The growing empirical quantitative literature on structural racism and health outcomes demonstrates researchers’ myriad approaches to measuring structural racism, from which scholars seeking to do equity-oriented research with a structural lens can learn. In this report, we condense and characterize patterns in the approaches taken to measuring structural racism in the health literature to facilitate that learning. We summarize measurement approaches, including the strengths, limitations, and strategic use cases. We also discuss crosscutting challenges to measuring structural racism that have implications beyond measurement.

WHY THIS MATTERS

Structural racism is a root cause of inequity, and researchers are increasingly called upon to study this relationship to equip policymakers, advocates, and communities to disrupt it. To do so, they will need varied methodological skills paired with strong conceptual foundations and a willingness to engage in self- and field-level critical praxis. Cognizant of this broad set of needed capacities, this report is intended to help researchers who are familiar with the concept of structural racism and who would like to quantitatively study it but need guidance in how to measure it as a construct.

WHAT WE FOUND

We identified three general approaches to operationalizing structural racism: the geographic approach, the self-reported approach, and the specific policy approach. Each approach is essential, leading researchers to sometimes use combinations. No single approach can overcome all the challenges inherent to measuring structural racism, which operates directly and indirectly, as a dependent and independent variable, at all geographical and social levels, historically and contemporarily, and in complex and nuanced combinations with other forms of identity-based oppression. Mitigating these challenges requires quantitative researchers to be theory-driven, historically rooted, and policy-specific. Working with people with lived experience of systemic inequity and with scholars from other disciplines and methodologies will help quantitative researchers situate their models in the context needed to improve their credibility, accuracy, resonance, and impact.

HOW WE DID IT

We scanned the quantitative empirical literature from the past 10 years that examined the relationship between structural racism and health. We reviewed 70 articles, focusing on their operationalization of structural racism as an independent variable.