Citation
Atere-Roberts, Joëlle Folasade Mandisa (2023). Structural Racism Across the Life Course and Cardiometabolic Health Among Black and White Young Adults.
Abstract
Measurement of structural racism has been heterogeneous with no “gold standard” approach to assess the impact on health. Few existing operationalizations have examined the distribution of structural racism indicators to understand them descriptively and how they are spatially patterned nor examined associations with health over time. The first paper uses county-level data from 2016-2020 American Community Survey to conduct a descriptive assessment of area-level indicators of structural racism (i.e., Black-White ratios of inequality, index of concentration at the extremes (ICE)) and used choropleth maps to assess the spatial patterning. The missingness varied, with the largest proportion of missing values observed for White-Black income (40%) and the lowest missingness for Black-White poverty (5%). Clear patterns of disadvantage for Black people were observed in the Southeast. The data anomalies have important methodological implications for using area-level indicators including Census data suppression, small sample sizes for race groups, and outlier detection methods. In the second paper, we use longitudinal data from Black and White respondents of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to conduct a confirmatory factor analysis (CFA) to specify a two-factor model of county-level structural racism across six domains. We estimated log-binomial models to assess the relationship between adolescent structural racism and five high-risk cardiometabolic outcomes (i.e., blood pressure, waist circumference, diabetes/prediabetes, inflammation, and hyperlipidemia). We found evidence of an association between adolescent county-level structural racism and diabetes/prediabetes and some evidence of modest variations in this association by race. Using area-level indicators requires rigorous and thoughtful evaluation for a better understanding of their prospects and limitations as it relates to measuring structural racism. Furthermore, our findings highlight the need to leverage longitudinal data and theory-informed measures of structural racism to understand the impact of structural racism among racial groups.
URL
https://www.proquest.com/docview/2912975735?pq-origsite=gscholar&fromopenview=true&sourcetype=Dissertations%20&%20Theses#Keyword(s)
Cardiometabolic health
Reference Type
Thesis/Dissertation
Book Title
Epidemiology
Author(s)
Atere-Roberts, Joëlle Folasade Mandisa
Editor(s)
Hargrove, Taylor WAiello, Allison E.Robinson, Whitney R.Delamater, Paul R.
Series Author(s)
Martin, Chantel L.
Year Published
2023
Volume Number
PhD
Pages
119
Publisher
The University of North Carolina at Chapel Hill
City of Publication
United States -- North Carolina
ISSN/ISBN
9798381385670
DOI
9798381385670
Reference ID
10267
Miscellaneous
30695748
