Purpose: Black women in the United States face poor outcomes across reproductive health measures—from pregnancy outcomes to gynecologic cancers. Racial health inequities are attributable to systemic racism, but few population studies of reproductive health outcomes integrate upstream measures of systemic racism, and those who do are limited to maternal and infant health outcomes. Advances in understanding and intervening on the pathway from racism to reproductive health outcomes are limited by a paucity of methodological guidance toward this end. We aim to fill this gap by identifying quantitative measures of systemic racism that are salient across reproductive health outcomes. Methods: We conducted a review of literature from 2000 to 2019 to identify studies that use quantitative measures of exposure to systemic racism in population reproductive health studies. We analyzed the catalog of literature to identify cohesive domains and measures that integrate data across domains. For each domain, we contextualize its use within population health research, describe metrics currently in use, and present opportunities for their application to reproductive health research. Results: We identified four domains of systemic racism that may affect reproductive health outcomes: (1) civil rights laws and legal racial discrimination, (2) residential segregation and housing discrimination, (3) police violence, and (4) mass incarceration. Multiple quantitative measures are available for each domain. In addition, a multidimensional measure exists and additional domains of systemic racism are salient for future development into distinct measures. Conclusion: There are quantitative measures of systemic racism available for incorporation into population studies of reproductive health that investigate hypotheses, including and beyond those related to maternal and infant health. There are also promising areas for future measure development, such as the child welfare system and intersectionality. Incorporating such measures is critical for appropriate assessment of and intervention in racial inequities in reproductive health outcomes.

About 16,000 families residing in Chicago's public housing have been relocated over the last two decades through the U.S. Department of Housing and Urban Development's Housing Opportunities for People Everywhere (HOPE VI) redevelopment initiative. We situate this paper within a larger conversation about the presence and utilization of community ties within public housing despite the territorial stigmatization of traditional public housing. Utilizing in-depth interviews with 20 Black caregiving grandmothers relocated from Chicago public housing we explore how women charged with performing the lion's share of the kinwork needed to ensure family stability experienced and created a sense of community while living in public housing. We show that by providing (1) safety nets for multiple generations, (2) social support and connections to neighborhood institutions, as well as (3) opportunities for Black activist mothering, these women, often at the heart of vertical lineages, created a sense of community amidst the problems in their communities.

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