Bridging Public Health and Critical Race Theory:

by Jon Scaccia December 30, 2024

We’ve all seen research and analyses fail to consider the systemic racism and inequities that make health unobtainable in many communities. This is the gap Critical Race Theory (CRT) seeks to bridge in public health education.

The Intersection of CRT and Public Health

For decades, public health has sought to understand and address health disparities among racial and ethnic minorities. Yet, as the field evolves, so does its recognition of the systemic forces that perpetuate these inequities. Enter CRT: a framework that confronts racism’s ordinariness and systemic roots, offering public health a lens to dismantle these oppressive structures.

Public Health Critical Race Praxis (PHCR) extends CRT into the public health arena, creating a blueprint for addressing racism’s impact on health outcomes. While PHCR principles are gaining traction in research, their adoption in public health education remains limited. A recent study analyzed syllabi from Master of Public Health (MPH) programs to evaluate how well CRT principles are being taught. The findings revealed both progress and gaps, highlighting the urgent need for a curriculum overhaul.

Unpacking the Study: What’s Being Taught and What’s Missing

Researchers reviewed syllabi from Council on Education for Public Health (CEPH)-accredited programs, focusing on how courses integrate CRT and antiracist principles. They identified several themes central to CRT, such as structural determinism, intersectionality, and voice, alongside newer concepts like antiracism practices and a culture of inclusivity. Here’s what they found:

• Structural Determinism: This theme dominated, reflecting how structural forces perpetuate inequities. Many syllabi included assignments exploring systemic racism, such as analyzing Flint, Michigan’s water crisis through policy and racial bias lenses.
• Antiracism Practices: Explicit calls to action, like applying health equity frameworks, were common in course objectives. Yet, these practices often lacked depth, with limited focus on actionable strategies.
• Intersectionality: While present, intersectionality—a core CRT tenet—was underrepresented compared to structural determinism. This disconnect suggests a need for educators to better integrate the interplay of multiple social identities into public health discussions.
• Race Consciousness: Surprisingly, this foundational CRT concept was the least represented. Without encouraging students to examine their racial identities and biases, programs miss a critical opportunity to foster future leaders who can confront and dismantle racism.

Why This Matters

The findings underscore a troubling reality: while public health education acknowledges systemic inequities, it often stops short of equipping students with the tools to address them. This gap has real-world consequences. Graduates lacking a critical race lens may design interventions that fail to address the root causes of disparities, perpetuating the very inequities they aim to eliminate.

Imagine a public health campaign targeting maternal mortality among Black women. Without understanding structural racism’s role, solutions may focus narrowly on clinical care, ignoring broader factors like housing, transportation, and implicit bias in healthcare systems. CRT provides a framework to create interventions that address these interconnected issues.

A Path Forward: Transforming Public Health Education

To align with CRT and antiracist principles, public health programs must take bold steps:

1. Revise Curricula: Integrate PHCR principles across all courses, emphasizing practical applications. For example, courses could include community-engaged projects addressing structural inequities.
2. Foster Inclusivity: Create classroom environments where diverse perspectives are valued and included in knowledge co-construction. Assignments could encourage students to analyze health issues through multiple lenses, incorporating lived experiences.
3. Promote Race Consciousness: Encourage self-reflection and open discussions about race and privilege. Faculty training in CRT and antiracism is essential to model these principles effectively.
4. Leverage Interdisciplinary Approaches: Collaborate with other disciplines, like law and sociology, to provide students with a well-rounded understanding of systemic racism’s impact on health.
5. Evaluate Outcomes: Track how well graduates apply CRT principles in their work. Are they designing equitable interventions? Are they challenging systemic barriers within their organizations?

What’s Next?

This study is just the beginning. Future research should explore how these principles translate into student competencies and professional practices. Moreover, examining the influence of political landscapes on CRT adoption in academia could uncover additional barriers and opportunities.

The journey toward equity in public health education requires collective action. Faculty, students, and administrators must work together to ensure curricula not only meet accreditation standards but also empower graduates to be agents of change.

Join the Conversation

What steps can educators take to make CRT principles more actionable in public health education? How do you see structural racism impacting health in your community? Share your thoughts in the comments or on social media using #PublicHealthEquity. Together, let’s reimagine public health education for a more equitable future.