I've been sitting on some thoughts about the perpetual search for useful, universal (quantitative) proxies for structural racism, and what it means when those proxies beg the question, rather than measure root causes.

One challenge is presentist ontologies in quant work.

The task is to reduce historical, ongoing socio-political processes that allocate life & death along the axes of assigned/ascribed race, ethnicity, along the axes of class strata... down to measurable, time-bound, point-in-time estimates.

This is often done w/o studying history.

There's also the question of who produces the datasets that are used as the basis for these proxies/indices. We have to consider the vested interests of the institutions that collect these data, b/c data collection/production is a political process.

e.g. we know that historical census data embedded notions of racial pathology- esp via the data collection. In places with few Black residents, they were overcounted as indigent or 'mad.'

We also know that American Indians who were not taxed were uncounted until 1860.

Some questions we want to address when I discuss approaches to measuring structural racism:

- Are we interested in exposure and dosage?
- Are we paying attention to racialization as a process that also has consequences for health?
- Or do we want convenience?

All that to say:

Operationalizing critical perspectives on structural racism & effects on health is not reducible to variable selection.

IME, it always always comes back to matching theory with methods in a thoughtful way.

I should have been more explicit about scale: If we are talking about *structural racism*, the variables should not only be individual-level. However, even w/ contextual variables, biomedical research can (& does) retrench methodological individualism. https://twitter.com/noelTbrewer/status/1310642889442168832?s=20

Yes, structural racism has biological consequences, freq observed in the clinic as embodied health outcomes among patients.

Importantly, contextual & envir factors shape health to a greater degree than behavior or genetics alone (gene expression is influenced by environment).

As a general rule: Any outcome we can measure at the individual level is likely *downstream* of structural racism (root cause). https://twitter.com/Arrianna_Planey/status/1310649765416374274?s=20