Yet We Live, Strive, and Succeed: Using Photovoice to Understand Community Members’ Experiences of Justice, Safety, Hope, and Racial Equity

Residents’ experiences provide rich insight into the factors that drive widening social and health disparities, and those experiences are not homogeneous. Only through attending to people’s lived experiences will society begin to see these as issues of the entire community, and only by engaging residents in the process of community change can the kinds of change that are needed ever be achieved. Photovoice is a participatory qualitative research method that gives voice to participants’ experiences and perspectives while simultaneously facilitating critical consciousness-raising for social action and social change. This study employed a Photovoice process to explore experiences and perspectives of residents and people working in organizations that serve West Louisville, and to facilitate dialogue and action leading to social change. Forty-three individuals across eight groups completed the Photovoice project, representing youth, older adults, LGBTQ people, faith leaders, educators, activists, and two groups of Black men. Analysis of photos and group dialogue within and across the eight groups identified several common themes that pointed at the historical and present structural racism in the community, the city’s lack of concern for the Black community, the importance of Black history, and the need for collective community action. The public Photovoice exhibit helped inform the subsequent agenda for the city’s Center for Health Equity.


Introduction
The year 2015 marked 150 years since the United States (U.S.) ratified the 13 th Amendment to the Constitution, yet African Americans continue to face the effects of racism, structural inequity, and systematic discrimination. While many people espouse the contemporary perception of a post-racial America (Bonilla-Silva, 2018), racial discrimination persists in sectors such as education, housing, hiring, lending, and the justice system (Bonilla-Silva, 2018;Pager & Shepherd, 2008). Many urban communities across the country remain highly segregated, with poverty and its sequelae concentrated in communities of color (Badger, 2014;Badger & Cameron, 2015). In 2016, 62 years after the Brown vs. Board of Education decision by the Supreme Court, a school district in Cleveland, Mississippi finally was court-ordered to desegregate schools (Berlinger & McLaughlin, 2016). The prison industrial complex, in which prisoners-disproportionately men of color-serve as a commodity, continues to be a strong economic driver (Brewer & Heitzeg, 2008). Police violence against people of color is undeniable (Danis, Wilson, & White, 2016). Michael Brown, Tanisha Anderson, Eric Garner, Yvette Smith, Tamir Rice, Miriam Carey, Terence Crutcher, Shelly Frey, Alton Sterling, Sandra Bland, Philando Castile, Darnisha Harris, Stephon Clark, and Aiyana Stanley-Jones are just a few of the many who have recently died at the hands of police (Hafner, 2018;Abbey-Lambertz, 2015). However, many narratives around these persistent issues deflect attention away from structural racism and toward other explanations (Bonilla-Silva, 2018). The country as a whole has long been divided over the topic of racism and injustice, making the issue a difficult one to collectively discuss, much less adequately address (PBS NewsHour/Marist Poll, 2015;National Advisory Commission on Civil Disorders, 1968).
Social and health-related racial inequities are well-documented, and a host of efforts have aimed to address them over time; unfortunately, the inequities persist (Penman-Aguilar et al., 2016). The current understanding of social determinants of health confirms their central role in the production of disparities; however, most interventions continue to focus on individual-level factors and are thus ineffective at the population level (Golden & Earp, 2012). Multiple disciplines and community sectors have tried to address these complex issues, but each from its own paradigm (Somerville & Rapport, 2002). Any actions toward community improvement ethically and morally demand an authentic understanding of the lived experiences of the community. Confronting the complexity of issues is critical to developing effective solutions, and residents' experiences provide rich insight into the factors that drive widening social and health disparities. It is only through attending to these lived experiences that society will begin to see these as issues of the entire community, and it is only by engaging residents in the process of community change that social justice and equity will ever be achieved.
Photovoice is a participatory, arts-based action research method that gives voice to participants' experiences and perspectives while simultaneously facilitating critical consciousness-raising for social action and social change (Carlson, Engebretson, & Chamberlain, 2006;Carmen et al., 2015;Catalani & Minkler, 2010;Hergenrather, Rhodes, Cowan, Bardhoshi, & Pula, 2009;Seedat, Suffla, & Bawa, 2015;Wang & Burris, 1997;Wang, Yi, Tao, & Carovano, 1998;Watts & Hipolito-Delgado, 2015). Photovoice is a social change intervention mediated through changes in individuals' consciousness about the root causes of issues that affect them and their willingness to take action. The current study employed a Photovoice process to explore common experiences and perspectives in West Louisville, Kentucky and to bring participants together to facilitate collective dialogue and action leading to social change. The purpose of this paper is to amplify participants' stories, demonstrate the extent to which the knowledge they offer can inform social action, and illustrate the utility of Photovoice as a tool for understanding community experiences within an impoverished urban community.

Background
Inequity and injustice echo daily in communities across the country (Badger & Cameron, 2015). Louisville, Kentucky serves as an apt illustration. The city is a microcosm of the tensions between the current national dialogue regarding inequity and the daily lives of community members who are affected by inequity in a variety of ways. People who reside on the east versus west sides of Louisville-separated by only about 5 miles-have a difference in life expectancy of up to 15 years (Louisville Metro Department of Public Health and Wellness, 2014). While the east end of Louisville is a predominantly affluent, White population, West Louisville is predominantly African American (79% compared to 21% in Louisville Metro), with an overall poverty rate of 43 percent (compared to 17% in Louisville Metro), median household income of $22,170 (compared to $46,701 in Louisville Metro), and unemployment rate of 23 percent (compared to 10% in Louisville Metro;United States Census Bureau, 2015).
In West Louisville, an abundance of quantitative data is available from sources such as Louisville Metro Police Department, Louisville Metro Public Health and Wellness Center for Health Equity, and hospital emergency room admissions. Unfortunately, the dominant overarching narrative accompanying such data is that West Louisville is marked by blight produced by majority Black residents who facilitate and maintain self-contrived conditions. The content of this narrative may be due, in part, to a lack of qualitative data yielding explanations of the community's experience and their own understanding of their physical and sociopolitical environment. To effectively align initiatives with community contexts and needs, input from those who are negatively impacted by the structures in their own environments is paramount.
The need for this input was highlighted for Louisville in August 2014, when the shooting death of Michael Brown catalyzed civil unrest and protests across the world, including Kentucky. Social justice activism in Louisville increased, especially collective protests, community organizing meetings, and research. The newly-heightened visibility of local issues gave rise to substantial political will within city government to create and implement strategies to reduce violence and promote social cohesion. Within that context, the University of Louisville Office of Public Health Practice partnered with the Mayor's Office of Safe and Healthy Neighborhoods to facilitate a Photovoice project to explore four key themes previously reiterated across a variety of local community conversations: justice/injustice, safety/unsafety, hope/hopelessness, and racial equity/racism.

Methods
Grounded in Freirean philosophy, feminist theory, and documentary photography, Photovoice is a process by which participants, often marginalized or disenfranchised populations, can identify, represent, and enhance their community through a photographic technique (Wang & Burris, 1994;Wang & Burris, 1997). The three main goals of Photovoice are: 1) to enable people to record and reflect their community's strengths and concerns, 2) to promote critical dialogue and knowledge about important community issues through large and small group discussions of photographs, and 3) to influence policymakers to facilitate changes deemed necessary by the community (Hergenrather et al., 2009;Wang & Burris, 1997). Through their photos and dialogue, participants become catalysts for personal and community change (Wang & Burris, 1997;Wang et al., 1998).
West Louisville is a frequently targeted community for research within the city because of the social and health disparities that exist. This "overuse" has left many West Louisville residents wary and skeptical towards the university and its affiliates. Thus, in addition to the need for increased community input, historical mistrust of research and the university guided the selection of Photovoice methodology for this study; the adoption of a co-learning relationship with community partners ensures the community a meaningful voice in the process. Magnifying the voices of community members who often remain unheard is a hallmark of Photovoice methodology and is a proven strategy for working with vulnerable populations (Walton, Schleien, Brake, Trovato & Oakes, 2012).
While the experience of marginalized populations is often referred to in the literature as monolithic, using an intersectionality lens demands recognizing the vast diversity of individuals' experiences, even within the same population (Crenshaw, 1991). Although previous Photovoice studies have focused on single identity groups; this approach risks overlooking the diversity of experiences in the creation of a common narrative. To mitigate this risk, the research team engaged groups who identified with different sectors or identities within West Louisville. Each group participated in its own dialogue catalyzed by the photographs contributed, and members participated in the analysis of their narratives. Subsequent data analysis, interpretation, presentation, and social action, hinged on the synthesis of visual and qualitative data created by all study participants; this included feedback from participants and other community members during two community meetings tied to the public Photovoice exhibit. This inclusive process allowed the study to attend to differences in experience and perspective (for example youth compared to older adults), while also recognizing common themes across those diverse experiences that point the community toward possibilities for collective community action.

Researcher Stance
The research team includes one member who grew up in West Louisville, and others who work extensively in the community. Everyone on the research team is engaged in social justice and health equity research in West Louisville; most of the team work in an office in a West Louisville neighborhood, and a few attend church in West Louisville. Several researchers have lived in communities very similar to West Louisville, while others had not. The team represents diverse identities based on age, gender expression, race/ethnicity, socioeconomic background, and education. Throughout the duration of the project, the research team met weekly to reflect on our perspectives and experiences both personally and with the project, deliberate over potential biases in our approach and how to address them, and determine how best to sustain participant engagement.

Participants
The research team's networks of agencies, community organizers, community centers, and civic groups helped recruit participants who lived or worked within West Louisville for the Photovoice project. As mentioned, the team was intentional about engaging groups with identified with different sectors of identities within West Louisville to ensure the inclusion of broad experiences. These groups included Black men, community activists, faith leaders, residents who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), older adults, youth, single mothers, educators, police officers, social service providers, and business owners. Participants self-selected their identity group for the project, recognizing that intersectional identities existed within each group. A dedicated research team member recruited and facilitated each group, with participants committing to a minimum of four weeks between June 2015 and March 2016. The researcher explained the purpose of the project and participants' rights and documented consent. In addition, participants provided consent to utilize their photos and narratives in a public exhibit and for research.
Each individual also identified how they wanted to be acknowledged when crediting their productions (e.g., first name only, first initial and last name, initials only, pseudonym, etc.).
The research team recruited a total of 77 participants, and ultimately 43 individuals across eight groups completed the Photovoice project. The groups ultimately represented include: youth, older adults, LGBTQ people, faith leaders, educators, activists, and two groups of Black men-one specifically comprised of men who had been justice-involved or engaged in illegal activity. Despite substantial efforts to recruit individuals representing law enforcement, the research team could not overcome officers' reluctance to speak publicly on issues of justice and racial equity. Despite attempts to recruit social service providers and local business owners, scheduling proved prohibitive to their participation.

Procedures
The research team created a standardized recruitment and procedure guide, consent forms, and photo release forms approved by the University of Louisville Institutional Review Board prior to starting data collection. After explaining the purpose of Photovoice and the project itself, the research team member guided participants through the four tasks asked of them: (1) receive training regarding camera use and photography ethics, (2) take photos representing the themes of justice/injustice, safety/unsafety, hope/hopelessness, and racial equity/racism, (3) select and title three or four photos they would like to discuss, and (4) participate in a group discussion in which each participant narrates their photos and discusses photos taken by other group members. Participants were able to use their cell phones or digital cameras to take photos, or were provided a disposable 35 mm camera. Each week, the researchers followed up with participants via email or phone to check their progress and answer any questions.
Training. An important component of the project was participant training in two primary areas. Technical training focused on how to use the camera and its features and how to take a good picture. Training on power, ethics, and safety centered on Wang and Redwood-Jones' (2010) key ethical guidelines for taking a picture: obtaining consent and ensuring that that photo release forms are signed before taking pictures of individuals; understanding how being behind the camera is powerful; being respectful of people, places, and things that are photographed; being judicious about individuals shown in photographs; ensuring that a photograph fairly represents the real situation, subject identity, or physical location; ensuring the picture is represented in a way that does not harm individual(s) in the image; and maintaining personal safety (Wang & Burris, 1997). The research team member provided each participant a project information card that included key points for project training and participation, along with the purpose of the study, the themes, and general reminders. The entire training, conducted individually with each participant, lasted approximately 20 minutes.
Photos and Dialogue. Prior to scheduled group discussions, participants either emailed their photos to the researcher or turned in their disposable cameras to the researchers to develop the film. True to Photovoice methodology, each respective group met to discuss their photos and engage in dialogue. The purpose of this "root-cause questioning" is to identify the problem or asset, critically discuss the roots of the situation, and develop strategies for changing the situation (Wallerstein & Bernstein, 1988;Wang & Burris, 1997). After reviewing a variety of resources regarding Photovoice studies and the methodologies they employ (Carlson et al., 2006;Carmen et al., 2015;Catalani & Minkler, 2010;Hergenrather et al., 2009;Seedat et al., 2015;Wang & Burris, 1997;Wang et al., 1998;Watts & Hipolito-Delgado, 2015), the researchers used a modified version of Wang & Burris's questions to facilitate the discussions: • Tell us about this picture. • Does this picture speak to anyone else's experience? • Why does this [situation, problem, strength] exist? • How can we become empowered by our understanding of this?
• What can we do?
During the group dialogues, the facilitator projected the photos, and each participant engaged in the contextualizing stage of Photovoice, sharing their stories about what the photographs meant (Wang et al., 1998). The facilitator then guided an iterative reflection process in which the participants identified themes they found significant within their current dialogue. The discussions were audio-recorded, and the audio files were transcribed for analysis. In addition, the facilitator asked each participant either to select an excerpt of the transcript narrative or provide a written narrative to accompany their pictures, some of which were ultimately displayed in the project's culminating public exhibit.

Public Exhibit
Upon hearing about the West Louisville Photovoice Project, the director of the Kentucky Center for African American Heritage (KCAAH) approached the research team to explore partnering to exhibit the community's work. This manifested in a collaboration that created exhibit space for the project, which participants named "Yet We Live, Strive, and Succeed." Admission to KCAAH is free, and the Center is a popular event venue; this increased the feasibility for community members across Louisville to view the exhibit.
The physical exhibit launched in August 2016, consisting of 35 photos and narratives collectively selected by participants. A participatory opening event introduced the exhibit to the community with music, spoken word performances by community members, and interaction from researchers who shared with attendees the overarching themes. The exhibit was initially slated to conclude in late September 2016; however, various community organizations requested that it remain open (ultimately through spring 2018) to allow incorporation of the exhibit into local meetings and events at KCAAH thus broadening exposure. In the same venue in October 2016, a follow-up community meeting focused on prioritizing actions based on the knowledge generated by project participants and the exhibit.

Analytic Strategy
Qualitative research is exploratory by nature and seeks to find meaning within a particular context. In Photovoice, the participants serve as the main instruments of data collection, which implies that the participants (and the researchers) use an interpretive lens to collect and analyze data. While the data collection and analysis process is flexible, the process must be systematic, organized, and documented to ensure credibility, dependability, and trustworthiness of the results presented. In Photovoice, there is considerable overlap between data collection and data analysis. In fact, Wang and Burris (1997) propose three primary ways of carrying out participatory analysis of data: selecting photographs; contextualizing; and codifying. This three-stage process was based on Freire's (1970) concept of promoting critical consciousness among the participants and audiences who will view the photos, narratives, and analysis of the project.
Participants individually selected which photos to share with their group and contextualized their photos at the outset of discussion. The process of codifying photos occurred during the group dialogue and again after the narrative for each discussed photo had been extracted from the audio recording and validated by the respondent. During the group dialogue, participants were asked to make note of key themes that seemed to be emerging in photos and conversation; a group discussion of these themes then occurred at the end of the dialogue. This allowed the participants to reflect on the conversation in its entirety and articulate the common elements or distinct contrasts they perceived important. The culminating exhibit highlighted these articulated themes.
Subsequently, the research team used a content analytic approach to examine the narratives of each participant group and all participants together as one collective, specifically highlighting representations of justice/injustice, safety/unsafety, hope/hopelessness, and racial equity/racism in West Louisville. Analysis began with initial coding of text segments from participant narratives, followed by an iterative process of grouping and re-grouping in order to identify emergent themes, accounting for themes identified by each group during its respective discussion. In addition to thematic analysis, facilitators' field notes identified recurring themes that arose from group dialogues and from supplemented participant narratives for accompanying photos. Throughout the overall analysis, researchers paid specific attention to identifying similarities and differences among narratives. Subsequent analysis focused on identifying relationships among ideas presented in the narratives, which generated major themes. The research team presented these themes to participants and other community members at the August opening event and following community meeting and facilitated dialogue to gather feedback regarding accuracy of the analysis.

Results
Despite varied experiences within and across the groups, the overall analysis yielded four common themes. The results presented below represent the comprehensive analysis across all participant groups and are organized by the identified themes.

Theme 1: Systemic Inequalities are Apparent and Oppressive in West Louisville
Participants consistently expressed experiencing systemic inequality in West Louisville, including institutionalized racism and white supremacy that have resulted in what participants describe as a "culture of hopelessness." For example, the activists' group noted that institutionalized racism and white supremacy are evident in Louisville's structures and in the county's very name. Memorials to Thomas Jefferson, for example, and the naming of "Jefferson County," presents colonialism in "a positive frame" that disregards the genocide and slavery its "successes" required. The photo and caption from a local activist in Figure 1 highlight this sentiment.
Another activist noted that men such as Jefferson and King Louis XVI (after whom Louisville is named) continue to be venerated without acknowledgment that they were "abusive, womanizing, disrespectful, rac-ist…" The result is that Louisville celebrates figures and events that exclusively benefited white people while actively harming people of color. That this continues to be the case-without criticism or disclaimers from those in positions of power-appeared to participants to indicate systemic failure to value the experiences of residents of color, both historical and current.
Institutionalized racism was further observed in education. While structures and memorials are visible and highlighted for Louis XVI and Thomas Jefferson, those honoring people of color are hidden in plain sight. For example, a youth participant mentioned that he attended a school named after Lyman T. Johnson, saying, "He was like, the first Black man to go to UK [University of Kentucky] … and I didn't know that until my grandmother told me." Significantly, this participant emphasized that knowing where "my ancestors come from … makes me want to try harder," and several participants identified the power in learning their history (see Theme 4). Thus, the failure to value Black history enough to ensure students know about their own school's namesake may perpetuate oppressive conditions. As one activist noted, the failure to include Black, Latinx, and Asian histories in school curricula sends the message to youth of color that the "only thing to ever happen in the whole wide world was Europe and America. That's all you need to know." Systemic inequalities also came up with regard to Zero Tolerance policies in schools and the criminal justice system-those that incur harsh minimum penalties at the first offense. Faith leaders criticized punitive school policies for ignoring the root causes of behavioral issues that disproportionately affect Black youth. By failing to equip Black youth with the tools necessary to handle difficult emotions or experiences, Zero Tolerance policies ensure that youth who experience and react to trauma are disproportionately suspended, expelled, or sent to alternative schools, which funnels them into the school-to-prison pipeline rather than receiving the support they need to thrive. Subsequent involvement with the justice system, one group of So, this is right there in front of city hall and the mayor's office and you know that little government complex area, the jail, the court, police station, all that stuff is right there. And I actually stood in the dirt where the flowers were, like I walked into someplace I wasn't supposed to walk to take this picture cause I wanted to get the Jefferson County historical marker and Jefferson in the same picture. Our county is Jefferson County and Thomas Jefferson did some horrible things…horrible things to like, all sorts of brown people like, that was kinda like his legacy. His legacy was…he was like a slaveholder and he had that weird relationship with one of his slaves, a teenager, and that's the PROUD legacy of Jefferson County, and it's just disgusting to me that he is standing there in front of everything, and we're supposed to celebrate… let's celebrate these white men who abused millions of human beings…Celebrate Thomas Jefferson and Jefferson County cause he came here and made it great for all the white people you know. Fuck you! How dare you, how dare you make me feel like I need to celebrate you and all the poison that you have put into the lives of the people I care about. Like, no, how dare you! Black men argued, leads only to more recidivism, because the criminal justice system teaches, reinforces, and benefits from criminal(ized) behavior among Black male youth.
Finally, systemic inequality was evident in the city's approach to health care and drug use. For example, one participant in the Black males group noted that Louisville's needle exchange was not available until addiction began affecting white residents. "When the Black people was down here melting down this shit and shooting it in their veins," he said, "there ain't no free needles." This is also apparent in the difference in language between the "War on Drugs" in the 1970s and '80s-aimed at the crack cocaine that had become part of the economy of urban African American communities-and the "Public Health Crisis" in the 2010s, which addresses heroin and opioid addictions that largely affect Whites.

Theme 2: Those Who have Power in the City do not Care about West Louisville -or Black Lives
Systemic inequalities were also perceived in the contrast between the way the City of Louisville interacts with "the West End," which is predominantly Black, and the way it interacts with "the East End" and other areas of the city that are predominantly White. This disparity in treatment came up in every group discussion, usually offered as evidence that the city does not care about West Louisville-which consistently translated to a sense that the city does not care about Black people. For example, every group submitted photographs of neglected properties, which are pervasive in West Louisville. In discussing the adverse psychological and emotional impact of these properties, participants consistently noted that such conditions "wouldn't be tolerated on the East End. " Figures 2 and 3 portray examples of the photos of neglected properties submitted. This photo represents hopelessness. Hopelessness deals with the breaking of the mind, the body, and the spirit. It doesn't just deal with one aspect; we are working with all three aspects of youth and environment. The environment is tearing down their mind, body, and spirit, therefore we can't focus on just one area; we must work on all areas to be successful, especially with the youth today. The bars symbolize total hopelessness because it breaks the mind, the body, and the spirit of the individual, which emphasizes the need to invest in our youth. It is common for those who are oppressed to engage in personalization and self-blame…Individuals of every age need to believe that they can be shapers of the story of their life. When that need is thwarted, when one feels incapable of navigating one's way toward desired goals, a feeling of powerlessness can set in.
Faith leaders argued that the city's failure to muster the political will to address West Louisville's abandoned properties-in contrast to its ability to better maintain other areas of the city-causes and perpetuates West End residents' distrust. In addition, several groups expressed a desire to take ownership and turn abandoned properties into thriving spaces, and many shared their experiences of having actively attempted to do so. However, current systems have prevented moves toward resident or community ownership. Faith leaders said, "There is so much red tape," while others related experiences with city leaders who seemed eager to meet with them and help, but ultimately failed to act. In short, the city has failed to demand ownermaintenance of West Louisville properties, while the consequences of this failure-including depression and hopelessness, continued poverty, and violence-are felt not by property owners or city officials but by West Louisville residents who have no recourse.
Importantly, participants' prevailing sense that "it wouldn't take much" for the city "to make good use" of vacant properties seems to have intensified the despair and anger associated with them. Because participants perceive improved housing policies on the West End as relatively simple city actions-"It could be cleaned up. The city got enough money to do it. It's just not."-the city's failure to act underscores the participants' sense that West Louisville simply does not matter to the city. Given the segregation and redlining that led to a predominantly Black population in the West End, participants readily connected the city's lack of concern for West Louisville to historical and systemic racism. "We're treated like second-class citizens," one activist noted, "and for what? The color of our skin, not the content of our character." Others noted that these circumstances are precisely the reason the "Black Lives Matter" movement is necessary: "Apparently, some folks think that Black lives don't matter so much, so there needed to be a calling card to say, 'You are all wrong…This needs to change.'" Participants also noted that the city's failure to value West Louisville and Black lives can be seen in media portrayals of their community. For example, an LGBTQ participant argued that positive aspects of West Louisville including parades or bucket shakes never get coverage; "but if somebody gets shot, you hear about that." Similarly, a youth participant noted that "people in the community want the positives [about West Louisville] to be recognized, but media and stuff don't want you to see the positives." One group of Black men again echoed this, saying, "the media tells you about killings, but they don't tell you about several people who have came out of the neighborhoods and did well." Instead, West Louisville is regularly portrayed on the news as dangerous-its residents either criminals or victims. Such reductive media portrayals function to "other" West Louisville and its residents, who are rarely portrayed as valuable, relatable, and community-oriented individuals with whom all Louisville residents could partner for improved city health and well-being. The ongoing representation of West Louisville as an isolated, problematic community has fostered participants' sense that they do not matter. When you see a structure that was once a beautiful home, but is now a shell of its former self, one cannot help but to feel a sense of hopelessness. I remember seeing this building…daily when I was growing up in West Louisville. It was lively, full of life and a staple in the neighborhood. Now it looks as though a bomb has been dropped on it. You have to ask, "Would this be allowed to happen to a home in the Highlands, Crestwood, or Indian Hills?" The likely answer is no. Now ask yourself "why is that?"

Theme 3: Despite the Rest of the City's Ambivalence, Black Lives and Black History Matter
While all groups expressed a sense that West Louisville residents (and, in conjunction, Black lives) do not matter to the City of Louisville, they were very clear that Black lives-and West Louisville-do matter. This was evident in participants' encouragement of the active and explicit valuing of Black lives; for example, one activist shared her desire to "put Black Lives Matter stuff up in the hood and say 'you're important, love yourself.'" She mentioned the need "to love each other as Black people and loving everything about ourselves as Black." Additionally, activists suggested that young people need parents who communicate to them that "they lives matter." Figure 4 shows a memorial to a young Black man killed by police in West Louisville. Like the above-mentioned youth who was inspired by knowing Lyman T. Johnson's story, many participants connected self-love to a knowledge of their history; indeed, these two ideas were almost always intertwined. A participant in one of the Black men's groups stated, "There's strength in where I came from… [T]he majority of us don't know our history…we don't have accurate knowledge of self, and therefore, we devalue ourselves." Similarly, the groups noted that often, Black men and women "are gifted, but we don't know who we are, so we throw our gifts…away." Such self-devaluation manifests as materialism; one participant in the Black men's group claimed that youth tend to be "defined by what's on your back" because they are unable to love themselves.
Because participants connected Black self-love-as well as a sense of meaning and purpose-so deeply to knowledge of Black history, many of them critiqued the lack of access in West Louisville to the truth about Black history and Black lives. For example, one participant in the Black men's group argued that young people "ain't getting the truth about who they are, and nothing they can apply to their lives right now to help better them." This was connected by several participants to historically racist systems and policies that segregated the city and molded educational curriculum while purposely preventing Black access to opportunity and improvement. In other words, current West Louisville conditions can be traced to historical practices. Activists also argued that youth are "indoctrinated" via a curriculum that excludes most of Black history while offering a "pretty selfie" version of White America's past. An accurate knowledge of their history, an activist claimed, would help Black residents to "feel empowered enough" to have and honor their own heroes. Another activist asked, "Why is it that we don't try…putting up billboards with famous Black people…and have different things up under [it] that explains that you come from so much greatness…that you don't have to feel like you ain't shit?" Many participants also mentioned the need to change harmful mentalities among West Louisville residents, particularly youth. These included the mentality that one must retaliate when disrespected, that violence and prison are "badges of honor," and that "everything negative is cool" while "all the positives are really negatives, [like] go[ing] to school, [or] if you're respectful." One participant noted youths' mentality of being in competition with one another, and thus unable to celebrate one another's successes. Others mentioned residents' mentality that "you'll never really own anything…you'll always be a renter"-which affects how (and whether) residents care for their properties and for themselves. This is connected to the youth mentality of "tear[ing] up anything good that's brought in," which is "learned behavior." Participants noted that it is a cultural norm in West Louisville to not plan for the future, to litter or see trash everywhere, and essentially to disrespect the community. These mentalities were often traced back to the despairing effects of the environment on residents, and the lack of love and meaning that results from not knowing one's history and value. In addition, this may be related to the perception that the city does not care about West Louisville, so residents do not see a reason to invest their energy in caring for their neighborhood either.
Importantly, participants not only felt that Black West Louisville residents lack the truth about their history (and thus about their identities), but also that White residents across the city lack the truth about Black history-and thus about their own identities. This shared lack of knowledge contributes to ongoing failures to address the institutional and systemic roots of the issues facing West Louisville.

Theme 4: Collective Community Action is Needed
The demands in Theme 3 for better communication of Black history and Black love all were raised in conversations about collective community action in West Louisville. Because participants traced hopelessness and violence in the community to the nihilism engendered by West Louisville's aesthetics and to residents' sense that they lack individual and civic agency ("I can't do anything about it"), many community action conversations centered on things like cleaning up and choosing not to litter. They discussed the need to "take ownership for what's happening and whatever change is going to be made because… [the city] got different agendas." Faith leaders suggested that residents learn to care not only for their own properties, but also for those of their neighbors, because "no one will [take care of it] if we don't for ourselves." The group of older adults provided an example of this, describing a little league coach who takes care of the practice field with his personal mower. Similarly, the activists noted that everyone must become involved in improving the community-because "if my brother is suffering, I am suffering." Figure 5 illustrates a place of hope created within the community, by the community. where we established another community garden. The theme of this picture is safety and hope. We hope that our kids can grow in a great environment (soil) so that they may sprout into incredible human beings (flowers) safely and securely so that they may pass it on to their offspring. We strive hard and feel like we bend over backwards to get things the way we know our community needs them, all in the effort of a "budding future." Discussions regarding community action also included providing new and necessary resources; as a hopegiving example, one activist cited the building and placement of mailbox-style "little libraries" throughout West Louisville. Others argued that residents should provide childcare for one another so that parents have more opportunity for education, work, and activism. Another suggestion for community action included better education for youth regarding their career options after high school. According to one of the faith leaders, West Louisville youth think they are going to "go pro" with sports or music, and thus "get out" or "make it" -but "the numbers just won't pan out." This is emphasized in Figure 6.
Similarly, a participant in one group of Black men claimed that "[w]e got to change the way these kids think…to let them know what's actually important and that [there's] life after sports, too." Participants expressed the need for youth to be exposed to multiple opportunities, so they can find something that captures their interest and at which they excel. "They don't even understand the plethora of jobs that exist or work to do or even using their own creativity," one activist argued. However, this work for and with West Louisville youth must be realistic. One participant in the Black men's group argued that "ain't nobody" want to be 18 years old, working for minimum wage, "bring [ing] home, what? $250?" He felt that young people will not take such a job unless they see how it is going to "build you in the workforce." Figure 6: Young Dreams, High Stakes. Submitted by S. Shabazz. This is where my heart was at one time, because I was one of those children that was taught that if "you run that football, you are going to make it out of here (the ghetto A related aspect of community action centered on meeting youths' need to be accepted and supported. For example, the faith leaders discussed at length the need for youth to have somewhere to go where they can know, "Whatever your need is, we're going to be there for you." One group of Black men similarly argued that youth need places where they feel welcome and unthreatened: where "no matter what color, what race, what size, who you are, you can be you in that area." A LGBTQ participant noted that the "injustice of our community is that everything that I had to make me feel hopeful and safe was based on substance abuse and partying." A group of Black men also lingered on the need for youth to have "somewhere to go. They don't got no games. You won't let them go to no parks. You shut that down on them. They can't hang out, just chill…" Others emphasized the importance of being dependable mentors: if youth "know you going to be there," one participant argued, "then [they] start listening to you." It was clear from group discussions that progress in West Louisville requires active investment in young people by teaching them their history, expanding their career options, and providing mentorship, activities, safe spaces, and valuable employment.
Participants also expressed a desire to address substance abuse in West Louisville. Most groups in some way acknowledged this as a problem in their community, regularly tracing it to hopelessness. Because of this, the activists argued that instead of criminalization, the community needs "therapists or social workers or psychologists" to help residents "get to a place where they feel they don't have to use the drugs or drink the alcohol." One of the older adults mentioned that those who "live on corners drinking all day" are often referred to as "a waste," indicating that the community has given up on many of its residents-and that it needs improved support. A LGBTQ participant recounted, "the only thing that I had [as a teenager] was the party scene. That is all that was there. All you had to look forward to." Participants also noted that drugriddled areas can be self-perpetuating: when "it's been the same for so long" and so "in-your-face," residents stop caring that drugs are being dealt on the corners where they live. Again, substance abuse was repeatedly connected to hopelessness and lack of self-love, which participants traced to the state of West Louisville, its lack of support from the city, and the need for better education and support networks.

Discussion
Several findings emerged over the course of the West Louisville Photovoice Project that may be beneficial to others interested in utilizing this participatory method to both understand and empower communities. The study enhanced the research team's understanding of the community, as well as its assets and needs. Hearing participants' unfiltered, first-hand accounts of their experiences enlightened local knowledge about what they need and want. For the community, it provided an opportunity to mobilize through a facilitated process of thinking through community strengths and weaknesses, networking, and raising critical consciousness-which leads to community empowerment (Freire, 1970). In addition, the process helped build critical consciousness among participants which points to potential avenues for change.
The purpose of this Photovoice project was to document the experiences and perceptions of safety/unsafety, hope/hopelessness, justice/injustice, and racial equity/racism among a diverse group of individuals who live or work in West Louisville. These concepts helped participants focus on experiences and perspectives that could provide insight into widespread violence in the community. Despite different experiences, what emerged were clear and cohesive narratives across nearly all photos and discussions.
One important element to note is the consistency of perspectives across different groups in the community. Community members and those who work in the community were consistent in their belief that West Louisville is a neglected area of the city. Each group conveyed distinctly that this neglect creates space for hopelessness that only further perpetuates the neglect in varying ways. They shared a profound sense that the neglect and presence of hopelessness in West Louisville is rooted in racism, which was another important concept to understand in relation to this community.
The effects of racism -both historical and systemic -are detrimental to the community in many aspects of life (Bonilla-Silva, 2018). A wealth of research illustrates the effects of racism on individuals and communities; it negatively impacts physical and mental health, reduces productivity, and impedes progress on a societal level (Williams, 1999;Williams & Williams-Morris, 2000;Williams, Neighbors & Jackson, 2003;Paradies, 2006;Nazroo, 2003). As discussed, West Louisville has some of the worst health outcomes, is economically underserved, and experiences some of the highest crime rates within the city (Center for Health Equity, 2017). While racism was the least explicit theme chosen for photos by participants, the group dialogues around the other themes were each rooted contextually in racism. So even though a photo may have been given the theme of hopelessness or injustice, racism was explained or identified in the photo's description or discussion. The existence and acceptance of both historic and systemic racism by those with power only further compounds the issues within the community, according to participants. While the community believes that racism should be addressed, they are also aware of the impediments to such progress.
There exists a juxtaposition within the community between being hopeful and believing change is possible and accepting hopelessness and despair due to decades (centuries) of injustice. Many participants discussed wanting to see change and wanting to be a part of the change, but also being apathetic about engaging in the change process because things have been wrong for so long. Some feel like the power structures under which they exist continually and purposefully facilitate racism and discrimination. Participants spoke about the local context and the history of how issues are handled in West Louisville; they mentioned that despite the existence of political will, it is not mobilized in the community. The circumstances of the community make it hard to mobilize, and there are not enough resources made available for improvements. Community members feel this is strategic and purposefully done in an effort to keep the community in a dilapidated state, which again is tied to the belief that the city does not care what happens in West Louisville because it is predominantly Black.
Having conversations about racism in this country has historically been controversial (Bonilla-Silva, 2018). Discussing the existence of discrimination currently has the U.S. divided between Black Lives Matter versus All Lives Matter, forcing a choice between a false dichotomy (Gallagher, Reagan, Danforth & Dodds, 2018). In analyzing the transcripts from the group dialogues, some of the content resulted in discomfort from the harshness of participants' lived realities, even for members of the research team. In reflection, it is important to acknowledge the need to consciously fight the inclination to filter or soften the language used by participants. There is a moral obligation to raw honesty in this project with the hope that acknowledging and elevating the visibility of these experiences will create space for conversations around the ugly truths that go unheard and contribute to the suffering of historically marginalized populations.
Simply put, any action toward community improvement demands an authentic understanding of the lived experience of community. Community members have to be recognized and valued as experts of their lived experience and of their communities. If the desire is indeed to improve the health and well-being of a particular population, it is important to listen to community residents and respect their roles as co-experts, coteachers, and co-generators of knowledge. In West Louisville, the community dialogues identified racism as a root cause of a variety of issues that many city entities seek to address. If the desire is to see improvements within the West Louisville community, a focus on racism and understanding the community's experiences of it must be a priority.
Issues of racism and injustice are not just West Louisville issues; they belong to the entire community and will require the entire community to resolve them. Multiple city leaders attended the public exhibit while it was on display, including representatives from the Mayor's office. The director of the city's Center for Health Equity found the exhibit compelling and requested to display some of the photos and narratives as part of a local policy summit. The summit, "My Dream for Lou," engaged people from all over the city. Interestingly, across all four topic tracks, racism emerged as a common theme, and participatory budgeting a common recommendation for policy action. Currently, Louisville is taking steps to address these recommendations by pilot testing a participatory budgeting process in two city council districts, one of which is in West Louisville. This is promising, as accurate planning and mobilization strategies in West Louisville require an understanding of the contexts and origins of existing problems. Meaningful community engagement should thus be a priority-not only in identifying problems, but in problem framing, strategizing, implementing, and evaluating the effectiveness of solutions.
Despite the depth of content in our qualitative findings, it is important to acknowledge several limitations in the current study. As mentioned, not all sectors of the community were represented among the participants. However, this type of study is not intended to produce generalizable findings, and the information discovered regarding both process and content was extremely valuable. In addition, we experienced substantial attrition once the project started. Seventy-seven participants were initially recruited, but only 43 completed the study. The time demand for taking photos and engaging in a group dialogue proved to be prohibitive for some, which is understandable given the context. For example, many work multiple jobs or are caring for dependent children or elders. Finally, although each group conducted its own analysis, participant engagement in the overarching analysis was limited to feedback at the exhibit launch.

Conclusion
The West Louisville Photovoice Project enabled local residents to give voice to their lived experience in a public forum, adding their voices to the local conceptualization of issues that need to be addressed. This methodology provides valuable insight into community perspectives; the unfiltered content reduces the risk that researchers will misinterpret or project their perspective onto participants' narratives. The results characterize commonalities across West Louisville participants' perceptions of the city in which they livedespite very different lived experiences among them, presenting a message that has largely gone unheard among city leadership. When residents share their experiences, and are heard by those with resources and decision-making authority, a foundation is created for raising critical consciousness in the community and igniting collective action to increase justice, safety, hope, and racial equity.