35. How does this CFP define and conceptualize systemic racism?


Systemic racism and structural racism are forms of injustice resulting from historical and contemporary laws, policies, and practices that perpetuate unfair treatment of people from racial and ethnic minority groups and indigenous communities. We use systemic racism and structural racism interchangeably in this CFP.  These forms of racism are deeply embedded in the institutions, delivery systems, and financing systems that shape the distribution of power and resources across American society.  Examples include: barriers to political participation such as political district gerrymandering, inequities in access to polling locations, and restrictive timeframes and mechanisms for ballot casting; lack of representation on governing boards and decision-making bodies; residential segregation by household race, ethnicity and income; inequities in access to capital and financial resources; maldistribution of health and social resources such as clinics, libraries, parks, teachers, sidewalks, and public transportation; environmental injustices such as exposure to polluting industries, hazardous infrastructure, and climate risks; and inequities in information such as the lack of disaggregated data about health and social needs and program effectiveness for specific racial and ethnic minority populations and indigenous communities.  Additional examples include racial patterning in the implementation and enforcement of public policies and administrative practices that require some level of discretionary decision-making, such as law enforcement use of force, incarceration, bail, probation, eviction, expulsion, child protective services actions, child support enforcement, occupational health and safety enforcement, employee recruitment, hiring and training practices, property valuation and tax assessments, medical necessity determinations, medical billing and debt collections, housing voucher acceptance, eligibility determination for Medicaid and other social assistance programs, hospital community benefit activities, and awarding of grants and contracts that fund health and social service programs. 
For more detailed definitions, examples, and potential solutions, see this review article:  https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01394. We encourage applicants to study how forms of systemic racism intersect and interact with other forms of marginalization and inequity in American society, such as those related to sexual orientation, gender identity, disability status, socioeconomic status, educational attainment, immigration and refugee status, national origin, language and literacy, religious affiliation, tribal membership, and rurality.