"Remember, we don't have race categories here": contradictions and reflections on racism, environment, and health from an interview study among Black German researchers, educators, and care providers.

Background: The global reckoning on race and racism in 2020 ushered in new or enhancement of existing governmental anti-discrimination and anti-racism initiatives at EU and German Federal levels. However, the role of racism, particularly structural racism, in health appears to be missing from community health and medical training and research, and from larger policy debates on environmental justice and health equity in Germany. Design/Methods: Participants were purposively recruited across 10 German cities selected to represent regional variability in racial diversity and engaged in semi-structured in-depth interviews that were audio-recorded and transcribed verbatim. Using thematic analysis, these qualitative interviews with 14 anti-racism researchers, community-based advocates and educators knowledgeable about environmental justice, racism, public health who identified as Black or Afro-German and/or work on behalf of racialized communities in Germany were analyzed to explore the challenges faced by minoritized communities in Germany in relation to environmental justice and health inequities, as well as strategies for addressing these issues. Results: Participants enumerated a number environmental conditions likely disproportionately impacting racialized minority groups in Germany. The extent of these issues is not known due to lack of data and empirical studies. Participants pointed to the myriad ways racism is structured in Germany, tracing how racialized and racially hierarchical values and beliefs become actualized through racially discriminatory policies and practices embedded in social institutions such as the government, the economy, the education system and the healthcare system which lead to racialized outcomes in health and environmental conditions. Conclusions: Interview participants identified pathways toward more effective research and policy initiatives on racism, environmental justice, community health and environmental heath equity in Germany including: collecting better data that is informed by structural theories of race/racialization and power; addressing history and national narratives; supporting more community-based participatory action research; engaging with existing civil society and non-governmental organizations that serve and advocate on behalf of minoritized communities; and building upon past and present progressive social movements.