Searching for Racial Health Equity in Schools of Public Health

Accredited schools of public health are required to prepare graduate students to competently discuss how racism undermines health equity. A systematic assessment of academic public health norms is needed to clarify how graduate education structures the profession of public health to address racial health inequities. Three aims guided my investigation of common practices of knowledge transmission and production in schools of public health: (1) to determine what is taught to students regarding racial health equity; (2) to classify students' use of race and theory; and (3) to categorize and contextualize students' discussions of racism. In this sequential explanatory mixed methods study of existing documents, I examined accreditation self-study reports (N=34) and course syllabi (N=67) from schools of public health (Aim 1) and public health theses and dissertations published between 2018-2022 in the ProQuest Dissertations and Theses database (N=13,797 abstracts for Aim 2; N=25 full-text dissertations for Aim 3). I conducted computational text analysis to estimate keyword distributions, manual content analysis to trace racial health equity concepts, and critical race discourse analysis to interpret patterns. Paper 1 revealed unequal exposure to race-related content. Fewer than half of the course syllabi listed learning objectives with racial health equity concepts. Two-thirds of schools of public health assigned journal articles with 'race' or 'racism'. In Paper 2, 36% of abstracts from students' dissertations and theses contained racial group and explicit theory terms; 62% omitted 'race.' The relative distribution of theories indicated students' focus on proximal exposures rather than structural determinants. In Paper 3, eight percent of abstracts (N=403) contained social inequality theory and racial group terms. I identified three racism narratives within the full-text sample of dissertations: exposure to racism (N=9); potential exposure to racial inequity (N=3); and another exposure among people (N=13). Student-authors' reflexivity and race conscious campus climates appear to promote public health research on racism. Dissertation findings can inform teaching, research, and practice approaches to racial health inequities. Exposing how everyday practices uphold white supremacist hegemony in schools of public health can accelerate the public health profession toward health equity. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]