Bell Caryn N, Blackson Emma A, Anderson Andrew, Stojanovski Kristefer, Weller Bridget E
Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
J Racial Ethn Health Disparities. 2025 Jun 4. doi: 10.1007/s40615-025-02484-9.
There has been an increase in both research and funding aimed at exploring the connections between racism and racial health inequities. Despite these efforts, some quantitative analyses fall short when they rely heavily on counterfactual thinking (e.g., asking "what if" questions) on race and racism. Such methods are based on a theorization of race and racism that inadequately captures the White privilege inherent in the system of racism. Therefore, counterfactual thinking and methods can potentially perpetuate harmful interpretations of data. To address these shortcomings, we advocate for the use of methods that can account for White privilege including race-specific comparative analyses or intra-racial analyses. Unlike traditional counterfactual-based approaches, these types of analyses can provide a comprehensive view of how racism influences health outcomes, recognizing the varying impacts on individuals within structurally disadvantaged groups as opposed to those experienced by White individuals. Furthermore, by focusing on the specific needs of those most affected by health inequities, race-specific and intra-racial analyses adhere to principles of health equity ensuring a more accurate and effective anti-racist approach to understanding and addressing racial health inequities.
针对探索种族主义与种族健康不平等之间联系的研究和资金投入都有所增加。尽管做出了这些努力，但一些定量分析在严重依赖关于种族和种族主义的反事实思维（例如，问“如果……会怎样”的问题）时存在不足。此类方法基于一种对种族和种族主义的理论化，这种理论化未能充分捕捉到种族主义体系中固有的白人特权。因此，反事实思维和方法可能会使有害的数据解释长期存在。为解决这些不足，我们提倡使用能够考虑白人特权的方法，包括按种族进行的比较分析或种族内分析。与传统的基于反事实的方法不同，这些类型的分析可以提供一个关于种族主义如何影响健康结果的全面视角，认识到对结构上处于不利地位群体中的个体与白人个体所经历的不同影响。此外，通过关注受健康不平等影响最严重人群的具体需求，按种族和种族内分析坚持健康公平原则，确保采用更准确、有效的反种族主义方法来理解和解决种族健康不平等问题。
