Primary Submission Category: Structural factors
A conceptual framework for investigating measures of neighborhood-level structural racism developed through academic and community collaboration
Authors: Mindy DeRouen, Meera Sangaramoorthy, Deirdre Johns, Palama Lee, ILA McDermott, Scarlett Gomez, Loic Le Marchand, Melinda Aldrich, Lani Park, Iona Cheng, Salma Shariff-Marco,
Presenting Author: Mindy DeRouen*
Background: Recent commentaries have called for more detailed conceptual frameworks that guide new data collection, study design, and analytic strategies for research of neighborhood structural racism and its impact on health inequities. We are developing a robust framework that applies nuance and precision to existing models to inform causal inference studies.
Methods: A draft conceptual framework has gone through multiple rounds of discussion among our academic/community collaboration comprising project investigators and community scientists residing in California, Hawai‘i, and Tennessee. The framework is currently being vetted in an epidemiological study of structural racism on lung cancer outcomes and in a study to assess the impact of new racial- and ethnic-specific indices of structural racism on life expectancy.
Results: Our framework includes factors that characterize domains of the process of structural racism (e.g., mortgage lending, policing, voting) and neighborhood-level consequences of structural racism (e.g., employment, food environment, air pollution), which guided selection of variables to consider for structural racism indices. Incorporating insights from community scientists, the model integrates neighborhood strengths, including social cohesion, shared norms, and culturally and linguistically relevant resources, that may protect against the harmful consequences of structural racism. Our framework builds upon existing models to hypothesize causal relationships between these risk and resiliency factors in addition to illustrating their downstream effects on health, which is informing causal inference approaches in both studies.
Conclusions: Our academic/community collaboration has resulted in productive discussions focused on (1) further specifying the mechanisms of causal relationships among and across domains of neighborhood factors and with individual-level factors and (2) adapting the overarching model to specific racial and ethnic populations.