Quantifying Older Black Americans’ Exposure to Structural Racial Discrimination: How Can We Measure the Water In Which We Swim?
Open accessAbstract
The USA was built on legalized racism that started with enslavement and continues in the form of structural racial discrimination. This discrimination is difficult to measure because its many manifestations are hard to observe and dynamic. A useful tool would measure across settings, institutions, time periods in a person’s life and the country’s history. The purpose of this study was to design a measure of structural racial discrimination that meets those criteria and can be used in large national datasets. To do this, we started with an exploratory mixed-methods instrument design, including qualitative interviews with 15 older Black adults and focus groups with 38 discrimination researchers and other key stakeholders. We then identified 27 indicators of structural racial discrimination across nine theorized discrimination contexts. We matched these with historical administrative data sets to develop an instrument that could quantify older Black Americans’ exposure to structural racial discrimination across contexts, the life course, and geographies. These can be mapped to the life course of structural discrimination based on the home addresses of those surveyed. Linking these to available indicators is a promising approach. It is a low burden for participants and enables increasingly multifaceted and focused measurement as more national datasets become available. A flexible, feasible comprehensive measure of structural discrimination could allow not only more thorough documentation of inequities but also allow informed decision making about policies and programs intended to promote racial equity. Significance Statement: To our knowledge, this is the first study that presents a framework for assessing structural racial discrimination across contexts, life course, and geography that is grounded in theory and in the lived experience of intended participants. Leading researchers and policy makers have called for improved measures of structural racism and discrimination and specifically for a lifecourse approach to measurement. This study is a step in that direction. Classification: Social Sciences
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Prior work has summarized the existing scientific evidence of the impact of context- or neighborhood-level factors on HIV-related outcomes without necessarily considering race and ethnicity or naming racism.
“Prior work has summarized the existing scientific evidence of the impact of context- or neighborhood-level factors on HIV-related outcomes, without necessarily considering race and ethnicity or naming racism [45].”
From Structural Racism Conceptualization and Operationalization for Research for the U.S. HIV Epidemic: Findings from a Scoping Review and Implications for Advancing Research for Structural Interventions (2024) · cites this paper as [45]
The Introduction discusses measures of structural discrimination and health outcomes, while the Findings describe neighborhood-level indicators for older Black Americans. Searches for HIV-related outcomes and reviews of neighborhood factors found no passage addressing the claim in our copy. (LLM, conf=0.76)
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Cites
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Sorted by citations
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- Authors
- LaFave, S. E., Bandeen-Roche, K., Gee, G., Thorpe, R. J., Li, Q., Crews, D., Samuel, L., Cooke, A., Hladek, M., & Szanton, S. L.
- Affiliations
- Johns Hopkins University (US)
- University of California, Los Angeles (US)
- Corresponding author
- Szanton, Sarah L.
- Venue
- Journal of Urban Health
- Published
- 2022-04-29
- Volume
- 99
- Issue
- 5
- Pages
- 794-802
- ISSN
- 0028-7091 (ISSN-L)
- 1099-3460
- 1468-2869
- PMC
- PMC9561453
- OpenAlex
- W4225140349
- Cited by
- 32
- References
- 5
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 8 · 2023: 11 · 2022: 2
- FWCI
- 10.79
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Urban Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Foundation for the National Institutes of Health (TL1-TR003100)
- National Institute on Aging (DP1AG069874)
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Keywords
- life course, residential geography, racial equity, racial inequity, administrative data linkage, instrument design
- MeSH terms
- Aged, Black or African American, Humans, Racism
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