Full Citation
Title: Structural Racism and Quantitative Causal Inference: A Life Course Mediation Framework for Decomposing Racial Health Disparities
Citation Type: Journal Article
Publication Year: 2022
ISBN:
ISSN: 2150-6000
DOI: 10.1177/00221465211066108
NSFID:
PMCID:
PMID: 35001689
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.
Url: https://pubmed.ncbi.nlm.nih.gov/35001689/
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Authors: Graetz, Nick; Boen, Courtney E.; Esposito, Michael H.
Periodical (Full): Journal of health and social behavior
Issue: 2
Volume: 63
Pages: 232-249
Countries: