Institutional racism is a wicked public health problem that fuels systemic health inequities between population groups in New Zealand, the United States and elsewhere. While literature has examined racism and its effects on health, the work describing how and where to intervene to reduce institutional racism in public health is less developed. In this paper, we advance anti-racism praxis as a tool to address inequities in public health. While the notion of raising awareness of racism is not new, given the way racism has morphed into new narratives in health institutional settings, it has become critical to offer a new framework for informing efforts to address racism as a fundamental cause of health inequities. Using the cases of Māori in New Zealand and Black Americans in the United States, we describe key tensions and necessary considerations for reducing the effects of institutional racism on health. Our anti-racism praxis is anchored in an analysis of racism that is rooted in an explication of power. Examining the processes and outcomes associated with three faces of power provides critical insight into the persistence of health inequities. This praxis model is based on the premise that racism is a modifiable determinant of health and racial inequities can be eliminated with the necessary political will and a planned systems change approach. Anti-racism praxis provides the tools to examine the interconnection and interdependence of cultural, and institutional factors in each context as a foundation for examining where and how we need to intervene to address racism.