The public health critical race methodology: Praxis for antiracism research☆
Introduction
A growing body of research applies conventional scientific methods to the study of racialized risk factors and populations. The aim of this research is to explain relationships between racism and health disparities. Although it advances understandings of racism as a social determinant of health, this work is largely disconnected from Critical Race Theory (CRT), the most dominant influence on racial scholarship since the 1980s. Reasons for the disconnect include CRT’s methodological complexity and jurisprudential orientation, both of which contrast with public health’s scientific approach and emphasis on practical application.
To improve the ease and fidelity with which public health researchers can use CRT to conduct health equity research, we developed the Public Health Critical Race praxis (PHCR). PHCR maintains public health’s high standards for scientific rigor while drawing on the robust body of antiracism work that exists outside public health.
As detailed elsewhere (Crenshaw et al., 1995, Delgado and Stefancic, 2001) (Ford & Airhihenbuwa, 2010), CRT is a decentralized movement among scholars, researchers and activists that coheres around a set of tenets regarding racialization, marginalization and the role of critical race theorists (i.e., ‘crits’) in producing knowledge about societal inequities (Delgado & Stefancic, 2001). That a study involves racialized exposures, populations or outcomes does not automatically make it a CRT endeavor. In fact, most such studies are not based on CRT. Studies are critical race endeavors if they adhere to CRT’s core tenets. PHCR is grounded in CRT. Both CRT and PHCR attempt to move beyond merely documenting health inequities toward understanding and challenging the power hierarchies that undergird them. PHCR helps public health researchers to carry out health equity research with fidelity to CRT.
The purpose of this paper is to describe our Public Health Critical Race praxis (PHCR). PHCR tailors CRT to the field of public health, thus facilitating the use of CRT for health equity research. An example of empirical research conducted using CRT has been published elsewhere (Ford & Airhihenbuwa, 2010). Here, we continue to build the capacity for CRT-based, health equity research. We summarize key characteristics of CRT and describe PHCR’s schematic, process, four focuses and ten principles. Finally, we discuss recommendations for and cautions regarding widespread uptake of PHCR within the field of public health.
Section snippets
Key characteristics of critical race theory (CRT)
CRT has at least four distinguishing characteristics. First, issues of racialization (i.e., racial phenomena, race, ethnicity and racism) are at its core. Racialization describes how socially constructed racial and ethnic categories are used to order groups in society. All critical race endeavors begin with the question, “How does racialization contribute to the problem at hand?” Accordingly, race consciousness is fundamental to CRT. As we discuss later, race consciousness connotes the
Public health critical race praxis (PHCR): the model and process
There are many ways to draw on CRT. What PHCR offers is a semi-structured process for conducting research that remains attentive to issues of both racial equity and methodologic rigor. As praxis (i.e., an iterative methodology), it combines theory, experiential knowledge, science and action to actively counter inequities. PHCR may be used either alone as a broad framework or in conjunction with other theories or methods. It informs research on the causes of health disparities. It also guides
Discussion
The time is ripe for racial equity public health praxis. Interest in addressing racial health inequities has grown substantially in recent years. So, too, have the capabilities for measuring racism effects. What until now has been missing is a public health framework that grounds the health equity efforts in the robust body of work outside the field and that moves us beyond merely documenting disparities in order to challenge their root causes. CRT has been informing work in law, education and
Conclusion
This paper presented the Public Health Critical Race praxis (PHCR), a new methodology grounded in Critical Race Theory that guides racial equity approaches to public health research. PHCR offers novel tools for investigating and attempting to eliminate health inequities. It informs all aspects of the research process; from the formulation of research questions to the actions taken based on the findings. Care must be taken to ensure PHCR’s use occurs with fidelity to Critical Race Theory.
References (47)
- et al.
A new conceptualization of ethnicity for social epidemiologic and health equity research
Social Science and Medicine
(2010) - et al.
Black sexuality, social construction and research targeting ‘The Down Low’ (‘The DL’)
Annals of Epidemiology
(2007) The “race” concept in smoking: a review of the research on African Americans
Social Science and Medicine
(1997)Health and culture: Beyond the western paradigm
(1995)Healing our differences
(2007)On being comfortable with being uncomfortable: centering an Africanist vision in our gateway to global health
Health Education & Behavior
(2007)- et al.
Eliminating health disparities in the African American population: the interface of culture, gender, and power
Health Education & Behavior
(2006) Research and intervention on racism as a fundamental cause of ethnic disparities in health
American Journal of Public Health
(2001)- et al.
Guest editorial. Making a case for the examination of ethnicity of Blacks in United States health research
Journal of Health Care for the Poor and Underserved
(2006) Racism is here to stay. Now what?
Howard Law Journal
(1991)
Inequalities that endure? Racial ideology, American politics, and the peculiar role of the social sciences
Racism without racists: Colorblind racism and the persistence of racial inequality in the United States
Whitewashing race: The myth of a color-blind society
Racism as a stressor for African Americans: a biopsychosocial model
American Psychologist
Black sexual politics: African Americans, gender, and the new racism
Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics
University of Chicago Legal Forum
The imperial scholar: Reflections on a review of civil rights literature
University of Pennsylvania Law Review
The imperial scholar revisited: how to marginalize outsider writing, ten years later
University of Pennsylvania Law Review
Critical race theory: An introduction
The souls of Black folk
The many costs of racism
Critical race theory, race equity, and public health: toward antiracism praxis
American Journal of Public Health
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This project received support from the W. K. Kellogg Foundation Kellogg Health Scholar’s Program (Grant #P0117943) as well as the AIDS Institute and California Center for Population Research at the University of California at Los Angeles. Portions of this paper were presented at the 2006 annual meeting of the Society for the Analysis of African American Public Health Issues and at the 2009 Critical Race Theory & HIV/AIDS Think Tank held at the UCLA School of Public Health. The authors acknowledge Peter E. Ford, JD and Phyllis M. Autry for their helpful insights regarding critical race scholarship.