Examining health equity through a race theory lens

Health disparities discourse in the U.S. has evolved around racial and ethnic health concerns. This contrasts with European Union nations' health equity emphasis on socioeconomic status. However, a health equity frame is gaining prominence in the U.S. to enhance attention from biomedical to social determinants of health and social justice concerns. How does this re-framing clarify or obscure the role of race in health disparities? Informed by critical race theories, this discourse analysis draws on health equity reports/policy statements and informant interview data from U.S. governmental and non-governmental organizations to explore how race is discussed in relation to class and social justice. Findings suggest tensions between determinants of health and determinants of health equity, disadvantage and privilege, and equal opportunity and fairness. Also addressed are concerns of representation and institutional racism. How a health issue is framed critically shapes subsequent research, interventions, political action, and other resource allocations. This analysis highlights integrative strategies that promote racial and ethnic concerns within the broader health equity context. By assessing the contributions of a health equity frame, and clarifying its operational definitions and action steps, this project can increase specificity and focus in public health research, policy, and practice aimed at eliminating health disparities.