Theories

Theory.mov

This page will briefly describe key theories commonly used in antiracism research and key references for those theories. We encourage researchers to use these theories and research paradigms in efforts to further support antiracist research.

Anti-Racism

Racism has been recognized as a fundamental determinant of health, shaping disparities through structural, institutional, and interpersonal mechanisms. As a praxis in public health, anti-racism involves actively identifying, challenging, and dismantling systems of oppression that sustain health inequities. This includes addressing discriminatory policies, improving healthcare access, and centering the voices of marginalized communities. By integrating anti-racist principles into research, policy, and practice, public health aims to shift from documenting disparities to implementing systemic change that promotes health equity and social justice.

Sources

Came, Heather, & Griffith, Derek. (2018). Tackling racism as a “wicked” public health problem: Enabling allies in anti-racism praxis. Social Science & Medicine (1982), 199, 181–188. Brown Access here
Crear-Perry, Joia, Maybank, Aletha, Keeys, Mia, Mitchell, Nia, & Godbolt, Dawn. (2020). Moving towards anti-racist praxis in medicine. The Lancet (British Edition), 396(10249), 451–453. Brown Access here
Gilbert, Keon L., & Roe, Kathleen M. (2023). From Health Disparities to an Agenda for Anti-Racism in Health Promotion. Health Promotion Practice, 24(2), 197–200. Brown Access here
Kendi, Ibram X. (2019). How to be an antiracist (First Edition.). One World. Brown Access here

Critical Race

Emerging in legal scholarship in the 1990s, Critical Race Theory (CRT) argues that racism is embedded in legal institutions and policies, not just individual bias. It posits that race is a socially constructed concept used to uphold economic and political power for white elites. Social, economic, and legal disparities between racial groups are deliberately created and maintained to serve these interests, systematically disadvantaging people of color. CRT challenges these structures, advocating for transformative change to achieve racial equity and justice.

Sources

Crenshaw, Kimberlé, Gotanda, Neil, Peller, Gary, & Thomas, Kendall (Eds.). (1995). Critical race theory : the key writings that formed the movement. New Press. Brown Access here
Delgado, Richard. (1995). Critical race theory : the cutting edge. Temple University Press. Brown Access here
Fletcher, Faith E., Jiang, Wendy, & Best, Alicia L. (2021). Antiracist Praxis in Public Health: A Call for Ethical Reflections. The Hastings Center Report, 51(2), 6–9. Brown Access here
Ford, Chandra L., & Airhihenbuwa, Collins O. (2010). Critical Race Theory, Race Equity, and Public Health: Toward Antiracism Praxis. American Journal of Public Health (1971), 100(S1), S30–S35. Brown Access here

Decolonization

Decolonization in public health seeks to dismantle colonial power structures that shape knowledge production, research, and health systems. This involves critically examining how colonial legacies perpetuate health inequities and prioritizing Indigenous, Black, and other marginalized voices. Decolonizing public health includes transforming research methods, challenging Eurocentric frameworks, reclaiming cultural knowledge, and promoting community-driven solutions. It also emphasizes accountability and critical consciousness, aiming to shift power dynamics, restore agency to oppressed communities, and create more equitable, inclusive, and culturally relevant health policies and practices.

Sources

McCoy, David, Kapilashrami, Anuj, Kumar, Ramya, Rhule, Emma, & Khosla, Rajat. (2024). Developing an agenda for the decolonization of global health. Bulletin of the World Health Organization, 102(2), 130–136. Brown Access here
Ritenburg, Heather, Leon, Alannah Earl Young, Linds, Warren, Nadeau, Denise Marie, Goulet, Linda M., Kovach, Margaret, & Marshall, Mary (Meri). (2014). Embodying Decolonization: Methodologies and Indigenization. AlterNative : An International Journal of Indigenous Peoples, 10(1), 67–80. Brown Access here
Smith, Linda Tuhiwai. (2021). Decolonizing methodologies : research and indigenous peoples (Third edition.). Zed Books. Brown Access here
Stein, S., & de Oliveira Andreotti, V. (2017). Decolonization and higher education. In M. Peters, Encyclopedia of Educational Philosophy and Theory (1st ed.). Springer Science+Business Media. Brown Access here

Ecosocial

Developed by Nancy Krieger in 1994, Ecosocial Theory integrates ecological, social, political, and historical processes to examine health outcomes across multiple levels, time periods, and locations. It challenges traditional notions of disease causation as strictly proximal or distal, instead emphasizing that health determinants operate simultaneously and dynamically over time and space. By linking biological pathways with social structures, the theory highlights how systemic inequities shape disease distribution, advocating for a more comprehensive approach to understanding and addressing health disparities.

Source

Krieger, Nancy. (1994). Epidemiology and the web of causation: Has anyone seen the spider? Social Science & Medicine (1982), 39(7), 887–903. Brown Access here
Krieger, Nancy. (2012). Methods for the Scientific Study of Discrimination and Health: An Ecosocial Approach. American Journal of Public Health (1971), 102(5), 936–945. Brown Access here
Krieger, Nancy. (2024). Theorizing epidemiology, the stories bodies tell, and embodied truths: a status update on contending 21 st c CE epidemiological theories of disease distribution. International Journal of Social Determinants of Health and Health Services (Print), 54(4), 331–342. Brown Access here
Krieger, Nancy. (2001). Theories for social epidemiology in the 21st century: an ecosocial perspective. International Journal of Epidemiology, 30(4), 668–677. Brown Access here

Intersectionality

Developed by Black feminist legal scholar Kimberlé Crenshaw, originally aimed to capture the unique experiences of Black women facing overlapping oppressions—racism and sexism. It highlights how social identities interact within systems of power, shaping lived experiences in ways that cannot be understood through single-axis frameworks. Since its inception, the theory has expanded to include individuals with various marginalized identities, emphasizing that oppression is multidimensional and context-dependent, requiring nuanced approaches to social justice, policy, and advocacy.

Sources

Alvidrez, Jennifer, Greenwood, Gregory L., Johnson, Tamara Lewis, & Parker, Karen L. (2021). Intersectionality in Public Health Research: A View From the National Institutes of Health. American Journal of Public Health (1971), 111(1), 95–97. Brown Access here
Bowleg, Lisa. (2021). Evolving Intersectionality Within Public Health: From Analysis to Action. American Journal of Public Health (1971), 111(1), 88–90. Brown Access here
Bowleg, Lisa. (2012). The Problem With the Phrase Women and Minorities: Intersectionality— an Important Theoretical Framework for Public Health. American Journal of Public Health (1971), 102(7), 1267–1273. Brown Access here
Crenshaw, Kimberle. (1991). Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color. Stanford Law Review, 43(6), 1241–1299. Brown Access here

Minority Stress

Originally developed to capture the experiences of gay men, Minority Stress Theory posits that sexual minorities face stressors beyond everyday life due to societal stigma. These stressors—both external (discrimination, victimization) and internal (expectations of rejection, internalized stigma)—negatively impact mental and physical health. The theory has since evolved into a broader framework, identifying three key psychological mediators through which minority stress operates: cognitive (perceptions and beliefs), affective (emotional responses), and social support processes, all of which shape coping, resilience, and well-being.

Sources

Frost, D. M., & Meyer, I. H. (2023). Minority stress theory: Application, critique, and continued relevance. Current Opinion in Psychology, 51, 101579. Brown Access here
Hatzenbuehler, Mark L. (2009). How Does Sexual Minority Stigma “Get Under the Skin”? A Psychological Mediation Framework. Psychological Bulletin, 135(5), 707–730. Brown Access here
Meyer, Ilan H. (1995). Minority Stress and Mental Health in Gay Men. Journal of Health and Social Behavior, 36(1), 38–56. Brown Access here
Meyer, Ilan H., & Cooper, Harris. (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin, 129(5), 674–697. Brown Access here

Social Ecological

Social Ecological Frameworks emphasize the direct impact of the environment on behavior, recognizing multiple levels of influence. Key conceptualizers include Bronfenbrenner (Ecological Systems Theory, 1979) and McLeroy (Social Ecological Model, 1988). These models assume that health behaviors are shaped by interacting individual, interpersonal, community, and societal factors. By acknowledging these cross-level interactions, they highlight the importance of multi-level interventions, suggesting that addressing behavioral determinants at multiple levels—rather than in isolation—may be the most effective approach for sustainable behavior change and improved health outcomes.

Sources

Bronfenbrenner, Urie. (1979). The ecology of human development : experiments by nature and design. Harvard University Press. Brown Access here
Golden, Shelley D., McLeroy, Kenneth R., Green, Lawrence W., Earp, Jo Anne L., & Lieberman, Lisa D. (2015). Upending the Social Ecological Model to Guide Health Promotion Efforts Toward Policy and Environmental Change. Health Education & Behavior, 42(1_suppl), 8S-14S. Brown Access here
Kilanowski, Jill F. (2017). Breadth of the Socio-Ecological Model. Journal of Agromedicine, 22(4), 295–297. Brown Access here
McLeroy, Kenneth R., Bibeau, Daniel, Steckler, Allan, & Glanz, Karen. (1988). An Ecological Perspective on Health Promotion Programs. Health Education Quarterly, 15(4), 351–377. Brown Access here

Social Determinants

Popularized in the 1990s, the Social Determinants of Health framework offers a depoliticized extension of the Social Production of Disease/Political Economy of Health theory, which emphasizes economic and political drivers of health inequities. While acknowledging these structural factors, it also highlights biological mechanisms through which social conditions impact health. This approach considers not only social determinants but also psychosocial exposures (e.g., stress, social hierarchies) and biological pathways of embodiment, emphasizing their relevance across the life course and multiple levels of influence.

Sources

Braveman, Paula, Egerter, Susan, & Williams, David R. (2011). The social determinants of health: coming of age. Annual Review of Public Health, 32(1), 381–398. Brown Access here
Donkin, Angela, Goldblatt, Peter, Allen, Jessica, Nathanson, Vivienne, & Marmot, Michael. (2018). Global action on the social determinants of health. BMJ Global Health, 3(Suppl 1), e000603–e000603. Brown Access here
Marmot, Michael. (2005). Social determinants of health inequalities. The Lancet (British Edition), 365(9464), 1099–1104. Brown Access here
Marmot, Michael, Friel, Sharon, Bell, Ruth, Houweling, Tanja AJ, & Taylor, Sebastian. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet (British Edition), 372(9650), 1661–1669. Brown Access here

Political Economy

Grounded in Marxist thought, the Social Production of Disease/Political Economy of Health theory argues that political, social, and economic institutions shape and sustain systems of privilege, driving health inequalities. It critiques capitalism’s morality, asserting that group health outcomes result from power dynamics and resource distribution. Unjust structures persist because they benefit those in power, despite harming others. Disease distribution is historically patterned and exceeds individual factors, as broader contextual forces—such as work conditions, living standards, and social responses to economic conditions—operate through multiple direct and indirect pathways.

Sources

Conrad, Peter, & Leiter, Valerie. (2013). The sociology of health & illness : critical perspectives (9th ed.). Worth Publishers. Brown Access here
Doyal, Lesley, & Pennell, Imogen. (1981). The political economy of health (1st U.S. ed.). South End Press. Brown Access here
Navarro, Vicenç. (1986). Crisis, health and medicine : a social critique. Tavistock. Brown Access here
Szreter, Simon, & Woolcock, Michael. (2004). Health by association? Social capital, social theory, and the political economy of public health. International Journal of Epidemiology, 33(4), 650–667. Brown Access here

Syndemics

Examines how interconnected health conditions, shaped by social and structural factors, exacerbate one another within marginalized populations. Coined by Singer (1996), the concept highlights how diseases interact biologically and socially, worsening health outcomes. Structural inequities—such as poverty, discrimination, and inadequate healthcare—amplify these interactions, creating a cycle of vulnerability. Rather than viewing conditions in isolation, syndemics theory emphasizes their synergistic effects, demonstrating how overlapping epidemics are driven by broader social determinants that must be addressed to improve public health outcomes.

Sources

Singer, Merrill, Bulled, Nicola, Ostrach, Bayla, & Mendenhall, Emily. (2017). Syndemics and the biosocial conception of health. The Lancet (British Edition), 389(10072), 941–950. Brown Access here
Singer, Merrill, Mendenhall, Emily, Abadía‐Barrero, César E., & Erickson, Pamela I. (2022). Syndemics in Global Health. In A Companion to Medical Anthropology (pp. 126–144). John Wiley & Sons, Inc. https://doi.org/10.1002/9781119718963.ch7 Singer, Merrill, Mendenhall, Emily, Abadía‐Barrero, César E., & Erickson, Pamela I. (2022). Syndemics in Global Health. In A Companion to Medical Anthropology (pp. 126–144). John Wiley & Sons, Inc. Brown Access here
Tsai, Alexander C., Mendenhall, Emily, Trostle, James A., & Kawachi, Ichiro. (2017). Co-occurring epidemics, syndemics, and population health. The Lancet (British Edition), 389(10072), 978–982. Brown Access here
Tsai, Alexander C., & Venkataramani, Atheendar S. (2016). Syndemics and Health Disparities: A Methodological Note. AIDS and Behavior, 20(2), 423–430. Brown Access here

Psychosocial

Drawing from psychology and physiology, explores stress as a biological and social phenomenon. Cannon (1915) introduced "fight or flight," while Selye (1936) identified universal stress responses. Psychological stressors—and their buffers—are socially patterned, shaped by social position and living/work conditions. Relative rank in social hierarchies is a key stressor. Chronic stress can harm mental and physical health through pathways involving the central nervous system, regulatory physiology, behavior, and illness, operating independently and synergistically to impact overall well-being.

Sources

Cannon, Walter B. (1935). Stresses and strains of homeostasis. The American Journal of the Medical Sciences, 189(1), 13–14. Brown Access here
Elstad, Jon Ivar. (1998). The Psycho‐social Perspective on Social Inequalities in Health. Sociology of Health & Illness, 20(5), 598–618. Brown Access here
Selye, Hans. (1951). The general adaptation syndrome and the diseases of adaptation. The American Journal of Medicine, 10(5), 549–555. Brown Access here
Singh-Manoux, A., Macleod, J., & Davey, S. (2003). Psychosocial factors and public health. Journal of Epidemiology and Community Health (1979), 57(8), 553–556. Brown Access here

Social Safety

Social Safety Theory highlights the fundamental human need for reliable social connection, inclusion, and protection, emphasizing how their absence contributes to health disparities. It builds on minority stress theory, arguing that stigma-related health issues stem not just from stress and discrimination but also from insufficient social safety. Chronic threat-vigilance caused by social exclusion negatively impacts cognitive, emotional, and immune functioning. By increasing social safety—through support, inclusion, and protection—we can improve mental and physical health across diverse populations, especially those facing stigma and marginalization.

Sources

Diamond, Lisa M., & Alley, Jenna. (2022). Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neuroscience and Biobehavioral Reviews, 138, 104720–104720. Brown Access here
Diamond, Lisa M., Dehlin, Adrian J., & Alley, Jenna. (2021). Systemic inflammation as a driver of health disparities among sexually-diverse and gender-diverse individuals. Psychoneuroendocrinology, 129, 105215–105215. Brown Access here
Slavich, George M. (2020). Social Safety Theory: A Biologically Based Evolutionary Perspective on Life Stress, Health, and Behavior. Annual Review of Clinical Psychology, 16(1), 265–295. Brown Access here
Slavich, George M., Roos, Lydia G., Mengelkoch, Summer, Webb, Christian A., Shattuck, Eric C., Moriarity, Daniel P., & Alley, Jenna C. (2023). Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions. Health Psychology Review, 17(1), 5–59. Brown Access here

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