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. 2023 Jan 6;22(1):4.
doi: 10.1186/s12939-022-01796-0.

Study designs, measures and indexes used in studying the structural racism as a social determinant of health in high income countries from 2000-2022: evidence from a scoping review

Md Koushik Ahmed  1 , Desiree Scretching  2 , Sandra D Lane  3
Affiliations

Study designs, measures and indexes used in studying the structural racism as a social determinant of health in high income countries from 2000-2022: evidence from a scoping review

Md Koushik Ahmed et al. Int J Equity Health. .

Abstract

Background: Globally, structural racism has been well documented as an important social determinant of health (SODH) resulting in racial inequality related to health. Although studies on structural racism have increased over the years, the selection of appropriate designs, measures, and indexes of measurement that respond to SODH has not been comprehensively documented. Therefore, the lack of evidence seems to exist. This scoping review was conducted to map and summarize global evidence on the use of various designs, measures, and indexes of measurement when studying structural racism as a social determinant of health.

Methods: We performed a scoping review of global evidence from 2000 to 2022 published in 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Web of Science, ProQuest, and relevant grey literature on structural racism. We conducted a systematic search using keywords and subject headings around 3 concepts. We included peer reviewed original research/review articles which conceived the framework of social determinants of health (SODH) and studied structural racism.

Results: Our review identified 1793 bibliographic citations for screening and 54 articles for final review. Articles reported 19 types of study design, 87 measures of exposure and 58 measures of health outcomes related to structural racism. 73 indexes or scales of measurement were used to assess health impacts of structural racism. Majority of articles were primary research (n = 43/54 articles; 79.6%), used quantitative research method (n = 32/54 articles; 59.3%) and predominantly conducted in the United States (n = 46/54 articles; 85.2.6%). Cross-sectional study design was the most used design (n = 17/54 articles; 31.5%) followed by systematic review (n = 7/54 articles; 13.0%) and narrative review (n = 6/54 articles; 11.1%). Housing and residential segregation was the largest cluster of exposure with the highest impact in infant health outcome.

Conclusions: Our review found several key gaps and research priorities on structural racism such as lack of longitudinal studies and availability of structural or ecological data, lack of consensus on the use of consolidated appropriate measures, indexes of measurement and appropriate study designs that can capture complex interactions of exposure and outcomes related to structural racism holistically.

Keywords: Community participatory research approach; Exposure; Indexes of measurement; Outcome; Social determinants of health; Structural racism.

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Conflict of interest statement

The authors do not have any competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the article screening process
Fig. 2
Fig. 2
Countries of publication of included studies (n = 54) from 2000–2022
Fig. 3
Fig. 3
Year of publication of included studies (n = 54) from 2000–2022
Fig. 4
Fig. 4
Distribution of study designs of included studies (n = 54) from 2000–2022
Fig. 5
Fig. 5
Cluster plotting of measures of exposure and measures of outcome in the included study (n = 54) from 2000–2022
See this image and copyright information in PMC

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