Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
J Racial Ethn Health Disparities. 2023 Aug;10(4):1997-2019. doi: 10.1007/s40615-022-01381-9. Epub 2022 Aug 22.
Despite growing interest in the health-related consequences of racially discriminatory institutional policies and practices, public health scholars have yet to reach a consensus on how to measure and analyze exposure to institutional racism. The purpose of this paper is to provide an overview of the conceptualization, measurement, and analysis of institutional racism in the context of quantitative research on minority health and health disparities in the United States. We begin by providing definitions of key concepts (e.g., racialization, racism, racial inequity) and describing linkages between these ideas. Next, we discuss the hypothesized mechanisms that link exposure to institutional racism with health. We then provide a framework to advance empirical research on institutional racism and health, informed by a literature review that summarizes measures and analytic approaches used in previous studies. The framework addresses six considerations: (1) policy identification, (2) population of interest, (3) exposure measurement, (4) outcome measurement, (5) study design, and (6) analytic approach. Research utilizing the proposed framework will help inform structural interventions to promote minority health and reduce racial and ethnic health disparities.
尽管人们对种族歧视性制度政策和做法对健康的影响越来越感兴趣，但公共卫生学者尚未就如何衡量和分析制度种族主义的暴露程度达成共识。本文旨在概述美国少数民族健康和健康差异的定量研究背景下，制度种族主义的概念化、衡量和分析。我们首先提供关键概念（例如，种族化、种族主义、种族不平等）的定义，并描述这些概念之间的联系。接下来，我们讨论假设的机制，这些机制将制度种族主义的暴露与健康联系起来。然后，我们提供了一个框架，以推进关于制度种族主义与健康的实证研究，该框架基于文献综述，总结了以前研究中使用的衡量和分析方法。该框架涉及六个考虑因素：（1）政策识别，（2）感兴趣的人群，（3）暴露测量，（4）结果测量，（5）研究设计，和（6）分析方法。利用所提出的框架进行的研究将有助于为促进少数民族健康和减少种族和族裔健康差距的结构干预措施提供信息。
