Measuring Structural Racism and Its Association with Racial Disparities in Firearm Homicide

Abstract

Introduction Structural racism is strongly related to racial health disparities. However, surprisingly few studies have developed empirical tools to measure structural racism. In addition, the few measures that have been employed have only considered structural racism at the neighborhood level. To expand upon previous studies, this paper uses a novel measure to measure structural racism at the county level for the non-Hispanic Black population. Methods We used confirmatory factor analysis to create a model to measure the latent construct of structural racism for 1181 US counties. The model included five indicators across five dimensions: racial segregation, incarceration, educational attainment, employment, and economic status/wealth. Structural equation modeling and factor analysis were used to generate factor scores that weighted the indicators in order to produce the best model fit. The resulting factor scores represented the level of structural racism in each county. We demonstrated the utility of this measure by demonstrating its strong correlation with Black-White disparities in firearm homicide rates. Results Our calculations revealed striking geographic differences across counties in the magnitude of structural racism, with the highest values generally being observed in the Midwest and Northeast. Structural racism was significantly associated with higher Black firearm homicide rates, lower White homicide rates, and a higher Black-White racial disparity in firearm homicide. Conclusions These new measures can be utilized by researchers to relate structural racism to racial health disparities at the county level.

Firearm injuries in Missouri

“…associated with poverty, urban areas in Missouri with firearm injuries represent extremely distressed and deprived communities. Combined with the fact that the vast majority of firearm injuries in these urban areas were to Black males, the data demonstrate the effects of longstanding structural racism on the epidemiology of firearm injuries [9][10][11].…”

Evolution of HIV Health Care Workforce Needs in the U.S. Mountain West During the COVID-19 Pandemic: A Mixed Method Study

“…HIV and COVID-19 each have a disproportionate impact on marginalized communities, creating the potential for an adverse impact on PWH (Shiau et al, 2020; Smith et al, 2019). These trends intersect with higher rates of substance use and mental health problems associated with SDOH, structural racism, and/or stigma, which are reinforced through housing, education, employment, health care access, financial benefits, and criminal justice systems (Siegel et al, 2023). Both COVID-19 and HIV disproportionately impact Black or African American, Native American, and Hispanic individuals (Centers for Disease Control and Prevention, 2022b; HIV.gov, 2023).…”

Race by Education Intersectional Differences in Exposure to Tobacco Advertisement in Baltimore City

“…A study developed a measure of structural racism at the county level, considering factors such as racial segregation, incarceration, educational attainment, employment, and economic status/wealth. They revealed significant geographic differences in the levels of structural racism, with higher levels generally observed in the Midwest and Northeast 29 . Another study discussed how systemic racism extends beyond the justice system to social, environmental, and economic structures, affecting health outcomes.…”