As the COVID-19 pandemic has exacerbated the health disparities that existed prior but with a widening gap, there is a call to us in the profession of nursing to take an introspective view on how research has been conducted with a focus on positionality. The communities in most need of quality, community-driven research have not been represented in research, nor in health care in general. Research teams have typically excluded those communities in which we are studying; yet, we as a profession have not held researchers accountable to declaring our positionality to the research being conducted. As a scientific community, we have not fostered individuals in marginalized communities to become researchers who would add immense and nuanced insight into the understanding of health equity research by virtue of their positionality and lived experience. Therefore, though National Institutes of Health (NIH) and National Science Foundation (NSF) pour billions of dollars into research every year, our health outcomes are not any better because we have failed to address this issue of positionality. Based on a recent analysis of NIH funding based on applications submitted from 2011 to 2015, there remains a huge gap in African American/Black scientists, and topic choice alone explained 20% of the funding gap after controlling for other factors.1
The lack of diversity of those receiving the most amount of money from federal funders like the NIH or NSF2 directly reflects the fact that researchers are not asking the kinds of questions most relevant to underserved communities and are not typically including members of these communities in their research proposals. More importantly, they are not in positions of power like on the Scientific Review Groups that evaluate proposals and can significantly affect funding decisions. By forcing researchers to declare their positionality to the topic or community in which they are researching, as a profession and as a science community, we are forcing researchers to think about their own limitations and the lens they bring to their research. This is imperative not only in funding decisions but also in editorial boards as it relates to publishing. I had the privilege of serving on a task force with Advances of Nursing Science journal when we revised our submission guidelines and specifically asked authors to state positionality in relation to their work. Contextualizing the researcher in relation to the topic or research being conducted is essential because it could expose limitations of the results of the research and how it should be interpreted. A great example of this was highlighted by Lett et al in coining the term “health equity tourism,” which they define as “researcher without prior experience or commitment to health equity research—parachuting into the field in response to timely and often temporary increases in public interest and resources.”3(p2) We must expect better from nursing scholars and the scientific community if we are truly going to do research that actually addresses health inequity and improves health outcomes for all.
—Jennifer Woo, PhD, CNM, WHNP, FACNM
Texas Woman's University
1. Hoppe TA, Litovitz A, Willis KA, et al. Topic choice contributes to the lower rate of NIH awards to African-American/black scientists. Sci Adv. 2019;5(10):eaaw7238. doi:10.1126/sciadv.aaw7238
2. Taffe MA, Gilpin NW. Racial inequity in grant funding from the US National Institutes of Health. Elife. 2021;10:e65697. doi:10.7554/eLife.65697
3. Lett E, Adekunle D, McMurray P, et al. Health equity tourism: ravaging the justice landscape. J Med Syst. 2022;46(3):17. doi:10.1007/s10916-022-01803-5