Breaking Barriers

In 2021, the Centers for Disease Control and Prevention acknowledged racism as a serious threat to public health. Since then, over 250 U.S. agencies and institutions have declared it a public health crisis. Today, racism is one of the most talked about topics in public health, and for good reason. But that wasn’t always the case, as Chandra L. Ford, PhD, knows from experience.

Ford wrote about racism for her public health doctoral program in the early 2000s. “Some faculty would grade me and say, ‘Well, that's not public health, you know. Glad you're interested in racism, but in terms of your life’s work…that’s not it.’”

Now she is an eminent scholar on racism, social justice, and public health. Earlier this year, Emory University welcomed Ford to its faculty as a professor with joint appointments in the Department of African American Studies at Emory College of Arts and Sciences and in the Department of Behavioral, Social, and Health Education Sciences at Rollins. She moved cross country from the Fielding School of Public Health at the University of California, Los Angeles, where she was a professor of community health sciences and founding director of the Center for the Study of Racism, Social Justice, and Health.

“Well-meaning people have said things to me like, ‘Well, you see racism everywhere,’” Ford recounts, as if awareness was a bad thing, or injustices were self-imagined. But, Ford points out, no one questions physicists who think about the laws of matter involved in everyday activities. Just like physics, racism is baked into modern society, and fighting it is her passion.

Her work is anchored in critical race theory, an academic discipline that analyzes how systemic racism has shaped society—and continues to do so—often in ways we might not immediately recognize.

The role of racism in public health

Racism is now widely acknowledged to be a major determinant of health. Discrimination exposes people to myriad stressors, including socioeconomic and psychological pressures, and also affects their access to resources to cope with those stressors. As a result, people of color are at higher risk of developing, and dying from, preventable diseases like diabetes, asthma, and COVID-19.

But racism can’t just be boiled down to a risk factor, Ford stresses. It’s ingrained in the world in which we live and often seen as a nebulous and overwhelming challenge, a shapeless specter hovering over society. Many people might not know what it looks like, especially in its more subtle forms, or how to combat it.

Ford wants to change that. She uses critical race theory to identify specific ways that racism operates in public health research: how it affects the topics being studied, the questions being asked, and the methods researchers use to answer those questions. By breaking racism down into smaller, recognizable patterns, she hopes that researchers can spot it more easily and address it—or at least acknowledge how it affects their work—throughout the research process.

“We are not just going to arrive in communities and solve their problems. We need to start with the ways in which we could be part of the problem,” she says. For example, unspoken assumptions about people’s motivations or abilities could lead to simplistic and unfair conclusions. In some cases, researchers may inadvertently take on the role of “the white savior,” which potentially could lead to devaluing a community’s perceptions or overlooking strengths that could form the backbone of effective interventions. Instead, well-meaning public health professionals could implement programs that do more harm than good.

“Focusing on the way that racism operates within the field is not just about identifying the problems but also identifying potential solutions.” —Chandra L. Ford, PhD

Photography by Theo Gayle

Tools for the public health professional

“Focusing on the way that racism operates within the field is not just about identifying the problems but also identifying potential solutions,” Ford explains. These solutions could be as simple as implementing moments of reflection at standard checkpoints during the research process. For instance, when choosing questionnaires and scales to use in their projects, researchers should consider what populations were used to validate those tools. The answer could help determine whether that tool is appropriate for the new project, or if any adjustments need to be made.

As acknowledgement of systemic racism and its impact has spread, interest in Ford’s research has grown. She’s astonished by the number of public health professionals who have stepped forward to learn more about racism and how they can address it in their own practices. Their interest led Ford to edit the book, Racism: Science & Tools for the Public Health Professional. A second edition is under way.

“Her text is an incredible resource for the entire field,” says Don Operario, PhD, chair of the Department of Behavioral, Social, and Health Education Sciences. “It raised our standards for the rigorous analysis of how racism affects health, and it helps us imagine and construct antiracist approaches to improve health and wellness in ways that are relevant to multiple settings and populations.”

Building interdisciplinary solutions

But Ford’s work doesn’t stop there. Other fields also could offer valuable tools to address racism. “In public health, we're trained to be the solution finders, so we feel like we can fix it all,” she says. “But if we look at the literature, other disciplines provide so many different and fruitful ways of thinking about possible solutions.”

For example, public health researchers might not consider the ways that everyday people define or think about race. But librarians, on the other hand, regularly tackle questions about how different concepts are defined or categorized. Ford, who holds dual degrees in public health and library and information sciences, integrates this perspective into her research. Her interdisciplinary background enables her to examine how different ways of thinking about race, including critical race theory, could impact the results of public health studies.

It also helps her think about how readability, internet access, and other barriers impact access to health information and further fuel disparities. For over two decades, librarians have been working to make scientific data, and the knowledge it produces, available to a range of communities. “Having these different disciplines to turn to really gives us new lenses and frameworks through which we can see the problem, interpret it, and think about how to solve it,” Ford says.

Quite often, solutions aren’t so simple. Different ways of thinking about racism and society can lead to different approaches to addressing it; sometimes, those approaches may contradict each other, making interdisciplinary partnerships even more important. Ford’s dual appointment in Emory College will allow her to start building them. “There is palpable interest in public health in African American Studies,” she says, “I see it as an excellent opportunity to build the pipeline of diverse burgeoning health equity leaders at Rollins.”

Ford is eager to continue pushing the limits of academic research and preparing a new generation of public health professionals who aren’t afraid to shake things up. Students shouldn’t let traditional disciplinary boundaries stifle their passions. “If I had,” she notes, “I wouldn't be doing the work that I'm doing now at all.”

At Emory, Ford has found a place that welcomes her fierce commitment to social justice, even when it means asking tough questions. Rollins is committed to thoughtful reflection as it works to promote equity on campus and beyond. Rollins, and the Department of Behavioral, Social, and Health Education Sciences in particular, appealed to Ford because everyone was excited to talk about health inequities.

“There are so many like-minded scholars at Rollins who have a genuine interest in and expertise doing social justice research,” says Tené T. Lewis, PhD, professor of epidemiology. “Having someone like Chandra at Rollins is only going to take what we do here at Emory to the next level.”