Structural Racism & Health Stratification: A New Theoretically-driven Empirical Approach

By: Dr. Tyson Brown

The disconnect between the conceptualization and measurement of structural racism has hindered our understanding of the relationship between structural racism and health. This study advances the field by 1) distilling central tenets of theories of structural racism into concrete measures of structural racism, 2) conceptualizing U.S. states as racializing institutional actors shaping health, 3) developing a novel latent measure of structural racism in states across multiple domains—e.g., e.g., education, economics, politics, housing, and the judicial system, 4) mapping structural racism, and 5) quantifying the relationships between structural racism and six health outcomes among Black and white adults. We use administrative data on state-level racial stratification linked to geocoded individual-level demographic and health data from the HRS (N=9,126) and the BRFSS (N=308,029). Results show that, whereas structural racism is consistently associated with worse health for Black people, it is either unrelated to health or predictive of better health among whites.

 Tyson H. Brown is an Associate Professor of Sociology at Duke University, where he is the inaugural Presidential Fellow (2021-2022) and directs the Center on Health & Society. His program of research examines the who, when, and how questions regarding ethnoracial inequalities in health and wealth. Dr. Brown has authored numerous articles in leading sociology and population health journals (CV), and his research contributions have been recognized with awards from the American Sociological Association. Brown was also the recipient of Duke University’s Thomas Langford Award and was a resident fellow at Oxford University (2019-2020).