Developing an Index to Measure Structural Racism: Methodological Process, Challenges, and Considerations

Area of Science:

• Public Health
• Social Epidemiology
• Health Equity Research

Background:

• Addressing health inequities requires valid measures of structural racism.
• Existing ecological-level indices for structural racism affecting Black and Hispanic populations in the U.S. are limited.
• The National Institute on Minority Health and Health Disparities framework guided the development process.

Purpose of the Study:

• To describe the methodological process for developing an ecological-level structural racism index.
• To document substantive methodological and data-related challenges encountered.
• To provide a guide for researchers developing similar indices.

Main Methods:

• A modified Delphi consensus process involving diverse experts (social epidemiologists, health inequality researchers, community members, economic inequality specialists, psychometricians).
• A five-step approach for extracting and harmonizing geographic-level data from public sources.
• Identification and selection of indicators for structural racism.

Main Results:

• Significant methodological and data challenges were encountered during index development.
• Key challenges include limited granular geographic data, poor data documentation, inconsistent reporting, and data adaptation difficulties.
• The paper focuses on the process and challenges rather than presenting a finalized index.

Conclusions:

• Developing ecological measures of structural racism is complex and data-intensive.
• Transparency, adaptability, and rigorous data selection are critical for advancing public health equity research.
• This paper serves as a methodological guide and cautionary account for future research.