Structural Racism and Health Stratification: Connecting Theory to Measurement
2024/02/03 by Tyson H. Brown, Patricia Homan · 115 citations
Health Professions · Psychology · Social Sciences · #Computer science #Conceptualization #Employment and Welfare Studies #Gender studies #Health care #Health disparities and outcomes #Health equity #Political science #Psychology #Psychometrics of racism #Racial and Ethnic Identity Research #Racism #Social psychology #Sociology #Structural equation modeling
paper · pdf · doi:10.1177/00221465231222924
published in Journal of Health and Social Behavior 65(1), 141-160 (SAGE Publishing)
openalex publication_date 2024/02/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05
Abstract
Less than 1% of studies on racialized health inequities have empirically examined their root cause: structural racism. Moreover, there has been a disconnect between the conceptualization and measurement of structural racism. This study advances the field by (1) distilling central tenets of theories of structural racism to inform measurement approaches, (2) conceptualizing U.S. states as racializing institutional actors shaping health, (3) developing a novel latent measure of structural racism in states, (4) using multilevel models to quantify the association between structural racism and five individual-level health outcomes among respondents from the Health and Retirement Study (N = 9,020) and the Behavioral Risk Factor Surveillance System (N = 308,029), and (5) making our measure of structural racism publicly available to catalyze research. Results show that structural racism is consistently associated with worse health for Black people but not White people. We conclude by highlighting this study's contributions (theoretical, methodological, and substantive) and important avenues for future research on the topic.
Citations
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