A Framework for Operationalizing the Structural Racism Construct in Minority and Immigrant Health Research

Racism is now widely recognized as a fundamental cause of health inequali­ties in the United States and health scholars are examining the role of struc­tural racism in fostering morbidity and mortality. But much of the prior scholarship about structural racism and health in the U.S. has narrowly focused on disparities between Black and White people or has narrowly interrogated one domain of racism (e.g., criminal justice system or the health care system) and called that single domain “structural racism.”

In a new paper, researchers Alexis C. Dennis, Esther O. Chung, Evans K. Lodge, Rae Anne Martinez, and Rachel E. Wilbur, all predoctoral trainees at the Carolina Population Center, argue that this approach is incomprehensive and overlooks the historical and lived experiences of other racial and ethnic groups.

“Looking Back to Leap Forward: A Framework for Operationalizing the Structural Racism Construct in Minority and Immigrant Health Research,” recently published in Ethnicity and Disease presents a theoretically grounded framework that illuminates several core mutually reinforcing domains of structural racism that have stratified opportunities for health in the United States from the late 1400s to the present day.

Dennis, the lead author and a PhD Candidate in Sociology at the University of North Carolina at Chapel Hill, says, “Our framework shows how various institutions, policies, laws, and cultural norms historically created different opportunity structures for those racialized as White, as compared with those racialized as Nonwhite in the United States. The legacy of these different opportunity structures shapes racial/ethnic health disparities today. In the paper, we illustrate the utility of our framework by applying it to the case of excess COVID-19 mortality among American Indians or Alaska Natives. We also discuss the framework’s broader implications for empirical health research.”

The framework Dennis and colleagues designed can help scholars identify and interrogate the important laws, policies, and norms that created unique socio-historical experiences across White, Black, Alaska Native or American Indian, Asian American, Hispanic/Latino, and Native Hawaiian or Pacific Islanders populations in the US across time, to better capture the broad and insidious effects of structural racism on health disparities, historically and today.