Dr. Christopher Williams answers the public's questions about the CRF

For Immediate Release
Contact: criticalraceframework@gmail.com

April 14, 2025

Dr. Christopher Williams answers the public's questions about the Critical Race Framework Study.

1. Why does your study say race shouldn’t be used in public health research? Isn’t it important for understanding health disparities? My study is highly technical. My arguments derive from scientific theories and methodologies, so it's likely too dense and unreadable for most of the public. However, the basic idea is that science deals in precision. We know what we're measuring, what it means, and how our models handle data. We scrutinize every aspect of our research, so that we make founded conclusions. But we have largely given race a pass. Race does not meet our standards. Race - as in the global notion of racial grouping - is too weak for research. 

Is race important for understanding health disparities? No, race is not important for health disparities without a valid construct. Without a definition, it's like measuring nothing scientifically. There is too much noise in the data to trust results. We know that we're struggling with making a turn on health equity in many respects. My research is that saying that we need science to reflect the populations that we're studying. Right now, research is using its racialized paint-by-number. We cannot assume the superiority or usefulness of race essentialism.

So we get back a study on racial disparities, but that doesn't mean that disparities are evenly distributed across racial populations. Take Black maternal mortality. In Washington, DC, it's largely a neighborhood and income issue. 70% of maternal deaths are in Wards 7 and 8 - historically neglected wards. I am also curious about nativity. My hunch is that native Washingtonians - meaning people who are born and live their entire lives in Washington, DC - are at highest risk across the health spectrum. District government has historically been highly dysfunctional, bureaucratic, and unable to attract and retain top talent for effective governance and program planning and implementation. It also tends to treat the poorer areas of the city as an afterthought - too busy with development wheeling and dealing elsewhere in the city to address deep social inequity. In 2005, the HIV/AIDS crisis was still raging and the District government's surveillance office had a 50% vacancy! In my experience, I see many appointed senior officials and highly paid health positions who are getting paid to make the mayor and her government look good and improving, as opposed to effective governance, oversight, and regulation. Everything is always "improving" even if it isn't. It doesn't help that senior officials refer to her government as "The Firm," as if a mafia of some sort. 

2. How can you claim race is a problem in research when so many studies use it? Are all those scientists wrong? Yes, that I am absolutely confident about. I use foundational science. Researchers have been ringing the alarm about the issue for over 30 years. I am just the first to create a critical appraisal tool. Are all of those scientists wrong? That's too judgmental from my perspective. I prefer scientific terms. Could scientists, journals, and funders have been more scrutinizing as part of the profession's obligations to scientific review? Absolutely.

3. What makes your Critical Race Framework better than existing ways of studying race in health research? This is a loaded question. There are countless ways of studying race or racial disparities in health research. My study is about the development and testing of a tool to improve health research. For the sake of equity and ethics, we cannot continue down this road of race essentialism.

4. Are you saying we should ignore race completely in public health? What about communities that face real inequities? Race, as currently conceptualized in terms of global races, is false. Yes, we need to absolutely ignore that. It should not be funded. It is a waste of resources. The research will have inherent weaknesses and severely limited generalizability. Now, we can and should assess structural inequity like racism, classism, historical legacies as in Jim Crow and American Indian removal, place-based determinants. I have a developed a separate theory on the public health economy. It's the second major economy.  The public health economy lacks order and morals. Perhaps, we'd be better off fixing the public health economy as a start. There is no point of investing trillions in a new medicine if people can't afford it or can only afford it if they eat once a day or sell their car. There is no point of increasing health insurance coverage if there are no doctors around - where there is practically no network. There is no point of healthier school meals if children won't eat them. You get my point?

I am in the communities that shoulder the burden of health inequity and anarchy in the public health economy. If research want to understand the issues that communities face, they should be in those communities. That my dissertation was motivated by my community work is telling. The whole of the Critical Race Framework study is a prime example of how researchers and research can be responsive to inequities when they have a deep understanding of community issues.

5. How will your framework actually change how researchers or policymakers deal with race and health? Not sure. The National Academies published recommendations in late 2024 that aligned with my study. It will take some time for researchers and funders to catch up. Since 2024, I have rejected several manuscripts as a reviewer for peer-reviewed journals that are working off of old standards. It may be a situation that funders, in and outside of government, will need to enforce new standards. Those who seek to publish will get away with what they are allowed to get away with. The profit-driven model of the publishing industry does concern me because they may be the least responsive to new thinking  - profit over quality.

*Questions generated from Grok(xAI) in April 2025; prompt, "What are five of the most likely questions from the public about the study?" Dr. Christopher Williams answered the questions.