Critical Race Theory, Race Equity, and Public Health: Toward Antiracism Praxis
Open accessAbstract
Racial scholars argue that racism produces rates of morbidity, mortality, and overall well-being that vary depending on socially assigned race. Eliminating racism is therefore central to achieving health equity, but this requires new paradigms that are responsive to structural racism's contemporary influence on health, health inequities, and research. Critical Race Theory is an emerging transdisciplinary, race-equity methodology that originated in legal studies and is grounded in social justice. Critical Race Theory's tools for conducting research and practice are intended to elucidate contemporary racial phenomena, expand the vocabulary with which to discuss complex racial concepts, and challenge racial hierarchies. We introduce Critical Race Theory to the public health community, highlight key Critical Race Theory characteristics (race consciousness, emphases on contemporary societal dynamics and socially marginalized groups, and praxis between research and practice) and describe Critical Race Theory's contribution to a study on racism and HIV testing among African Americans.
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In recent years, anti-racist efforts have emerged within public health that more thoroughly integrate critical race theory into methodologies and discourse.
“In recent years, anti-racist efforts have emerged within public health that more thoroughly integrate critical race theory into methodologies and discourse [35, 36].”
From Towards a critical race methodology in algorithmic fairness (2020) · cites this paper as [36]
The PHCR praxis is an extension of CRT that infuses CRT tenets with public health practices through four identified focuses and ten guiding principles.
“The PHCR praxis is an extension of CRT, as it infuses CRT tenets with public health practices through four identified focuses and ten guiding principles that imitate and expand upon the original CRT tenets (23, 24).”
From Exploring public health education’s integration of critical race theories: A scoping review (2023) · cites this paper as [24]
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“Critical race theory also provides a framework for analyzing varying experiences of perceived discrimination and medical mistrust, by presenting race as an indicator of racism-related exposures [20].”
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Breaking down the monolith: Understanding flu vaccine uptake among African Americans
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BackgroundResultInfluentialConceptualising fairness: three pillars for medical algorithms and health equity
Sikstrom, L., Maslej, M. M., Hui, K., Findlay, Z., Buchman, D. Z., & Hill, S. L. (2022) · BMJ Health & Care Informatics · doi:10.1136/bmjhci-2021-100459 · Cited by 76 · see citing works
Experiences of Racial and Ethnic Discrimination Are Associated with Food Insecurity and Poor Health
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“While there is ample evidence of persistent racial and ethnic health disparities, there are methodological weaknesses in the conventional public health approach—namely, its emphasis on individual mechanisms rather than the subtle and systemic ways racism shapes access to opportunities in education, employment, housing…”
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“These might include systems science (44), syndemics (114), critical race theory (42, 43), life course approach (62), intersectionality (50), feminism (28, 108), and chaos and complexity theory (103, 121).”
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Castle, B., Wendel, M., Kerr, J., Brooms, D., & Rollins, A. (2019) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-018-0494-x · Cited by 81 · see citing works
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“For example, qualitative methods could be informed by or could apply, test, and refine theories that center health equity or racial equity, including Public Health Critical Race Praxis (40, 41) or theories of structural violence (128, 132).”
MethodRebchook, G., Keatley, J. G., Contreras, R., Perloff, J., Molano, L. F., Reback, C. J., Ducheny, K., Nemoto, T., Lin, R., Birnbaum, J. M., et al. (2017) · American Journal of Public Health · doi:10.2105/ajph.2016.303582 · Cited by 67 · see citing works
Clark, E., Cranston, E., Polin, T., Ndumbe-Eyoh, S., Macdonald, D., Betker, C., & Dobbins, M. (2022) · BMC Public Health · doi:10.1186/s12889-022-14603-w · Cited by 64 · see citing works
Duarte, C., Moses, C., Brown, M., Kajeepeta, S., Prins, S. J., Scott, J. T., & Mujahid, M. S. (2022) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.14922 · Cited by 64 · see citing works
Slopen, N. B., & Heard‐Garris, N. (2021) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2021.3594 · Cited by 62 · see citing works
Hood, A., Booker, S. Q., Moraís, C. A., Goodin, B. R., Letzen, J. E., Campbell, L. C., Merriwether, E. N., Aroke, E. N., Campbell, C. M., Mathur, V. A., et al. (2022) · Journal of Pain · doi:10.1016/j.jpain.2022.01.008 · Cited by 68 · see citing works
“41 Terminology and language choices in this 3-part series have been deliberately chosen to reduce harm.”
Doll, K. M. (2018) · Gynecologic Oncology · doi:10.1016/j.ygyno.2017.10.002 · Cited by 66 · see citing works
COVID-19 Vaccine Hesitancy and Experiences of Discrimination Among Black Adults
Willis, D. E., Andersen, J. A., Montgomery, B. E. E., Selig, J. P., Shah, S. K., Zaller, N. D., Bryant‐Moore, K., Scott, A. J., Williams, M. L., & McElfish, P. A. (2022) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-022-01290-x · Cited by 63 · see citing works
“Additionally, our focus on Black adults is consistent with Public Health Critical Race (PHCR) Praxis which encourages exploring the diversity of experiences and attitudes among marginalized groups, challenging assumptions of homogeneity that exacerbate stereotypes and shifting the focus from race to racism [19, 24, 25…”
BackgroundExploring How Substance Use Impedes Engagement along the HIV Care Continuum: A Qualitative Study
Gwadz, M. V., de Guzman, R., Freeman, R., Kutnick, A. H., Silverman, E., Leonard, N. R., Ritchie, A. S., Muñoz-Plaza, C., Salomon, N., Wolfe, H. E., et al. (2016) · Frontiers in Public Health · doi:10.3389/fpubh.2016.00062 · Cited by 60 · see citing works
Akinade, T., Kheyfets, A., Piverger, N., Layne, T. M., Howell, E. A., & Janevic, T. M. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.114983 · Cited by 61 · see citing works
Changes in Racial Disparities in Mortality After Cancer Surgery in the US, 2007-2016
Lam, M. B., Raphael, K., Mehtsun, W., Phelan, J., Orav, E., Jha, A. K., & Figueroa, J. F. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.27415 · Cited by 57
Identifying and Treating Race-Based Trauma in Counseling.
Hemmings, C., & Evans, A. (2018) · Journal of Multicultural Counseling and Development · doi:10.1002/jmcd.12090 · Cited by 58 · see citing works
Participatory health research with migrants: Opportunities, challenges, and way forwards
Roura, M., Dias, S., LeMaster, J. W., & MacFarlane, A. E. (2021) · Health Expectations · doi:10.1111/hex.13201 · Cited by 66 · see citing works
Retention of faculty of color in academic nursing.
Hamilton, N., & Haozous, E. (2017) · Nursing Outlook · doi:10.1016/j.outlook.2016.11.003 · Cited by 56 · see citing works
Haight, S. C., Daw, J. R., Martin, C. L., Sheffield-Abdullah, K. M., Verbiest, S., Pence, B. W., & Maselko, J. (2024) · Health Affairs · doi:10.1377/hlthaff.2023.01434 · Cited by 59 · see citing works
“37,38 Rather, interpersonal and structural racism experienced by groups that have been historically marginalized increases stress, weathering, and allostatic load, which can increase depressive symptoms, 39,40 a process that has been demonstrated in the perinatal period.”
Residential Structural Racism and Prevalence of Chronic Health Conditions
Mohottige, D., Davenport, C. A., Bhavsar, N. A., Schappe, T., Lyn, M., Maxson, P. J., Johnson, F., Planey, A. M., McElroy, L. M., Wang, V., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.48914 · Cited by 58 · see citing works
Diversified innovations in the health sciences: Proposal for a Diversity Minimal Item Set (DiMIS)
Stadler, G., Chesaniuk, M., Haering, S., Roseman, J., Straßburger, V. M., Martina, S., Aisha-Nusrat, A., Maisha, A., Banas, K., Borde, T., et al. (2023) · Sustainable Chemistry and Pharmacy · doi:10.1016/j.scp.2023.101072 · Cited by 60 · see citing works
Tsai, J., Lindo, E., & Bridges, K. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.653643 · Cited by 55 · see citing works
“Importantly, CRT is not only interested in scholarship for scholarship’s sake; It is committed to action that advances social equity (66, 67).”
BackgroundWong, S., Gishen, F., & Lokugamage, A. U. (2021) · London Review of Education · doi:10.14324/lre.19.1.16 · Cited by 90 · see citing works
“Through the lens of critical race theory, systemic racism is preserved through the false attribution of health disparities to racial difference, concealing how ethnic minority populations are disadvantaged by broader sociopolitical determinants of health (Brown, 2003; Ford and Airhihenbuwa, 2010; Jensen et al., 2020;…”
BackgroundRacial/Ethnic and Socioeconomic Disparities in Osteoarthritis Management
Reyes, A. M., & Katz, J. N. (2020) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2020.09.006 · Cited by 55 · see citing works
Sexual health among U.S. black and Hispanic men and women: a nationally representative study.
Dodge, B., Reece, M., Herbenick, D., Schick, V., Sanders, S. A., & Fortenberry, J. (2010) · Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02019.x · Cited by 55
Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021
Casey, J. A., Daouda, M., Babadi, R. S., Do, V., Flores, N. M., Berzansky, I., González, D. J. X., Horne, Y. O. V., & James-Todd, T. M. (2023) · Current Environmental Health Reports · doi:10.1007/s40572-023-00406-7 · Cited by 62 · see citing works
Grounding implementation science in health equity for cancer prevention and control
Adsul, P., Chambers, D., Brandt, H. M., Fernández, M. E., Ramanadhan, S., Torres, E., Leeman, J., Baquero, B. I., Fleisher, L. G., Escoffery, C., et al. (2022) · Implementation Science Communications · doi:10.1186/s43058-022-00311-4 · Cited by 66 · see citing works
“In fact, to effectively “design for dissemination” intervention researchers and/or program developers must assess, document, and address realworld needs, assets, and contextual realities of priority populations through consistent participatory engagement and co-learning [37, 83].”
BackgroundPayne-Sturges, D., Gee, G. C., & Cory‐Slechta, D. A. (2021) · Environmental Health Perspectives · doi:10.1289/ehp8186 · Cited by 71 · see citing works
Artificial Intelligence and Medical Humanities
Ostherr, K. (2020) · Journal of Medical Humanities · doi:10.1007/s10912-020-09636-4 · Cited by 68 · see citing works
- Authors
- Ford, C. L., & Airhihenbuwa, C. O.
- Affiliations
- Pennsylvania State University (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2010-04
- Volume
- 100
- Issue
- S1
- Pages
- S30-S35
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC2837428
- OpenAlex
- W1965164285
- Cited by
- 995
- References
- 38
- Citations by year
- 2026: 54 · 2025: 91 · 2024: 107 · 2023: 126 · 2022: 160 · 2021: 150 · 2020: 81 · 2019: 43 · 2018: 38 · 2017: 40 · 2016: 18 · 2015: 29 · 2014: 23 · 2013: 14 · 2012: 9
- FWCI
- 34.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- University Libraries (University of Maryland) (submittedVersion)
- Digital Repository at the University of Maryland (University of Maryland College Park)
- Funders
- W.K. Kellogg Foundation
- Center for AIDS Research, University of Washington
- National Institute on Minority Health and Health Disparities
- UCLA AIDS Institute
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Sociology and Political Science › Critical Race Theory in Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Race, Genetics, and Society
- Keywords
- critical race theory, racial equity, anti-racism, structural racism, health equity, HIV testing, African Americans, racial consciousness, marginalized communities, racial hierarchy
- MeSH terms
- Humans, Models, Theoretical, Prejudice, Public Health, United States, Racial Groups, Health Status Disparities
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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