Structural Racism and Quantitative Causal Inference A Life Course Mediation Framework for Decomposing Racial Health Disparities
Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach...
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| Published in | Journal of health and social behavior Vol. 63; no. 2; pp. 232 - 249 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
Los Angeles, CA
Sage Publications, Inc
01.06.2022
SAGE Publications American Sociological Association |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0022-1465 2150-6000 2150-6000 |
| DOI | 10.1177/00221465211066108 |
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| Abstract | Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a “race” variable as part of a social process (racism) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect (“unobserved racism”), proportions attributable to interaction (“racial discrimination”), and pure indirect effects (“emergent discrimination”). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities. |
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| AbstractList | Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a “race” variable as part of a social process (racism) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect (“unobserved racism”), proportions attributable to interaction (“racial discrimination”), and pure indirect effects (“emergent discrimination”). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities. Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a "race" variable as part of a social process (racism) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect ("unobserved racism"), proportions attributable to interaction ("racial discrimination"), and pure indirect effects ("emergent discrimination"). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities.Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a "race" variable as part of a social process (racism) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect ("unobserved racism"), proportions attributable to interaction ("racial discrimination"), and pure indirect effects ("emergent discrimination"). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities. Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a "race" variable as part of a social process ( ) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect ("unobserved racism"), proportions attributable to interaction ("racial discrimination"), and pure indirect effects ("emergent discrimination"). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities. Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardio-metabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a “race” variable as part of a social process ( racism ) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect (“unobserved racism”), proportions attributable to interaction (“racial discrimination”), and pure indirect effects (“emergent discrimination”). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities. |
| Author | Boen, Courtney E. Graetz, Nick Esposito, Michael H. |
| AuthorAffiliation | 1 Department of Sociology, Princeton University 3 Department of Sociology, Population Aging Research Center, Leonard Davis Institute for Health Economics, University of Pennsylvania 4 Department of Sociology, Washington University in St. Louis 2 Population Studies Center, University of Pennsylvania |
| AuthorAffiliation_xml | – name: 2 Population Studies Center, University of Pennsylvania – name: 3 Department of Sociology, Population Aging Research Center, Leonard Davis Institute for Health Economics, University of Pennsylvania – name: 1 Department of Sociology, Princeton University – name: 4 Department of Sociology, Washington University in St. Louis |
| Author_xml | – sequence: 1 givenname: Nick surname: Graetz fullname: Graetz, Nick – sequence: 2 givenname: Courtney E. surname: Boen fullname: Boen, Courtney E. – sequence: 3 givenname: Michael H. surname: Esposito fullname: Esposito, Michael H. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35001689$$D View this record in MEDLINE/PubMed |
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| Snippet | Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue... |
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| SubjectTerms | Adolescent Adolescents Adult Counterfactual thinking Decomposition Discrimination Health disparities Health Inequities Health risks Humans Indirect effects Individual Characteristics Inequality Interconnections Life Change Events Life course Longitudinal Studies Mediation Operational definitions Quantitative analysis Quantitative research Race Racial discrimination Racial inequality Racialization Racism Social processes Systemic Racism |
| Subtitle | A Life Course Mediation Framework for Decomposing Racial Health Disparities |
| Title | Structural Racism and Quantitative Causal Inference |
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