Assessing intersectional, multilevel and multidimensional structural racism for English- and Spanish-speaking populations in the US

摘要 在美国推进种族平等首先要收集关于结构性种族主义的有效和可靠的数据。结构性 种族主义代表了多种制度和机构相互作用以断言种族主义的全部方式 关于被边缘化群体中的人的政策、实践和信仰。结构设计的模式与实践 种族主义，如保健治疗和促进健康的资源分配不公，造成和 使健康差距长期存在。迄今为止，结构性种族主义的措施在若干方面受到限制： 首先，我们的初步数据显示，黑人和白人对个人收集的社会指标进行解读 由于措施预期之外的原因而导致水平不同。这种差异表明了一种偏见 由于缺乏测量不变性(或等价性)而可操作。第二，现有措施过度 专注于单一人口--黑人--而忽视了拉美裔/拉美裔人口，预计 到2030年，美国人口的21%。第三，基于个人和社会层面变量的当前指数 捕捉有限的领域，缺乏经济部门的指标，这是衡量不可或缺的 结构性种族主义。种族和民族之间的贫富差距直接与结构性种族主义及其 下游对健康的因果影响。根据领先的社会流行病学家南希·克里格博士的说法，“你不能 理解种族不公正的制度，而不理解它与经济不公正的联系 (2022年)。为确定减少结构性种族主义的有效干预措施，公共卫生迫切需要 捕捉多文化和多种族社会中结构性种族主义的复杂性质和影响。我们的 总体目标是发展交叉性、综合性、多层次、多维度的结构性 具有测量不变性并且对黑人和西班牙裔/拉丁裔都有效的种族主义度量。我们用 现代心理测量技术，并纳入更好地捕捉社会劣势的经济指标。 我们的具体目标是：1)纳入包含经济指标的新数据来源，以评估 健康差距的生态层面决定因素；2)根据现有的歧视创建题库 黑人和黑人之间具有测量不变性的经济歧视做法的测量和项目 拉美裔/拉丁裔；和3)用不同的样本测试新的结构性种族主义措施的有效性 黑人和西班牙裔/拉丁裔。在拟议的研究完成后，预期的结果将是 理论驱动的、与文化和种族相关的、具有心理测量学意义的测量方法，可供公众使用 评估结构性种族主义。该工具的总体积极影响将是它在研究环境中的使用，以找到 采取有效干预措施，减少种族健康不平等现象。

SUMMARY Advancing racial equity in the U.S. starts by collecting valid and reliable data on structural racism. Structural racism represents the totality of ways in which multiple systems and institutions interact to assert racist policies, practices, and beliefs about people in a marginalized group. The patterns and practices of structural racism, such as inequitable distribution of health care treatment and health-promoting resources, create and perpetuate health disparities. To date, measures of structural racism have been limited in a number of ways: First, our preliminary data revealed that Blacks and Whites interpret social indicators collected at the individual level differently for reasons other than those intended by the measure. That difference indicates a bias operationalized by the lack of measurement invariance (or equivalence). Second, existing measures are overly focused on a single population—Blacks—and overlook the Hispanic/Latino population, which is expected to be 21% of the U.S. population by 2030. Third, current indices based on individual- and societal-level variables capture limited domains and lack indicators from the economic sector, which is indispensable to measuring structural racism. The wealth gap across race and ethnic groups is directly related to structural racism and its downstream causal effects on health. According to leading social epidemiologist Dr. Nancy Krieger, “you can’t understand the system of racial injustice without understanding how it ties to economic injustice” (2022). To identify effective interventions to reduce structural racism, there is an urgent public health need to capture the complex nature and impacts of structural racism in a multicultural and multiracial society. Our overall objective is to develop an intersectional, comprehensive, multilevel, and multidimensional Structural Racism Measure that has measurement invariance and is valid for both Blacks and Hispanics/Latinos. We use modern psychometric techniques and incorporate economic indicators that better capture social disadvantage. Our specific aims are to: 1) Incorporate novel data sources that comprise economic indicators to assess ecological-level determinants of health disparities; 2) Create an item bank from existing discrimination measures and items of economic discrimination practices with measurement invariance across Blacks and Hispanics/Latinos; and 3) Test the validity of the new Structural Racism Measure with a diverse sample of Blacks and Hispanics/Latinos. At the completion of the proposed research, the expected outcome will be a theory-driven, culturally- and racially-relevant, and psychometrically sound measure available to the public to assess structural racism. The overall positive impact of the tool will be its use in research settings to find effective interventions to reduce racial health inequities.