What Structural Racism Is (or Is Not) and How to Measure It: Clarity for Public Health and Medical Researchers
Open accessAbstract
Interest in studying structural racism’s impacts on health has grown exponentially in recent years. Across these studies, there is much heterogeneity in the definition and measurement of structural racism, leading to mixed interpretations of structural racism’s impact on health. A precise definition of structural racism can offer conceptual clarity to inform what mechanisms to investigate and is imperative for conducting high-quality research on it and dismantling it. In this commentary, we trace the evolution of the definitions of structural racism and suggest ways in which the measurement of structural racism should move forward given these definitions.
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The published empirical literature provides a narrow view of structural racism's impacts on HIV health outcomes, partly due to the finite ways of practically measuring racism at a structural level.
“First, as our review demonstrates, the published empirical literature provides a narrow view of structural racism’s impacts on the health outcomes for HIV, partly due to the finite ways of practically measuring racism at a structural level [36,37].”
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 [36]
The STRUCTURAL RACISM MEASURES section (page unavailable) says existing measures can miss the interacting effects of societal structures, and Table 1 identifies further measurement limitations. This supports the claim that measurement practices constrain what researchers can assess, but the paper does not establish that the empirical literature provides a narrow view specifically of HIV health outcomes; the citing authors attribute that finding to their own review. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSeveral studies used experiences of racial discrimination as proxies for structural racism within HIV research.
“Several studies utilized experiences of racial discrimination as “proxies” for structural racism within HIV research [36].”
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 [36]
The 'WHAT STRUCTURAL RACISM IS NOT' section distinguishes interpersonal racism from structural racism, and 'STRUCTURAL RACISM MEASURES' discusses other measures used in health research. Neither section reports that HIV studies used experiences of racial discrimination as proxies for structural racism. Searches for HIV and for discrimination used as a proxy found no passage addressing that claim; page numbers were unavailable in our copy. (LLM, conf=0.76)
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Cites
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Measuring Structural Racism and Its Association With BMI
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“, used a 5-domain index to capture the compounding effects of county-level structural racism in education, housing, employment, criminal justice, and health care and applied it to body mass index (weight (kg)/ height (m)2) (23).”
MethodSelf-citation
Flagged first, then by citations
Research works printed but not linked: 21
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Cited by
Sorted by citations
Price, M. A., Hollinsaid, N. L., McKetta, S., Mellen, E. J., & Rakhilin, M. (2024) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-023-02482-4 · Cited by 81 · see citing works
Muno, B. A., Islam, J. Y., Schwartz, R., Wallace, S., Camacho-Rivera, M., & Patel, R. C. (2024) · AIDS and Behavior · doi:10.1007/s10461-024-04417-9 · Cited by 9 · see citing works
- Authors
- Dean, L. T., & Thorpe, R. J.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Dean, Lorraine T
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-07-05
- Volume
- 191
- Issue
- 9
- Pages
- 1521-1526
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC9437815
- OpenAlex
- W4284668277
- Cited by
- 212
- References
- 2
- Citations by year
- 2026: 29 · 2025: 53 · 2024: 58 · 2023: 63 · 2022: 9
- FWCI
- 65.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Epidemiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Johns Hopkins University
- National Institutes of Health
- Johns Hopkins Bloomberg School of Public Health
- National Institute on Aging (K02AG059140, DP1AG069874, P30AG059298)
- National Heart, Lung, and Blood Institute (R01HL164116)
- National Institute of Mental Health (R25MH083620)
- National Institute on Minority Health and Health Disparities (U54MD000214)
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Health › Health disparities and outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Race, Genetics, and Society
- Keywords
- structural racism, health disparities, conceptual clarity, racism and health, public health research
- MeSH terms
- Systemic Racism, Health Personnel, Humans, Public Health, Racism
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