CrossRefGoogle Scholar
- Kirkwood & Kirkwood (1989). Living adult education. Retrieved 2/2/16 from https://www.sensepublishers.com/media/619-living-adult-education.pdf.
- Kübler-Ross, E. (1969). On death and dying. New York: Macmillan.Google Scholar
- Macias, K. (2017). Black women are dying from pregnancy and childbirth at alarming rates due to structural racism. Daily KOS Retrieved from https://www.dailykos.com/stories/2017/12/7/1722255/-Black-women-are-dying-from-pregnancy-and-childbirth-at-alarming-rates-due-to-structural-racism?detail=emaildkre.
- Mahler, M., Pine, F., & Bergman, A. (1975). The psychological birth of the human infant: symbiosis and individuation. New York: Basic Books.Google Scholar
- Mead, H., Cartwright-Smith, L., Jones, K., Ramos, C., Woods, K., & Siegel, B. (2008). Racial and ethnic disparities in U.S. healthcare: a chartbook. The Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/~/media/files/publications/chartbook/2008/mar/racial-and-ethnic-disparities-in-u-s--health-care--a-chartbook/mead_racialethnicdisparities_chartbook_1111-pdf.pdf.
- Mullaly, B. (2002). Challenging oppression: a critical social work approach (p. 232). Don Mills: Oxford University Press.Google Scholar
- National Association of Social Workers (NASW). (approved 1996, revised 2017). Code of ethics of the National Association of Social Workers. Retrieved 3/1/18 from https://www.socialworkers.org/LinkClick.aspx?fileticket=ms_ArtLqzeI%3D&portalid=0.
- National Economic & Social Rights Initiative (NESRI) (2017). What is the human right to health and health care? Retrieved 7/17/17 from https://www.nesri.org/programs/what-is-the-human-right-to-health-and-health-care
- Nichol, S. N. M. (2004). “We make the road by walking:” reflections on the legacy of white anti-racism activism. In J. Harvey, K. A. Case, & R. H. Gorsline (Eds.), Disrupting white supremacy from within: white people on what we need to do (pp. 188–211). Cleveland: The Pilgrim Press.Google Scholar
- Rappaport, J. (1981). In praise of paradox: A social policy of empowerment over prevention. American Journal of Community Psychology, 9, 1–25. https://doi.org/10.1007/BF00919275.
- Shonkoff, J. P., Garner, A. S., & The Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, and Section on Developmental and Behavioral Pediatrics. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), 232–246. https://doi.org/10.1542/peds.2011-2663.CrossRefGoogle Scholar
- Watts, R. J., Diemer, M. A., & Voight, A. M. (2011). Critical consciousness: current status and future directions. In C. A. Flanagan & B. D. Christens (Eds.), Youth civic development: work at the cutting edge. New Directions for Child and Adolescent Development, 134, 43–57. https://doi.org/10.1002/cd.310.
- Windsor, L., Jemal, A., & Benoit, E. (2014a). Community wise: paving the way for empowerment in community reentry. International Journal of Law and Psychiatry, 37(5), 501–511. https://doi.org/10.1016/j.ijlp.2014.02.023.NIHMS576112.CrossRefGoogle Scholar
- Windsor, L., Jessell, L., Lassiter, T., & Benoit, E. (2015a). Community wise: a formative evaluation of a community based health intervention. International Public Health Journal, 7(1), 79–90 NIHMSID 714802.Google Scholar
- Wise, T. J. (2010). Colorblind: the rise of post-racial politics and the retreat from racial equity. San Francisco: City Lights Books.Google Scholar
- Zaff, J., Boyd, M., Li, Y., Lerner, J. V., & Lerner, R. M. (2010). Active and engaged citizenship: Multi-group and longitudinal factorial analysis of an integrated construct of civic engagement. Journal of Youth and Adolescence, 39, 736–750. https://doi.org/10.1007/s10964-010-9541-6.CrossRefGoogle Scholar
- Zimmerman, M. A., Ramirez-Valles, J., & Maton, K. I. (1999). Resilience among urban African American male adolescents: A study of the protective effects of sociopolitical control on their mental health. American Journal of Community Psychology, 27(6), 733–751. https://doi.org/10.1023/A:1022205008237.CrossRefGoogle Scholar