Quantifying Older Black Americans’ Exposure to Structural Racial Discrimination: How Can We Measure the Water In Which We Swim?

Abstract

The USA was built on legalized racism that started with enslavement and continues in the form of structural racial discrimination. This discrimination is difficult to measure because its many manifestations are hard to observe and dynamic. A useful tool would measure across settings, institutions, time periods in a person’s life and the country’s history. The purpose of this study was to design a measure of structural racial discrimination that meets those criteria and can be used in large national datasets. To do this, we started with an exploratory mixed-methods instrument design, including qualitative interviews with 15 older Black adults and focus groups with 38 discrimination researchers and other key stakeholders. We then identified 27 indicators of structural racial discrimination across nine theorized discrimination contexts. We matched these with historical administrative data sets to develop an instrument that could quantify older Black Americans’ exposure to structural racial discrimination across contexts, the life course, and geographies. These can be mapped to the life course of structural discrimination based on the home addresses of those surveyed. Linking these to available indicators is a promising approach. It is a low burden for participants and enables increasingly multifaceted and focused measurement as more national datasets become available. A flexible, feasible comprehensive measure of structural discrimination could allow not only more thorough documentation of inequities but also allow informed decision making about policies and programs intended to promote racial equity. Significance Statement To our knowledge, this is the first study that presents a framework for assessing structural racial discrimination across contexts, life course, and geography that is grounded in theory and in the lived experience of intended participants. Leading researchers and policy makers have called for improved measures of structural racism and discrimination and specifically for a lifecourse approach to measurement. This study is a step in that direction. Classification Social Sciences

Racial inequality in functional trajectories between Black and White U.S. veterans

“…Widespread systemic racism across numerous societal domains (e.g., criminallegal, educational, and political systems; credit, housing, and labor markets; white supremacist ideologies and practices) likely has deleterious effects on Black Veterans' health and resources, as they do in the civilian population. [38][39][40] Our finding that functional disparities decreased when controlling for wealth disparities is in line with prior research indicating that although Black Veterans do experience increases in civilian earnings relative to non-Veterans, these tend to be relatively modest over the long-run and cannot make up for the wealth gaps that exist for Black Americans at birth and persist into old age. 8,41 Prior research has also found that military service may have a "knifing -off" effect of previous experience and disadvantage for Black Veterans.…”

Structural racism theory, measurement, and methods: A scoping review

“…A growing body of scholarship operationalizes structural racism as an explicitly multidimensional construct and measure ( 12 , 13 , 68 , 69 , 73 , 74 , 84 , 86 , 91 , 92 , 98 , 106 ). Multidimensional measures can be created with latent-class models incorporating indicators across domains of structural racism as illustrated by Chantarat et al ( 68 ).…”

“…Given the complexity of measuring structural racism, some empirical (quantitative) studies may not be appropriate, and qualitative or mixed-method studies should be considered ( 12 , 13 ). For example, qualitative study design (e.g., focus groups) may be ideal for research questions identifying domains of structural racism relevant to their outcome or population, as stakeholders may be more intimately familiar with these interlocking institutions ( 67 , 91 , 104 , 109 ). Examples include Sabo et al's ( 104 ) use of mixed methods to illustrate how anti-immigrant policies may lead to institutional practices that lead to race and ethnicity being conflated with immigration status among residents of Mexican descent, Chambers' ( 67 ) work conducting focus groups with Black women across the reproductive lifespan to generate and validate domains of structural racism, and LaFave et al's ( 91 ) use of interviews and focus groups with older Black adults, discrimination researchers, and stakeholders to design a measure of “structural racial discrimination” for older Black Americans ( 74 , 88 ).…”

“…Utilize qualitative and mixed methods, particularly with respect to defining or validating domains of structural racism ( 12 , 13 , 67 , 91 , 104 ).…”

Unintended consequences of measuring equity, diversity, and inclusion in medicine

“…Surveys tend to emphasise experiences of interpersonal discrimination while overlooking systemic and structural discrimination,36 which are equally, if not more, important to address. EDI committees could instead consider critical policy analysis37—evaluating who is disproportionately helped, harmed, or excluded by institutional policies—or measuring systemic indicators of inequity,38 such as the proportion of trainees from certain groups with access to summer research projects. Climate surveys, which assess staff perceptions and perspectives of an organisation, can be used to assess structural discrimination 39…”