Division of Epidemiology, School of Public Health, University of California.
Division of Epidemiology & Population Health, Stanford University School of Medicine.
Milbank Q. 2023 Sep;101(3):768-814. doi: 10.1111/1468-0009.12662. Epub 2023 Jul 12.
Policy Points Cultural racism-or the widespread values that privilege and protect Whiteness and White social and economic power-permeates all levels of society, uplifts other dimensions of racism, and contributes to health inequities. Overt forms of racism, such as racial hate crimes, represent only the "tip of the iceberg," whereas structural and institutional racism represent its base. This paper advances cultural racism as the "water surrounding the iceberg," allowing it to float while obscuring its base. Considering the fundamental role of cultural racism is needed to advance health equity.
Cultural racism is a pervasive social toxin that surrounds all other dimensions of racism to produce and maintain racial health inequities. Yet, cultural racism has received relatively little attention in the public health literature. The purpose of this paper is to 1) provide public health researchers and policymakers with a clearer understanding of what cultural racism is, 2) provide an understanding of how it operates in conjunction with the other dimensions of racism to produce health inequities, and 3) offer directions for future research and interventions on cultural racism.
We conducted a nonsystematic, multidisciplinary review of theory and empirical evidence that conceptualizes, measures, and documents the consequences of cultural racism for social and health inequities.
Cultural racism can be defined as a culture of White supremacy, which values, protects, and normalizes Whiteness and White social and economic power. This ideological system operates at the level of our shared social consciousness and is expressed in the language, symbols, and media representations of dominant society. Cultural racism surrounds and bolsters structural, institutional, personally mediated, and internalized racism, undermining health through material, cognitive/affective, biologic, and behavioral mechanisms across the life course.
More time, research, and funding is needed to advance measurement, elucidate mechanisms, and develop evidence-based policy interventions to reduce cultural racism and promote health equity.
政策要点文化种族主义——即普遍存在的价值观，这些价值观使白人及其社会和经济权力得到优待和保护——渗透到社会的各个层面，提升了其他形式的种族主义，导致了健康的不平等。公开形式的种族主义，如种族仇恨犯罪，仅代表“冰山一角”，而结构性和制度性种族主义则代表其基础。本文将文化种族主义视为“冰山的周围水域”，使其能够漂浮，同时掩盖其基础。考虑到文化种族主义在促进健康公平方面的基本作用是必要的。
文化种族主义是一种普遍存在的社会毒素，它包围着所有其他形式的种族主义，以产生和维持种族健康的不平等。然而，文化种族主义在公共卫生文献中相对较少受到关注。本文的目的是 1）为公共卫生研究人员和政策制定者提供对文化种族主义的更清晰理解，2）了解它如何与其他形式的种族主义一起运作，以产生健康的不平等，以及 3）为文化种族主义的未来研究和干预提供方向。
我们对理论和实证证据进行了非系统性的多学科综述，这些理论和实证证据概念化、衡量和记录了文化种族主义对社会和健康不平等的影响。
文化种族主义可以定义为一种白人至上的文化，它重视、保护和使白人及其社会和经济权力正常化。这种意识形态体系在我们共同的社会意识层面运作，并表现在主导社会的语言、符号和媒体表现形式中。文化种族主义围绕并支持结构性、制度性、个人介导的和内化的种族主义，通过物质、认知/情感、生物和行为机制在整个生命周期中破坏健康。
需要更多的时间、研究和资金来推进衡量、阐明机制，并制定基于证据的政策干预措施，以减少文化种族主义，促进健康公平。
