Policies and indicators to operationalize structural racism for quantitative health research

The field of structural racism is developing rapidly, with researchers moving from commentaries and review papers toward empirical research that aims to quantify the impact of exposure to structural racism on racial and ethnic inequities in health. Despite the increasing recognition of the impact of structural racism on health outcomes, its measurement in the empirical literature has focused on a limited set of area-based measures. We propose 2 ways to expand the measurement of structural racism in public health research: first, by situating indicators of structural racism within the broader context of discriminatory policies that gave rise to racial and ethnic inequities; and second, by broadening the range of area-level indicators of structural racism beyond what has been used in the extant literature. We provide practical tools, including an extensive list of discriminatory federal policies, a list of common and novel indicators of structural racism across multiple domains, and an applied example showing how to connect policies and indicators of structural racism. These tools will aid researchers in developing a robust empirical evidence base to examine the role of structural racism in long-standing health inequities and advance quantitative research on the impact of structural racism on health inequities.