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Public health critical race praxis at the intersection of traffic stops and injury epidemiology



Law enforcement traffic stops are one of the most common entryways to the US justice system. Conventional frameworks suggest traffic stops promote public safety by reducing dangerous driving practices and non-vehicular crime with little to no collateral damage to individuals and communities. Critical frameworks interrogate these assumptions, identifying significant individual and community harms that disparately impact Black, Indigenous, and People of Color (BIPOC) and low-income communities.


The Public Health Critical Race Praxis (PHCRP) and multi-level frameworks from community anti-racist training were combined into a structured diagram to guide intervention and research teams in contrasting conventional and critical perspectives on traffic stops. The diagram divides law enforcement and drivers/residents as two separate agent types that interact during traffic stops. These two agent types have different conventional and critical histories, priorities, and perspectives at multiple levels, including individual, interpersonal, institutional, and cultural levels. Conventional solutions (identifying explicitly racist officers, “meet-a-cop” programs, police interaction training for drivers) are born from conventional frameworks (rewarding crime prevention regardless of cost, the war on drugs saves lives, driver behavior perfectionism). While conventional perspectives focus on individual and interpersonal levels, critical perspectives more deeply acknowledge dynamics at institutional and cultural levels. Critical solutions may be hard to discover without critical frameworks, including that law enforcement creates measurable collateral damage and disparate social control effects; neighborhood patrol priorities can be set without community self-determination or accountability and may trump individual and interpersonal dynamics; and the war on drugs is highly racialized and disproportionally enforced through traffic stop programs.


Traffic stop enforcement and crash prevention programs that do not deeply and critically consider these dynamics at multiple levels, not just law enforcement-driver interactions at the individual and interpersonal levels, may be at increased risk of propagating histories of BIPOC discrimination. In contrast, public health and transportation researchers and practitioners engaged in crash and injury prevention strategies that employ law enforcement should critically consider disparate history and impacts of law enforcement in BIPOC communities. PHCRP, anti-racism frameworks, and the included diagram may assist them in organizing critical thinking about research studies, interventions, and impacts.


Law enforcement traffic stops are one of the most common entryways to the US justice system. Conventional public health frameworks suggest traffic stops promote public safety by reducing dangerous driving practices while having little if any collateral damage to individuals and communities. Conventional law enforcement frameworks (Scalia 1996) see traffic stops as a legally valid reason to investigate any person viewed with suspicion, which may lead them to target individuals based on their intersectional identities rather than driving behaviors. Viewed critically through racialized history and context, traffic stops have clear harms at the individual, interpersonal, institutional, and cultural levels. These harms, especially those disparately affecting Black, Indigenous, and People of Color (BIPOC) and low-income communities, must be weighed against stated public health benefits.

Traffic safety interventions, including popular Vision Zero campaigns (Conner 2017), require a critical view of the role that traffic enforcement can play in public safety. There are proven interventions to reduce crashes and racial disparities in traffic stops, including one we evaluated previously in Injury Epidemiology (Fliss et al. 2020). Injury epidemiology has a long history of applying critical thinking frameworks such as the Haddon Matrix while conceiving and critiquing interventions. This commentary combines two frameworks, the Public Health Critical Race Praxis (PHRCP) and community anti-racism trainings, into a diagram that supports public health practitioners, researchers, and community groups to think critically about involving law enforcement in crash prevention.

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What are critical race theory (CRT) and public health critical race praxis (PHCRP)?

Critical Race Theory (CRT) ‘defines the set of anti-racist tenets, modes of knowledge production, and strategies a group of legal scholars of color in the 1980s organized into a framework targeting the subtle and systemic ways racism currently operates above and beyond any overtly racist expressions’ (Ford and Airhihenbuwa 2018). CRT distinguishes itself from both colorblind approaches to racism, such as a feminism or class critique disconnected from intersectional race realities, and from civil rights approaches that seek redress for racism without changing underlying racist structures.

Ford and Airhihenbuwa called for CRT’s inclusion in public health in 2010 (Ford and Airhihenbuwa 2010) and again in 2018 (Ford and Airhihenbuwa 2018), promoting the PHCRP as a semi-structured framework to facilitate the integration of CRT into public health research disciplines, including epidemiology, that produce and interpret evidence used for intervention evaluation and policy promotion.

The PHCRP has four foci and eleven affiliated, interrelated principles. The four foci are (1) contemporary patterns of racial relations, (2) knowledge production, (3) conceptualization and measurement, and (4) action. The eleven principles that relate to one or more foci are: (1) race consciousness, (2) primacy of racialization, (3) race as a social construct, (4) gender as a social construct, (5) ordinariness of racism, (6) structural determinism, (7) social construction of knowledge, (8) critical approaches, (9) intersectionality, (10) disciplinary self-critique, and (11) voice.

We have not formally been formally trained in PHCRP (Ford and Airhihenbuwa 2018), so humbly offer our application as much to demonstrate its application to traffic stops as to advance our own understanding. We also draw on previous experience with community anti-racism training (through dismantling Racism Works and the Racial Equity Institute) based on frameworks from the People’s Institute for Survival and Beyond (PISB) (The People’s Institute 2019). These characteristics of institutions (Okun 2010) overlap with PHCRP in many ways. Contrasting the conventional view of racism as purely interpersonal, PISB-influenced trainings present racism as both hierarchical and nested (i.e., internalized racial superiority and inferiority, interpersonal interactions, institutional settings, and cultural context). This model mirrors multilevel (Diez 2002) frameworks used in social epidemiology (Gee 2008), traffic crash research (Adanu et al. 2017), geography (Kim and Subramanian 2016), and criminology (Jones and Pridemore 2018) settings.

Since its introduction, CRT and the PHCRP have been increasingly used to guide study design, interpretation, and suggest areas for future research. These applications are varied, including public park features in Latino immigrant neighborhoods (García et al. 2016), lead water contamination in Flint, MI (Muhammad et al. 2018), and law enforcement “justifiable” homicides of Black men (García et al. 2016).

Applying CRT/PHCRP to traffic stops

We follow the example from Gilbert and Ray (2015) by contrasting a conventional interpretation with a PHCRP interpretation for each principle in a tabular format based on literature review, community practice, and known disparities (Table 1). Themes from the conventional and critical contrasts are combined into a single figure describing these nested, multi-level dynamics within the unique nexus of traffic stops.

Table 1 PHCRP versus conventional view of traffic stop frameworks

Nested, multi-level, dual-agent PHCRP framework for traffic stops

The conventional and PHCRP principles included in Table 1 could expand to its own full-length book. However, we believe there is utility in having a more condensed resource that connects the PHCRP framework to the traffic-stop setting visually. The PHCRP framework when expressed tabularly does not convey (1) the nested, multi-level dynamics of people, inter-personal interactions, institutions, and cultures, and (2) does not separate drivers and residents from law enforcement as unique loci for critical analysis, with their interaction being the nexus of the traffic stop. To that end, we built the following visual framework (Fig. 1) to contrast PHCRP and conventional frameworks nested within these multi-level structures, separating law enforcement and driver agents that meet at the traffic stop nexus. This figure and the PHCRP were used together to critically examine (1) limitations of a traffic stop intervention designed to reduce disparities and save lives (Fliss et al. 2020) and (2) issues with accurate measurement of traffic stop disparities (Fliss 2019).

Fig. 1
figure 1

Nested, dual-agent PHCRP framework for critical examination of traffic stop dynamics and interventions. Conventional frameworks prioritize the individual (behaviors and internalized mindsets) and interpersonal levels, and limit interaction to focus on the traffic stop itself as a time and level of interaction. PHCRP emphasizes higher levels dynamics (institutional, cultural), root and historical causes, and collateral consequences


We recommend using PHCRP as a framework to guide more equitable and less unjust traffic stop policies and public health/law enforcement collaborations. We acknowledge PHCRP may be uncritically applied; its application is not automatic approval for interventions without leadership from disparately impacted communities. In contrast, a truly critical framework must contend with the possibility that few to no aspects of traffic stop programs may be equitable under the PHCRP. However, given training in PHCRP, communities, public health, and law enforcement may co-design traffic stop injury prevention programs that are tightly limited by anti-racist ethics, efficient and effective in application, and serve to deepen community trust instead of endangering it. Whether this is overly idealistic or can be done in practice is yet to be determined.

One way we have attempted to grapple with the application of PHCRP is to map it to dual-agent, nested traffic stop dynamics. While this diagram captures some nuances that the tabular form does not and may be useful as a blank template in group brainstorming sessions, it does not provide the same principle-specific contrasts as the full table. Researchers in other injury epidemiology settings may find utility in building diagrams that suit their research settings.

Both frameworks benefit from considering time in short (years) and longer (decades or centuries) scales. As acknowledged in the “the social construction of knowledge” principle, individual race-ethnicity is often tacitly used as a proxy for (or removed from) structural, historical, multi-generational racism and discrimination (VanderWeele and Robinson 2014). Frameworks such as PHCRP can help disentangle model variables by separating time and multi-level, structural phenomena such as racism. Sequencing important traffic stop related moments in time in the short term (e.g., pre-stop, stop, potential citation, potential search, potential arrest or use of force, etc.) and longer epochs (origins and historical milestones of policing and traffic stop enforcement) further separate those constructs.

We aspire to continual anti-racist learning and find PHCRP a useful framework for those efforts. Considering PHCRP principles under a multi-level framework of people, institutions, and culture may provide additional opportunities for reflection when applied to injury epidemiology related events such as traffic crashes and stops. We look forward to reading of its use in other injury epidemiology topics.

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Critical race theory


Black, indigenous, and people of color


Public health critical race praxis


People’s Institute for Survival and Beyond


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We acknowledge the support of the Orange County Bias-Free Policing Task Force, the Fayetteville Police Department, and the Southern Coalition for Social Justice for their work on these topics. We further acknowledge the late Steve Wing, PhD, professor of epidemiology at UNC Chapel Hill, for his initial guidance and advising on this project.


The associated multi-year dissertation research was unfunded except for a small one-time stipend to summarize the preliminary results in a more lay-readable format for the Fayetteville Police Department. That funding was provided by the Southern Coalition for Social Justice. Dr. Whitney Robinson is funded by National Institute of Minority Health and Health Disparities (NIMHD) of the National Institutes of Health (NIH) under award number NIH-R01MD01168, National Institutes of Health under award K01CA172717-01, and Carolina Community Network II Cancer Health Disparities Pilot Grant. Dr. Marshall is partly supported by an Injury Control Research Center award (R49-CE003092) from the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. The findings and conclusions in this publication are those of the authors and do not necessarily represent the views of the CDC.

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MDF completed this work as part of his PhD dissertation in epidemiology, including project conception, all analysis, and primary manuscript authorship. Co-authors FRB, PD, SWM, CP, and WR read, provided edits, and approved the dissertation and final manuscript. All authors read and approved the final manuscript.

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Correspondence to Michael Dolan Fliss.

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This commentary does not include any data but was accessory to a dissertation on traffic stop disparities using only de-identified, administrative, secondary data collection. The project’s ethics were reviewed and approved, and found to be exempt under UNC IRB #18-2186.

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The authors declare that they have no competing interests.

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Fliss, M.D., Baumgartner, F.R., Delamater, P. et al. Public health critical race praxis at the intersection of traffic stops and injury epidemiology. Inj. Epidemiol. 9, 9 (2022).

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