In our state public health organization, we’ve been struggling with authentically measuring racism and social determinants of health without retraumatizing folks who have been historically discriminated against by our existing systems. We’ve heard from partners that Center for Disease Control and Prevention’s (CDCs) proposed questions could be harmful because toxic stress from racism is a collective experience, and these questions are overly individualistic, reflecting a white dominant cultural perspective, and lays the blame or burden entirely on the individual.
The Feb 2022 Health Affairs Issue on Racism and Health offers some ideas like measuring residential segregation and displacement but would love to hear from this group about other ways to measure discrimination and racism with humility. (We’re open to survey questions as well as community level measures.)
Hi @amyzlot, I think that this is SUCH an important point. It’s really not nuanced enough to say “measure racism” in our work, something that I have definitely been guilty of in the past. The difference between trying to capture someone’s experience of racism at an individual level is completely different than trying to measure the quantity and impact of systemic racism at a systematic, group, or societal level. If the ozone layer is melting, the answer can’t be going around to each person and asking them if they are using enough sunblock. When we only measure racism at an individual level, we can accidentally imply that it’s an individual problem, or an individual experience.
Often We All Count advises moving away from “race” as a proxy for racism to something else more directly about the experience of racism, but I think it’s an equally valid direction to instead take your focus up a level or two. I’ve often dreamed about some kind of “racism coefficient” that could reflect like… a shared measurable environmental factor or something… but obviously, that’s fraught for so many reasons. Doesn’t mean it’s not an idea worth pursuing!
Thanks, @Bruno! The idea is to have better tools to get to the root causes of health disparities with the ultimate goal of moving toward racial health justice. I’ve been trained to compare groups and call out differences between groups (e.g. ‘gap gazing’), but that isn’t particularly helpful. We know there are differences, but why are there differences, and how can we collect and use data that are context-driven and action oriented?
@amyzlot that’s great clarification on what you’re working on! For me whenever we go from comparing gaps or looking at differences between groups and starting to investigate why there are differences, ends up being less about how to collect data on racism than about how to analyze data about racism.
Descriptive analysis is going to give us info about the size of differences. Only causal analysis (in the world of quantitative data) can start to give us info about why there are differences.
I can see why you would be unsatisfied with something like rates of residential segregation because even though that is a more collective look at racialization and inequity than an individually oriented question, on its own it’s not causal, not pointing to a possible why, just saying what is.
If you want to see gaps, descriptive analysis is great, but if as you said above you also want to move to “what should we do about it”, some kind of causal analysis is where I’d start. And… causal analysis can work with individual or contextual measures relating to racism, so luckily it’s not a tradeoff there.