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Toward the Development of a Multilevel Measure of Structural Racism: Theory and Methods.

Ester Villalonga Olives1, Alisha Crump1, Yusuf Ransome2

  • 1Department of Practice, Sciences, and Health Outcomes Research University of Maryland Baltimore, Baltimore, Maryland, United States.

American Journal of Epidemiology
|May 25, 2026
PubMed
Summary
This summary is machine-generated.

This study developed a new measure to identify structural racism

Keywords:
Delphi panelStructural racismmeasurementmultidimensionalmultilevel

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Area of Science:

  • Social Epidemiology
  • Health Equity Research
  • Public Health

Background:

  • Structural racism negatively impacts the health of Black and Hispanic/Latino Americans.
  • Existing measures may not fully capture the complexities of structural racism.
  • A robust measurement tool is needed to address health disparities.

Purpose of the Study:

  • To establish a theoretical foundation for a novel multilevel structural racism measure.
  • To develop a practical tool for assessing structural racism in Black and Hispanic/Latino communities.
  • To guide interventions aimed at achieving health equity.

Main Methods:

  • Utilized the National Institute on Minority Health and Health Disparities (NIMHD) framework.
  • Employed a content development team of social epidemiologists.
  • Conducted a modified three-phase Delphi panel with community leaders and researchers.

Main Results:

  • Pre-selected 68 candidate indicators based on existing literature.
  • The Delphi process resulted in 71 indicators for structural racism measurement.
  • Indicators spanned multiple domains of the NIMHD framework.

Conclusions:

  • This research lays the groundwork for a new structural racism measurement tool.
  • The tool will aid researchers, clinicians, and policymakers in identifying and addressing structural racism.
  • Findings support efforts toward achieving health equity and justice.