Racism and racial health inequity: four theories for public health

Virtually all public health practitioners acknowledge the need to combat racism. Yet very few public health initiatives in the United Kingdom (UK) are rooted in social scientific ideas offering testable, adaptable frameworks for understanding and dismantling racial inequality. This reluctance does not stem from a lack of awareness of the causes of racial disparities—such as European colonialism, slavery, and their ongoing reverberations—but from the field’s focus on immediate, practical responses to urgent public health issues. As a result, social scientific theories—especially those exploring how ‘race’ is constructed and racial inequality perpetuated—are unevenly integrated into practice. But the social sciences offer precisely the concepts that are needed for understanding how racial categories are constructed and how they come to normalize racial health inequities, including those generated by public health. This article identifies four key social theories essential to combatting racism and racial health inequity. These theories emerged when the London Association of Directors of Public Health (ADPHL) engaged two anthropologists, Dr Parker and Professor Parker, to help develop their anti-racism strategy. Over the past year, we collaborated through discussions and critically examined literature in critical race theory, Black studies, race and ethnicity studies, and the anthropology of white supremacy. Together, these sources form a body of conceptual tools to help public health dismantle racism and disparities.