Asking MultiCrit Questions: A Reflexive and Critical Framework to Promote Health Data Equity for the Multiracial Population

Early View Perspective
Health Equity
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Policy Points:

  • Health equity work primarily centers monoracial populations; however, the rapid growth of the Multiracial population and increasingly clear health disparities affecting the people in that population complicate our understanding of racial health equity.
  • Limited resources exist for health researchers and professionals grappling with this complexity, likely contributing to the relative dearth of health literature describing the Multiracial population.
  • We introduce a question-based framework built on core principles from Critical Multiracial Theory (MultiCrit) and Critical Race Public Health Praxis, designed for researchers, clinicians, and policymakers to encourage health data equity for the Multiracial population.

Racial inequities in health and well-being began in the United States with colonization and slavery and have persisted as direct consequences of historic and ongoing systemic racism.1, 2 The use of racial categories to describe such disparities has been closely tied to the Census Bureau’s definitions of race and has evolved with the changing demographics of the country.3, 4 In 2000, the Census allowed respondents to select multiple races for the first time; since then, the number of people who have done so has increased by 276%, from 9 million in 2000 to 34 million in 2020 (approximately 10% of the US population).5 Multiracial people face some of the highest prevalences of adverse childhood experiences,6, 7 asthma,8 obesity,9 substance use,10 mental illness, hopeless feelings, and serious psychological distress11 of all racial groups, but studies attempting to explain these patterns are rare. Today, many medical and public health researchers view race as a socially structured marker of relative (dis)advantage rather than of biological difference,12-16 but because of long-standing institutionalized practices and for methodologic simplicity, they often continue to be measure race in mutually exclusive categories.17 However, the growing size of Multiracial populations, whose identities do not fit neatly into these categories and which have distinct racialized social experiences, draw these practices into question.18 A frequent line of questioning from those who work in these fields is, “What do I do about Multiracial people? Where do they fit into my work?” As a group of Multiracial epidemiologists (see positionality statements in Box 1), we are excited by and encourage greater engagement with these kinds of questions given present opportunities to improve equity through visibility in health data.19 We hope our framework will spur conversation and help practitioners, researchers, and policymakers think through their answers to these questions as they relate to racial health equity work.


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Lam-Hine T. Forthal S. Johnson CY, Chin HB. Asking MultiCrit Questions: A Reflexive and Critical Framework to Promote Health Data Equity for the Multiracial Population. Milbank Q.2024;102(2):0306.