A Standard Measure of Structural Racism, Do We Have One? Can We Have One? A Narrative Review of Commonly Used Measures and Domains of Use.

BACKGROUND

A lack of a "gold standard" operationalized index to measure structural racism (SR) in the current literature limits the comparison of the evidence available. This study aims to synthesize the measures of SR from the current literature to identify the measures used to date, study the indicators included, and investigate its expanding domain.

METHODS

A literature search of original quantitative studies in the Google Scholar and PubMed databases for articles dated January 1, 2000-July 31, 2023, was conducted with search terms: ["Institutionalized Racism" OR "Systemic Racism", OR "Structural Racism"] AND "Health" AND "United States." The studies were summarized and extracted based on the type of SR index used, the domains of SR incorporated, and the health outcomes studied.

RESULTS

A total of 74 articles were included in the final review. The historical redlining score, G-statistics, index of concentration, and structural racism index were common quantifiable measures of SR. These indices capture 56 indicators across 11 significant domains to measure SR. Similarly, SR indices are being used mostly to study the impact of SR on cardiovascular diseases and other chronic health conditions, women's and maternal health-related issues, and COVID-19 outcomes.

CONCLUSION

Multiple indices have been developed to capture SR, and since the COVID-19 pandemic, we have observed an increased interest in understanding health disparities through the lens of SR. With the rise in evidence on experiences of minority races related to racism, there is a high need for a standard approach to measuring SR.