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Necessary Conversations: Understanding Racism as a Barrier to Achieving Health Equity reflects the conviction that a true prioritization of health in our communities is impossible without a commitment to racial equity. Drawing on the pivotal social events of 2020 in America, it extends a powerful
call to action based on a growing body of evidence that racism is the underlying cause of so many poor health outcomes. Contributors across health, education, law, and media further the longstanding work of the Robert Wood Johnson Foundation to create a "Culture of Health" by engaging in authentic
discussions about the systems and structures that harm people of color and offering provocative ideas and strategies to inspire action.

Necessary Conversations ultimately highlights the importance of building leadership and partnerships through those who are most affected in the community. It considers what it would take to overhaul institutions that treat people differently on the basis of race and recognizes that we all must share
resources and join together to support the advancement of health and racial equity.

Alonzo L. Plough, PhD, MPH, MA, is Chief Science Officer and Vice President of Research-Evaluation-Learning at the Robert Wood Johnson Foundation. Plough has had a distinguished career in public health practice, academia, and philanthropy. His work focuses on improving health and well-being, and
achieving health equity. Plough serves as a board member for many health and social welfare organizations.

Introduction

Prologue: Setting the Stage: The History, Struggle, and Strength of Mississippi

Part I: How Racism Becomes a Structural Problem
Chapter 1: Racial Hierarchy, Race Narrative, and the Structures that Sustain Them
Chapter 2: Beyond the Black/White Binary: Confronting Invisibility and the Harms of "Othering"
Chapter 3: Keeping it Real: Pathways to Authentic Connections
Spotlight - Sharing Stories to Advance Racial Healing

Part II: The Harms of Racial Injustice
Chapter 4: Structural Racism in Black Maternal Healthcare
Spotlight - Partnering to Improve Outcomes for Postpartum Women
Chapter 5: The Health Harms of Incarceration and Punishment
Chapter 6: Immigrant Health: Inequity and Fear
Spotlight - Creative Approaches to Support Immigrant Families
Chapter 7: Climate Crisis, Environmental Justice, and Racial Justice

Part III: Strategies to Advance Racial Equity
Chapter 8: Learning the Lessons of History
Spotlight - Youth Changing the Narrative on Health
Chapter 9: Fair Housing, Equitable Communities
Spotlight - Creating a Healthy, Livable Community
Chapter 10: Transforming Research and Evaluation
Spotlight - Racial Equity and Social Justice in City Health Department Practices
Chapter 11: Racial Justice Through Civic Engagement: A Look at Voting and the Census

Epilogue- RWJF Looks Toward the Future
Spotlight - Building on Past Work to Seize a Moment