Table 1.

Components of US undergraduate and graduate public health training programs, curricula, and pedagogical methods for teaching about structural racism and racial equity in studies published before April 2020: results of a systematic review

Author	Program description	Intervention setting, duration, materials, and evaluation	Audience a	Instructor(s) b	Pedagogical approach c
Browne et al, 2013 28	Program summary: Authors analyzed online responses to local news stories about health disparities and reflected on how that information could be used to prepare students for work on eliminating health disparities. Responses to news stories showed the public’s belief that disparities were “leftist liberal” political agendas or the result of individual factors of Black people. Authors suggest framing health disparities in terms of “agent” (ie, group to whom society has given greater power/privilege) and “target” (ie, group for whom society limits power) groups to encourage students to examine oppression at a structural rather than individual level, using these real-world examples. Key topic areas: Health disparities, structural issues, racialized contexts	Setting: Classroom Duration: Not stated Materials: Action planning worksheet, discussion questions Evaluated: No	Graduate students and undergraduate students	Faculty	Group discussion
Buttress et al, 2013 31	Program summary: Seminar series that used The Wire to examine the context of urban health disparities: the interplay among political, cultural, structural, and individual factors that perpetuate disparities. For example, one seminar used The Wire to frame a discussion on the relationships among deindustrialization, policing, drug policy, and gun violence among African American young people. Key topic areas: Structural issues that affect urban health	Setting: Johns Hopkins Bloomberg School of Public Health seminar series Duration: 9 seminars Materials: The Wire (HBO series) Evaluated: No	This seminar was hosted by the Johns Hopkins Bloomberg School of Public Health and open to the community, including students. It was not clear if the seminar was targeted specifically for undergraduate or graduate public health students.	Faculty, community members, organizations, other	Didactic lecture/seminar talk, group discussion
Chávez et al, 2006 38	Program summary: A semester-long course, “Public Health Through a Lens of Community Organizing,” used pedagogy of collegiality d to shift students’ thinking from a biomedical understanding of illness and disease to an explicit use of language about social justice, cultural competence, and human rights. Instructors used techniques such as journaling, ethnographic study, and community circle to teach about such topics as social justice, human rights, ethics of community-based research, and power, oppression, and privilege. Key topic areas: Pedagogy of collegiality centered on 4 essential features: (1) principles of community organizing, (2) building community and valuing diversity, (3) engaging the senses, and (4) writing across the curriculum.	Setting: Introductory public health course for students in master of public health program Duration: 15-wk semester Materials: Music, classroom decorations (eg, textiles from various cultures), paper Evaluated: Yes	Graduate students	Faculty, graduate teaching assistants	Didactic lecture/seminar talk, group discussion, group project, individual project, experiential
Dennis et al, 2019 33	Program summary: Program integrated a didactic lesson on the Three Levels of Racism, 38 workshops on privilege and implicit bias, and a museum tour of an exhibit on Black Wall Street and the Tulsa Race Massacre. Key topic areas: Understanding racism as an SDH by examining structural, personally mediated, and internalized racism	Setting: Lecture and workshop series for a community medicine residency program and community health leadership program Duration: 4-5 h during an 11-mo period Materials: YouTube videos, paper, community report cards, museum exhibit Evaluated: Yes	Graduate students	Faculty, community members, or organizations	Didactic lecture/seminar talk, group discussion, experiential
Garcia et al, 2019 32	Program summary: Facilitators used interactive didactic PowerPoint presentations and videos to discuss SDH and structural determinants of health (eg, the effect of federal policies on health outcomes of American Indian/Alaska Native people). They then engaged participants in a storytelling activity to teach about access to health care among American Indian/Alaska Native people. Key topic areas: SDH and structural determinants of health among urban American Indian/Alaska Native people	Setting: Workshop for medical students, residents, physicians, and other health care professionals or trainees, including graduate students in public health Duration: 90 min Materials: Facilitator’s guide, PowerPoint presentation, land acknowledgment resources, videos (Honor Native Land, The Art of Indigenous Resistance), storytelling cards, evaluation forms Evaluated: Yes	Graduate students	Faculty, other (racial equity consultants from outside the host institution)	Didactic lecture/seminar talk, group discussion, experiential
Hagopian et al, 2018 35	Program summary: A schoolwide antiracism competency that was adopted to guide antiracism training across programs and departments. Courses designed to meet this competency developed skills in antiracist analysis. Key topic area: Antiracism competency to “recognize the means by which social inequities and racism, generated by power and privilege, undermine health.”	Setting: Schoolwide antiracism competency Duration: Ongoing Materials: Toolkit with case examples to guide course instructors to improve inclusive teaching practices Evaluated: Yes	Graduate students and undergraduate students	Faculty, graduate teaching assistants, other (racial equity consultants from outside the host institution)	Guiding competency
McGrath, 2019 29	Program summary: Described a pedagogical approach for teaching about social processes that produce health inequities among African communities (on and off the continent) in a way that does not reify the inequities themselves—in particular, by using arts rooted in these communities. Suggests studying present and past forms of public health by examining historical relations among political authorities, individuals, and collectives. Key topic areas: Social processes that produce health inequities among African communities	Setting: Classroom Duration: Not stated Materials: Unequal Causes documentary, artistic materials that represent African lives (eg, Everyday Africa Instagram account), materials by and about African people Evaluated: No	Graduate students and undergraduate students	Faculty	Didactic lecture/seminar talk, group discussion
Mogford et al, 2011 34	Program summary: A critical health literacy workshop or course that can be adapted to meet the needs of the audience. The curriculum is guided by a 4-part framework: (1) Knowledge of SDH and health as a human right. This component includes a “causes of the causes” activity, pushing students to analyze individual behaviors in the context of social, political, and economic upstream factors such as international trade agreements and global markets. (2) Students as social change agents. (3) Advocacy tools and strategies. (4) Development and implementation of actions intended to increase equity by addressing SDH. Key topic area: Applying the critical health literacy framework to address SDH	Setting: Course or workshop in a classroom, community health center, or other community settings Duration: Ranged from 2-h workshop to 12-wk course Materials: Universal Declaration of Human Rights; Just Health Actions advocacy continuum; Strengths, Weaknesses, Opportunities, and Treats analysis tool; Objective, Reflective, Interpretive, Decisional facilitation tool Evaluated: Yes	Graduate students and undergraduate students	Community members or organizations	Didactic lecture/seminar talk, group discussion, group project, individual project
Rosales et al, 2012 36	Program summary: Described strategies to incorporate social justice into the master of public health curriculum, including discussions in existing courses, lunchtime discussions and trainings on research and interventions, service learning with community coalitions to learn about the short-term and long-term effects of social injustice, an annual social justice symposium, and a course with service-learning opportunities that includes working with underserved communities to raise awareness of how federal and state policies affect communities. Key topic areas: Social justice and health	Setting: Public health courses Duration: Not stated Materials: Not stated Evaluated: No	Graduate students and undergraduate students	Faculty	Didactic lecture/seminar talk, group discussion, experiential
Taualii et al, 2013 37	Program summary: Six competencies to prepare students to assist in addressing the health and wellness needs of Indigenous People: (1) Describe Indigenous Peoples’ health in a historical context and analyze the effect of colonial processes on health outcomes. (2) Analyze key comparative health indicators and SDH for Indigenous Peoples. (3) Critically evaluate Indigenous public health policy and programs. (4) Apply the principles of economic evaluation to Indigenous programs, with a particular focus on the allocation of resources relative to need. (5) Demonstrate a reflexive public health practice for the health contexts of Indigenous Peoples. (6) Demonstrate a disease prevention strategy that values and incorporates the traditional knowledge of Indigenous Peoples. Key topic area: Native Hawaiian and Indigenous health	Setting: Competencies to support a Native Hawaiian and Indigenous Health concentration Duration: Master of public health program Materials: Not stated Evaluated: No	Graduate students	Faculty	Didactic lecture/seminar talk, experiential, guiding competency
Tettey, 2018 30	Program summary: Students watched season 4 of The Wire and used the socioecological model to analyze a character’s life and the contextual factors that influence that character. The Wire helps students understand both the “what” of health disparities and the “how” and “why” by presenting the intersectionality of concentrated poverty, a failed education system, corrupt government, mass incarceration, and the war on drugs, among other factors. Key topic area: Health disparities	Setting: Undergraduate public health course Duration: Semester Materials: Season 4 of The Wire (HBO series) Evaluated: Yes	Undergraduate students	Faculty	Group discussion, individual project

Abbreviation: SDH, social determinants of health.

^aCategories were graduate students and undergraduate students.

^bCategories were faculty, graduate teaching assistants, community members or organizations, and other.

^cCategories were didactic lecture/seminar talk, group discussion, group project, individual project, experiential, and guiding competency (ie, competency adopted by a school or program of public health specifying knowledge and/or skills that all students should learn).

^dApplication of feminist and critical theories in classroom activities and assignments to promote inclusion of diverse learning styles, open communication between students and instructors, community building, and multicultural education.