Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

Until Earth and Heaven Ring: How Academicians Can Recognize and Help Dismantle Systemic Racism in Child Health

Ray Bignall (Nationwide Children’s Hospital)

B. F. Skinner Lecture Series Paper



Biography:O. N. Ray Bignall II, MD, FAAP, FASN is Director of Kidney Health Advocacy and Community Engagement in the Division of Nephrology and Hypertension at Nationwide Children's Hospital, and Assistant Professor of Pediatrics at The Ohio State University College of Medicine. A graduate of Howard University and Meharry Medical College, Dr. Bignall completed his general pediatrics residency, clinical fellowship in nephrology, and NIH post-doctoral research fellowship at Cincinnati Children’s Hospital Medical Center. As a physician-advocate, Dr. Bignall’s work addresses the social determinants of child health, kidney disease, and transplantation through community-based scholarship, engagement, and advocacy. He is an appointed Fellow of the American Society of Nephrology (ASN); the Founding Chair of the ASN’s Health Care Justice Committee; and serves as a member of the Council on Medical Legislation for the National Medical Association. Dr. Bignall is a recipient of the American Academy of Pediatrics Community Access to Child Health (CATCH) Award; a John E Lewy Fund Advocacy Scholar of the American Society of Pediatric Nephrology; and was named a 40 Under 40 Leader in Minority Health by the National Minority Quality Forum and the Congressional Black Caucus Health Braintrust. Twitter: @DrRayMD



Structural racism is one of the most pervasive and impactful social paradigms in American life, and often works in tandem with systems of inequality to drive social factors that adversely affect child health. Understanding the influence of racism on these unjust systems can aid individuals in narrowing health disparities. First, individuals should acknowledge a shared definition of racism as a “system of structuring opportunity and assigning value based on the social interpretation of how one looks… that unfairly disadvantages some… unfairly advantages others, and saps the strength of the whole society through the waste of human resources.” Next, an identification of these systemic inequities should be made, with throughlines drawn connecting social adversity with poor health outcomes. Finally, intentional and evidence-based strategies should be employed to counteract these adverse influences in both health care and society, and these interventions studied to gauge efficacy and direct resources.


Modifed by Eddie Soh