Transformative Consciousness of Health Inequities: Oppression Is a Virus and Critical Consciousness Is the Antidote

Abstract

Oppression has been identified as a fundamental cause of disease. Like a self-replicating virus, it infects systems from the biological to the political, contributing to personal (e.g., substance use, low self-esteem) and social (e.g., community violence, mass incarceration) dysfunction. Paulo Freire’s critical consciousness (CC) is a philosophical, theoretical, and practice-based framework that has been identified as an antidote to oppression. Critical consciousness constitutes an awareness of, and action against, institutional, historical, and systemic forces that limit or promote opportunities for certain groups. Although the CC theory has been used to address inequity, very few scholars have attempted to conceptualize, operationalize, and describe the development process of CC. In response to the conceptual inconsistencies widely noted in the CC literature, this paper presents a new construct, transformative consciousness (TC), composed of three domains: awareness, behavioral-response, and consequence, for each level of the socio-ecosystem. The staged process of TC development is also described. The theoretical framework of TC can be applied to various social issues, such as violence, targeted incarceration, homelessness, HIV/STI infection, and substance use—all of which have tremendous implications for health and well-being as a human right. With further research, transformative consciousness may prove necessary to move persons in the direction of anti-oppressive, individual, and collective action to overcome and dismantle oppression, creating a healthier and more just and liberated society.