The populations impacted most by COVID are also impacted by racism and related social stigma; however, traditional surveillance tools may not capture the intersectionality of these relationships. We conducted a detailed assessment of diverse surveillance systems and databases to identify characteristics, constraints and best practices that might inform the development of a novel COVID surveillance system that achieves these aims. We used subject area expertise, an expert panel and CDC guidance to generate an initial list of N > 50 existing surveillance systems as of 29 October 2020, and systematically excluded those not advancing the project aims. This yielded a final reduced group (n = 10) of COVID surveillance systems (n = 3), other public health systems (4) and systems tracking racism and/or social stigma (n = 3, which we evaluated by using CDC evaluation criteria and Critical Race Theory. Overall, the most important contribution of COVID-19 surveillance systems is their real-time (e.g., daily) or near-real-time (e.g., weekly) reporting; however, they are severely constrained by the lack of complete data on race/ethnicity, making it difficult to monitor racial/ethnic inequities. Other public health systems have validated measures of psychosocial and behavioral factors and some racism or stigma-related factors but lack the timeliness needed in a pandemic. Systems that monitor racism report historical data on, for instance, hate crimes, but do not capture current patterns, and it is unclear how representativeness the findings are. Though existing surveillance systems offer important strengths for monitoring health conditions or racism and related stigma, new surveillance strategies are needed to monitor their intersecting relationships more rigorously.

Community-Engaged Research (CER) arose as a means of increasing the democratic participation of communities that study outcomes directly impact. CER has been identified as a recommended approach for conducting biomedical and behavioral health research with Black communities, a population that has been excluded from and exploited by academic health research for centuries. However, solely increasing community participation without identifying and redressing racialized power imbalances within community–academic partnerships involving Black populations can stall progress towards racial health equity. The purpose of this study was to explore how power can be redistributed equitably in community–academic health research partnerships involving Black populations. Utilizing the qualitative methodological approach of critical narrative inquiry, counter-stories from 12 Black individuals who have served as community partners on U.S.-based academic health research teams were collected via in-depth semi-structured narrative interviews. A reflexive thematic analysis approach was utilized to identify and analyze strategies expressed by study participants for increasing community agency, efficacy, and solidarity in health research. By centering the voices of Black community members who have directly engaged with academic health research institutions, this study sought to amplify the desires and aspirations of Black communities regarding shifting power in health research processes and outcomes.

The predominantly Black city of Albany, Georgia, and its metropolitan region, was hard hit during the first wave of COVID-19. In the midst of the wave, the local hospital produced a video of a Blac...

This commentary argues that the crises facing the U.S. public health workforce - marked by mass attrition, particularly among Black women, increasing incidence of disease and illness, loss of critical social safety nets, mediated surveillance, and eroding public trust - represent a manifestation of state-sanctioned violence through decades of systemic divestment and political attack. Drawing on Black feminist, Indigenous, and decolonial theoretical traditions, we propose the Critical Matriarchal Framework for Health Communication as a transformative alternative to hierarchical, extractive models of public health practice. This framework centers relational authority, collective responsibility, intergenerational knowledge, and care-based leadership to address and reduce persistent health inequities that are fundamentally rooted in fractured systems of care and community relationships. Using case analyses, authors will demonstrate that without trusted communicators embedded in communities, without frameworks that center reciprocity and care, and without addressing the trauma and structural violence that undermine trust, public health institutions cannot effectively communicate for behavioral changes during emergencies. This intervention has implications beyond public health, offering a model for sectors experiencing similar legitimacy crises and calling for institutional realignment that examines power structures, redistributes leadership, and centers community accountability over bureaucratic metrics. The Critical Matriarchal Framework for Health Communication is necessary because it transforms crisis communication from a technical problem (how to disseminate information) into a relational practice (how to build trust, share power, and co-create solutions with communities). This perspective is about fundamentally reimagining who has authority to speak, whose knowledge counts, and what public health communication is ultimately for: institutional legitimacy and community flourishing. In the context of ongoing and future crises (climate disasters, pandemics, political violence), this framework offers a pathway toward health communication practices that do not just inform behavior but transform systems, that reach communities and honor their wisdom, and that manage crises by building collective capacity for resilience.