FROM “CUSTOMER SERVICE” TO “CULTURAL HUMILITY”— ADVANCING AN ANTIRACIST CULTURE OF CARE AT WIC

Abstract

With racism driving perinatal health disparities, antiracist tools and trainings are necessary for WIC nutrition professionals who serve as frontline providers for Black and Indigenous families of color. Black families, in particular, are the most likely to experience harms from discrimination in health care and health services, even from well-intentioned providers in caring professions. This thesis investigates the role of racism, both interpersonal and structural, and how it may influence WIC enrollment, participation and culture of care. After providing a basic overview about WIC including recent participation and demographic statistics and trends, I share my own ethnographic observations and reflections on my positionality in the WIC clinic setting. I review research on the most commonly identified barriers to and benefits from WIC participation, including how those benefits intersect with contributing factors in the crisis in Black perinatal health in the United States, and make the case for including experiences of bias and racism as an overlooked barrier. With a focus on improving the client experience, I use an urban bioethics lens to inform strategies (including antiracism training for WIC staff) to increase and sustain WIC participation and the concomitant benefits participation can incur, particularly for Black mothers and birthing people and their families. I review the literature that informed our training, describe key components of the training, and summarize the findings from the evaluation and assessment of the WIC nutrition professionals who attended. Lastly, I posit how the convergence of COVID-19 and the racial justice uprisings of 2020, both accelerated the acceptance of the need for innovations in how WIC is implemented, and created the conditions to facilitate rapid changes towards more equitable policies and procedures at both the local and federal level. Many of these changes were previously thought to be desirable but unattainable, and I reflect on the need to seize this opportunity to intentionally build upon that progress by applying a racial equity framework to envision a post-pandemic WIC.