From racialized think-pieces toward anti-racist praxis in our science, education, and practice

KEYWORDS:

• Occupational science
• Anti-racism
• Injustice
• Racism

The process of evaluating and understanding occupation as something people want or are obligated to do and its impact on health and survival is as old as the occupational therapy profession (Johnson & Dickie, 2019). However, from 1917 to 1991, occupational therapists more often conceptualized occupation through its utility in practice rather than as a sociological phenomenon in and of itself (Hammell, 2009a), and as a consequence, neglected examination of the racialized context through which it developed (Grenier, 2020). This orientation fostered a knowledge base rooted in Whiteness—a privileged exclusionary category generally based on having White skin and the accumulation of social, economic, and political power (Christian, 2018)—and was consistently only interested in the benefits of occupation. Simultaneously, founders utilized these benefits in order to carve out political power to capitalize on evolving health systems (Calhoun, 2020; Yerxa, 1993). Occupational science was born from this knowledge base and a need to gain traction and power as an emerging basic science in the academy, and subsequently, enable a more efficacious practice within medical and therapeutic fields (Yerxa, 1990). Early occupational scientists, therefore, would have found little utility in turning a critical eye toward the founding construct of the discipline as a potential locus for injustice, especially in relation to racism (Clark et al., 1991; Yerxa, 2000).

It was not until the late 2000s and 2010s when researchers began offering socio-political critiques of the construct of occupation within occupational science such as Dickie and colleagues (2006), Hammell (2009a, 2009b), Laliberte Rudman (2013), Angell (2014), Ramugondo (2015), and Simó Algado and colleagues (2016) to name a few. These scholars challenged occupational scientists to historicize and critically analyze the emergence of occupation as a construct with greater complexity. These ongoing critiques, coupled with disciplinary maturity, position occupational science in a marked and essential critical turn, urging its proponents to more substantially leverage critical perspectives to enact an applied anti-racist praxis across their work.

We believe the article for which this commentary is written (Lavalley & Johnson, 2020) follows suit in this important critical shift. In current occupational science literature, scholars attend to labels of race to ensure representation, but simultaneously often over-intellectualize the role of race in occupation. Thus, they neglect the systems and structures that produced those labels—and racialized occupational experiences—in the first place (Grenier, 2020). This not only restricts occupational science scholarship from contributing to active anti-racist deconstruction of oppressive systems to bring about a more just and equitable social order, it deprives occupational therapy educators of opportunity to teach future practitioners to be actively anti-racist in their practice and conceptualization of occupation. Therefore, the purpose of this commentary is not to chastise the discipline’s historical foci, but to call scholars to join a critical shift that will support transformative employment of occupational science constructs.

Author Positionality

Our articulation to discussions of racism in occupational science research, Whiteness in occupation-based curricula, and structural racism in occupational therapy practice result from the long-term effects of the sociocultural contexts through which our intersecting identities are derived. We are formally educated in the United States and each hold a Doctor of Philosophy degree in occupational science; consequently, our conceptualizations and perceptions of occupation are informed by experiences of the hegemonic and racialized institutions of this country. As a Black cis-female occupational scientist and therapist, daily experiences of racism and the perpetual public display of race-based injustices in the United States (e.g., political disenfranchisement, legitimized discrimination, police brutality, resource deprivation) directly influence Dr. Johnson’s conceptions of occupation in relation to social justice. Further, she manages additional responsibilities often conferred to Black academics to redress inclusivity and racial equity in research, pedagogy, and clinical practice. While coming from an overall position of privilege as a White cis-male, his queer identity and experience in a heteronormative world spurred Dr. Lavalley toward a deeper pursuit of understanding systemic oppression. This pursuit requires him to engage in critical self-reflection to hold himself and other White scholars and practitioners accountable in doing the work necessary to deconstruct power and privilege from which White researchers and educators have long benefited. Our experiences at the nexus of these identities of difference (Collins & Bilge, 2016; Crenshaw, 1989) drive our interrogation of the relationality of racism, occupation, and occupational science.

A Convergence of Experiences and Interests

Understanding occupation as emerging through social relationships (Dickie et al., 2006) while imbued with power (Huot et al., 2020; Laliberte Rudman, 2013) and communal meanings (Hannam, 1997; Reed et al., 2010) turned the approach of our research toward the role of occupation in institutional (Johnson & Bagatell, 2017) and community processes (Lavalley & Bailliard, 2020). Structural racism and racialized stratification of occupation emerged as predominant components in both our dissertation studies (Johnson & Bagatell, 2020; Lavalley et al., 2020), highlighting how humans create communal processes and routines through everyday life that can foster both injustices and justices. Both our personal and research experiences compelled us to further integrate analysis of historical, social, and structural perspectives of racism into our research, teaching, and practice related to occupation. Yet, we found little literature (e.g., Grenier, 2020; Restall et al., 2016) acknowledging and addressing the historical, social, and structural emergence of occupational therapy and occupational science through racism, particularly in the United States, and even less that conceptualized the construction of racism through an occupation-based lens.

Within our work, we sought to foster understanding, analysis, and—most importantly—critique of the roots and origins of the construct of occupation and its potential role in creating racist social systems, policies, and practice. As occupational scientists situate occupation among its social and communal relations (Cutchin et al., 2017; Delaisse et al., 2020; Lavalley et al., 2020), we, along with our students, sought deeper analysis of occupation’s part in mechanisms and processes of racism. When preparing the first iteration of our module of Race and Occupation in 2019, we found English and Spanish literature that described injustices (e.g., Bailliard, 2013; Huot, 2013), resilience (e.g., Pyatak & Muccitelli, 2011; Simaan, 2017), and experiences of occupation for various racialized groups (e.g., Adrian, 2013; Beagan & Etowa, 2011), or emphasized the need to epistemologically and historically critique occupational therapy through decolonizing perspectives (e.g., Guajardo et al., 2015; Simó Algado et al., 2016; Restall et al., 2016). We did not identify literature that took a critical lens in uncovering the potential role occupation plays as the vehicle through which racist practices and policies develop and are disseminated.

Further, in contrast to claims made by the pledge introducing this special issue and similarly noted by Kronenberg (2020), we did not identify occupation-centric literature that actively supported anti-racist deconstruction and action in research, education, and practice related to occupation. There was a dearth of literature that underscored the historical construction of racism in and through everyday life, impeding our ability to deconstruct and address it through an occupational lens with our students. This work requires examination beyond occupation-centric think pieces focused on unjust experiences of occupation; it is a radical application of critical inquiry—anti-racist praxis—to actively deconstruct biases and reorient utilization of the founding construct of occupational science and occupational therapy practice to support transformative social change.

Addressing Racism and Occupation in the Classroom

To more fully incorporate these perspectives into an occupational science course in the masters of occupational therapy program at the University of North Carolina at Chapel Hill, we reviewed policies, everyday practices, and other potential historical manifestations of racism through occupation in the United States context. We identified relationships among occupation and the historical construction of racism through systems of religion, economics, law, judicial decisions, education, social norms, and countless other components of everyday life using various texts (e.g., Allen, 2012; Berrey, 2015; Cannon, 2008; Coates, 2017; Kendi, 2016, 2019). This review was fodder for discussion and analysis among occupational therapy students facilitated by both authors. Having both a Black and White voice facilitating discussion amplified the perspective of someone who is most directly impacted by these injustices without tokenization, while still holding a White person in a position of authority accountable to address and mitigate White supremacy in an educational setting. Student response to this content was overwhelmingly positive and energized us to develop a formal article on the topic.

Our Charge to Occupational Scientists

The explicit mention of racism as a “global hierarchy of superiority and inferiority along the line of the human that have been politically, culturally and economically produced and reproduced” (Grosfoguel, 2011, p. 10) is minimal in occupational science discourse (Kronenberg, 2020). This may be an unintended outcome of racialization that is inherent in the research enterprise. That is, categorizations with no genetic or biological origins (Lang, 2000) are taken up and applied in occupational science scholarship when describing the experience of racialized groups without proper deconstruction or contextualization of this hegemonic social system. Without addressing the influence of racism in the occupational experience being studied, and therefore their conceptualization of it, occupational scientists may inadvertently produce new and reproduce old forms of racism disguised as culturally affirming or justice seeking scholarship. Mentions of race, as an extension of cultural explorations and post hoc analyses, is not a sufficient vehicle to offer scholars appropriate tools and strategies to deconstruct and actively revolt against racist structures and systems as scholars purport their efforts to do. Situating occupational science in modern understandings of race and racism necessitates occupational scientists turn a reflexive eye toward the discipline and recognize that processes and systems of racism are under-examined.

Although the scope of this commentary does not allow for comprehensive word mining and analyses of the literature, we lay bare the need for more nuanced critical inquiry and reconceptualization of occupation as a site where racism is enacted and sustained. This work may include, but is not limited to, the following:

• Make prominent racializations of occupation in the literature a point of deliberation. Occupational scientists must avoid being tacitly complicit in contributing to rather than dismantling the marginalization and oppressions of populations with whom they study and write about.

• Reconsider utilization of underrepresented minorities. “Underrepresented” emphasizes representation proportionality and “minority” overlooks differential experiences between and within groups (Walden et al., 2018; Zuberi & Bonilla-Silva, 2008). People of color make up the world’s majority but are minoritized in places and spaces where there is an overrepresentation of White people. Failure to make this distinction further legitimizes racist labeling in occupational science scholarship. Academics have offered “excluded identities” and “minoritized” or “racialized” groups as alternatives among others (Grenier, 2020; Walden et al., 2018).

• There is power in naming and we contend justice is in framing. Framing racism in relation to occupation offers an occupation-based schema of interpretation, situating experience within cultural contexts. In other words, framing is integral to conveying and processing how systems of racism articulate to occupation.

• Exercise plurality of occupational perspectives. The paucity of voices of occupational scientists from underrepresented racial and cultural groups stifles the systems of knowledge through which anti-racist responsiveness in scholarship may emerge (Restall et al., 2019; Zuberi & Bonilla-Silva, 2008). Thus, we challenge our discipline to intentionally seek, support, and accentuate contributions of colleagues and stakeholders from different racial and ethnic backgrounds and institute dissemination practices that amplify the voices of minoritized groups.

Zuberi and Bonilla-Silva (2008) affirmed that “social science is at its best when it is self-critical and relentlessly self-correcting … [social scientists] must be open to a critical evaluation. … and the conclusions that we come to” (p. 5). Similarly, occupational scientists must contend that the discipline’s current theoretical and methodological approaches are liable to socio-cultural and racialized inaccuracies, in particular the blinding influence of Whiteness on the sociological and occupation-oriented imagination. This commentary serves as a call to recognize the inadequacies of undertheorizing racism and its importance in conceptualizing occupation. Occupational scientists must move beyond critical inquiry toward critical praxis (Galvaan, 2020). That is, scholarship must be anti-racist in focus and in outcome. Doing so can inform anti-racist applications of occupational science literature and theory in occupational therapy practice and across disciplinary boundaries. We re-emphasize that naming and framing racism in the discipline’s scholarship forms the basis through which occupational scientists can enact anti-racist decision-making and action, leveraging occupation to foster transformative and justice-oriented change across all communities.

Acknowledgements

We honor the 330,000+ stolen enslaved peoples of Africa whose bodies forged the economy of North Carolina and constructed the earliest structures of the University of North Carolina at Chapel Hill (UNC-CH), and the Occaneechi Band of the Saponi Nation whose ancestral lands lie beneath UNC-CH.

Disclosure Statement

No potential conflict of interest was reported by the author(s).