Advancing Reparative Knowledge Toward Health Equity: The Importance of Slavery Heritage Sites

Background

Research has linked racial slavery to health inequities in contemporary society; and much of this research has been done in the U.S. context. Heritage sites of transatlantic enslavement, such as those in African and Caribbean sites of European colonialization, carry varied patterns of African cultural practices, diseases, and climates. They are thus critical contexts for generating reparative knowledge to address racial health inequities. A growing body of work suggests that the epistemic resources by which we conceptualize diseases and develop responses to illness were generated in the context of Atlantic slavery, and they continue to sustain racialization to (re)produce health inequity. Racial slavery, alongside unhealthy conditions and climates unfamiliar to Europeans, produced an ideal setting for the racialized construction of medical knowledge and colonial medicine. The current study, grounded in structural competency, collective memory, and reparative futures, analyzes reparative health knowledge possibilities in one of the slave dungeons in Ghana.

Methods

Study participants included university students from the U.S. (n=5, Mean age =19.8, 3 males, 2 females, all whites) and Ghana (n=8, mean age 26, 5 males, 3 females, all Africans) who visited the Cape Coast Castle, including the dungeon. All participants were public or population health focused students, except for one with a focus on criminology. Following the visit to Cape Coast Castle, participants engaged in a focus group discussion on the conditions experienced by enslaved Africans and contrasting quarters of the Europeans. Participants were asked questions about how the conditions under which the captured Africans lived could affect their health and parallels contemporary conditions that are linked to health disparities. They were also asked how such understanding might help envision just conditions for advancing healthy communities. The focus group session was recorded, transcribed, and analyzed using the sort and sift, think and shift (SSTS) approach to qualitative research (Maietta, 2021).

Findings

Analysis of the focus group data yielded three key themes. They suggest that engagement with heritage sites of slavery can (1) provide an important context to health disparities which in turn can engender collective empathy, responsibility, and moral obligation to address disease induced structures; (2) proactively direct the creation of conditions and structures that reduce vulnerabilities to health compromising forces; and (3) decenter hierarchy-based epistemologies that perpetuate social determinants of health, unjust patterns, and knowledge systems linked to health inequities.

Discussion/Conclusion

Slavery’s epistemic endurance has implications for research seeking to address health inequities. A reparative health system and practice that situates slavery and its reproductive afterlife at the center of our epistemic tools and collective memories can generate new insight for us to conceptualize a future that advances just health. Engagement with slavery heritage sites is methodologically, politically and epistemically relevant for advancing health justice research.