Elsevier

Social Science & Medicine

Volume 71, Issue 8, October 2010, Pages 1390-1398
Social Science & Medicine

The public health critical race methodology: Praxis for antiracism research

https://doi.org/10.1016/j.socscimed.2010.07.030Get rights and content

Abstract

The number of studies targeting racial health inequities and the capabilities for measuring racism effects have grown substantially in recent years. Still, the need remains for a public health framework that moves beyond merely documenting disparities toward eliminating them. Critical Race Theory (CRT) has been the dominant influence on racial scholarship since the 1980s; however, its jurisprudential origins have, until now, limited its application to public health research. To improve the ease and fidelity with which health equity research applies CRT, this paper introduces the Public Health Critical Race praxis (PHCR). PHCR aids the study of contemporary racial phenomena, illuminates disciplinary conventions that may inadvertently reinforce social hierarchies and offers tools for racial equity approaches to knowledge production.

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.

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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.

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