Sociology Department, University of North Carolina at Chapel Hill, NC.
Carolina Population Center, University of North Carolina at Chapel Hill, NC.
Ethn Dis. 2021 May 20;31(Suppl 1):301-310. doi: 10.18865/ed.31.S1.301. eCollection 2021.
Racism is now widely recognized as a fundamental cause of health inequalities in the United States. As such, health scholars have rightly turned their attention toward examining the role of structural racism in fostering morbidity and mortality. However, to date, much of the empirical structural racism-health disparities literature limits the operationalization of structural racism to a single domain or orients the construct around a White/Black racial frame. This operationalization approach is incomprehensive and overlooks the heterogeneity of historical and lived experiences among other racial and ethnic groups. To address this gap, we present a theoretically grounded framework that illuminates core mutually reinforcing domains of structural racism that have stratified opportunities for health in the United States. We catalog instances of structural discrimination that were particularly constraining (or advantageous) to the health of racial and ethnic groups from the late 1400s to present. We then illustrate the utility of this framework by applying it to American Indians or Alaska Natives and discuss the framework's broader implications for empirical health research. This framework should help future scholars across disciplines as they identify and interrogate important laws, policies, and norms that have differentially constrained opportunities for health among racial and ethnic groups.
种族主义现在被广泛认为是美国健康不平等的根本原因。因此，健康学者正确地将注意力转向研究结构性种族主义在促进发病和死亡方面的作用。然而，迄今为止，大部分实证性结构性种族主义与健康差异的文献将结构性种族主义的运作限制在单一领域，或者将这一概念围绕白人与黑人的种族框架展开。这种运作方法不全面，忽略了其他种族和族裔群体之间历史和生活经历的异质性。为了解决这一差距，我们提出了一个理论基础框架，阐明了在美国造成健康机会分层的结构性种族主义的核心相互强化领域。我们列举了从 15 世纪后期到现在对种族和族裔群体的健康特别具有限制（或有利）的结构性歧视实例。然后，我们通过将其应用于美洲印第安人或阿拉斯加原住民来说明该框架的实用性，并讨论该框架对实证健康研究的更广泛影响。该框架应帮助各学科的未来学者在识别和审查对不同种族和族裔群体的健康机会具有不同限制作用的重要法律、政策和规范时发挥作用。
