Insights

3 Strategies for Navigating Equity Fatigue and Maintaining Engagement in Equity Initiatives

Advice from Three Experts

Research continues to emerge highlighting racism and discrimination as key drivers of negative health outcomes impacting historically marginalized communities.  

Some providers, hospitals, and communities, particularly in the maternal and child health space, have acknowledged that exposure to social, economic, and political oppression contributes to adverse perinatal outcomes. Though organizations have been working on addressing this issue, the path to a solution is unclear, and often, the burden of this work often falls on staff of color, who are provided with limited resources. This can lead to both equity and ally fatigue.  

The term “Equity Fatigue” refers to the exhaustion and frustration experienced by individuals, organizations, or communities engaged in long-term efforts to promote equity, diversity, and inclusion. “Racial Equity Fatigue” and “Ally Fatigue” often refer to people who are tired of talking about racial equity. Racial Equity and Ally Fatigue contribute to emotional and physical exhaustion, high turnover rates, reduced advocacy, and reduced funding and support for equity work.

During the Equity Exchange S1 E3: Combating Weathering + Equity Fatigue, we speak with three experts to discuss the challenges of enduring racist and discriminatory systems while working to dismantle them. Below are three strategies for maintaining engagement in equity initiatives and navigating equity and ally fatigue.

About the Contributors

Kezia Ofosu Atta, MPA,

Kezia Ofosu Atta, MPA is the owner of ICAD CONSULTING LLC, an independent policy analysis, grant writing, and government affairs agency. Atta has an extensive background in education, health policy, and legislation.

Becky Russell, MSPHBecky Russell, MSPH, is NICHQ’s Vice President of Applied Research and Evaluation. Russell is a long-time MCH researcher with expertise in collecting, evaluating, and presenting data to help eliminate health disparities. 

Jacqueline Kellachan, MPH, Jacqueline Kellachan, MPH, a project director at NICHQ, has worked extensively with state hospital teams to improve equity initiatives – including through enhanced data collection and reporting

Build strong coalitions to address systemic challenges

Coalition building is a key strategy that organizations can use to help maintain momentum in equity initiatives whilst navigating environments that may have become hostile to diversity, equity, and inclusion efforts. Bringing together individuals, organizations, and groups with similar policy interests helps create a strong and focused group dedicated to achieving equity in health and other systems.

“In these coalitions, you can have a shared strategic plan with specified outcomes and actionable steps outlined so each member of the coalition can leverage their strengths to help promote and attain the goal at hand,” Atta explained.

As organizations work to improve health outcomes for historically minoritized populations, Atta said it’s important to engage frontline workers, such as medical providers, nurses, and community health workers, who can enter legislative spaces and share their experience in the field. Many frontline workers have observed or experienced equity-related challenges and can offer potential ongoing solutions to address systemic issues.

“Solutions to systemic issues require continuous, specified, targeted work to arrive at these goals –It makes individuals that work in these equity spaces burn out,” Atta said. “In addition to burning out, we go to legislators that would only like to fund things with a one-time investment, and when something is systemic, you cannot just throw funds one time to it.”

Use data to hold your organization accountable for the work.

Evaluation and data collection is an important consideration for any organization that is doing equity-focused work. While data is commonly used in public health to demonstrate impact externally, it can also be used internally to measure progress and hold staff and partners accountable to ongoing participation in equity learning and work.

Organizations can utilize surveys, affinity groups, and other anonymous feedback mechanisms to collect data about staff members’ experiences, and then leadership is responsible for following up and acting on the feedback received.

“It’s important to understand both the perspective of staff and their experiences. This is something that we often overlook, but the System Justification Theory tells us that people really want to assume the best of the systems in which they work, in which they live, and so just asking them what they think or what they’re observing isn’t the whole picture,” explained Becky Russell, VP of Applied Research and Evaluation at NICHQ.

Russell suggests asking about experiences with equity and then comparing that data to the perspectives and using that analysis to gain a better understanding of where your organization is at, and where you’d like to be in terms of your equity work.

Though organizations often attempt to make many changes as quickly as possible, it’s important to be mindful not to try to measure and collect everything at once. This will help enable your staff to test and implement changes upon collecting data and ensure staff has the capacity to participate in equity-focused data collection.

“We also need to recognize that data collection is just one more thing that we’re asking our staff to do that can contribute to that overall fatigue and so it’s really important to think carefully through what you’re collecting and why,” Russell said.

Establish buy-in and support from leadership.

People begin from different points of understanding in their equity journey. To ensure continued growth and learning by staff, it’s important for an organization’s leadership to foster a supportive and educational environment when doing equity work. With support and encouragement from leadership, organizations can focus on assembling diverse, multi-disciplinary teams that have a shared responsibility to focus on equity initiatives, helping to prevent staff burnout.

“What can be very challenging is in the case of some facilities there is not a lot of support from leadership to do this work,” said Jacqueline Kellachan, MPH, a project director at NICHQ. “Sometimes there can be a very small team, and this work isn’t being compensated, aside from the freedom to work in the building. So, the work becomes overwhelming for some people and there was a lot of staff turnover.”

To help establish buy-in from leadership and other staff, Kellachan recommends testing small changes and allowing your organization to see positive results. As your initiatives continue to gain momentum, leadership teams can begin investing more deeply in equity projects, prioritizing the work, and creating additional capacity to focus on projects that support Black, Indigenous, and people of color in achieving their optimal health.

Learn more about the weathering hypothesis, equity fatigue, and ally fatigue in an informational video from NICHQ’s VP of Health Equity Innovation Stacy Scott, PH.D., MPA.