Less than 1% of studies on racialized health inequities have empirically examined their root cause: structural racism. Moreover, there has been a disconnect between the conceptualization and measurement of structural racism. This study advances the field by (1) distilling central tenets of theories of structural racism to inform measurement approaches, (2) conceptualizing U.S. states as racializing institutional actors shaping health, (3) developing a novel latent measure of structural racism in states, (4) using multilevel models to quantify the association between structural racism and five individual-level health outcomes among respondents from the Health and Retirement Study (N = 9,020) and the Behavioral Risk Factor Surveillance System (N = 308,029), and (5) making our measure of structural racism publicly available to catalyze research. Results show that structural racism is consistently associated with worse health for Black people but not White people. We conclude by highlighting this study’s contributions (theoretical, methodological, and substantive) and important avenues for future research on the topic.

中文翻译：

---

结构性种族主义和健康分层：理论与测量的联系


在有关种族化健康不平等的研究中，只有不到 1% 的研究实证检验了其根本原因：结构性种族主义。此外，结构性种族主义的概念化和衡量之间存在脱节。这项研究通过以下方式推进了该领域的发展：（1）提炼结构性种族主义理论的核心原则，为测量方法提供信息；（2）将美国各州概念化为塑造健康的种族化机构行为者；（3）开发一种新的国家结构性种族主义的潜在测量方法；（ 4) 使用多层次模型来量化健康与退休研究 (N = 9,020) 和行为风险因素监测系统 (N = 308,029) 受访者中结构性种族主义与五种个人层面的健康结果之间的关联，以及 (5)我们对结构性种族主义的衡量标准已公开，以促进研究。结果表明，结构性种族主义始终与黑人的健康状况恶化有关，但与白人的健康状况无关。最后，我们强调了这项研究的贡献（理论、方法和实质性）以及该主题未来研究的重要途径。