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      Naming Institutionalized Racism in the Public Health Literature: A Systematic Literature Review

      1 , 1 , 1 , 2 , 1

      Public Health Reports

      SAGE Publications

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          Abstract

          <div class="section"> <a class="named-anchor" id="d3434140e135"> <!-- named anchor --> </a> <h5 class="section-title" id="d3434140e136">Objectives:</h5> <p id="d3434140e138">Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article. </p> </div><div class="section"> <a class="named-anchor" id="d3434140e140"> <!-- named anchor --> </a> <h5 class="section-title" id="d3434140e141">Methods:</h5> <p id="d3434140e143">We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts. </p> </div><div class="section"> <a class="named-anchor" id="d3434140e145"> <!-- named anchor --> </a> <h5 class="section-title" id="d3434140e146">Results:</h5> <p id="d3434140e148">We found only 25 articles that named institutionalized racism in the title or abstract among all articles published in the public health literature during 2002-2015 in the 50 highest-impact journals and 6 categories representing the public health field in the United States. Institutionalized racism was a core concept in 16 of the 25 articles. </p> </div><div class="section"> <a class="named-anchor" id="d3434140e150"> <!-- named anchor --> </a> <h5 class="section-title" id="d3434140e151">Conclusions:</h5> <p id="d3434140e153">Although institutionalized racism is recognized as a fundamental cause of health inequities, it was not often explicitly named in the titles or abstracts of articles published in the public health literature during 2002-2015. Our results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research. More public health research on institutionalized racism could help efforts to overcome its substantial, longstanding effects on health and well-being. </p> </div>

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          Most cited references 31

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          Critical Race Theory, race equity, and public health: toward antiracism praxis.

          Racial scholars argue that racism produces rates of morbidity, mortality, and overall well-being that vary depending on socially assigned race. Eliminating racism is therefore central to achieving health equity, but this requires new paradigms that are responsive to structural racism's contemporary influence on health, health inequities, and research. Critical Race Theory is an emerging transdisciplinary, race-equity methodology that originated in legal studies and is grounded in social justice. Critical Race Theory's tools for conducting research and practice are intended to elucidate contemporary racial phenomena, expand the vocabulary with which to discuss complex racial concepts, and challenge racial hierarchies. We introduce Critical Race Theory to the public health community, highlight key Critical Race Theory characteristics (race consciousness, emphases on contemporary societal dynamics and socially marginalized groups, and praxis between research and practice) and describe Critical Race Theory's contribution to a study on racism and HIV testing among African Americans.
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            The Emergence and Transformation of Disputes: Naming, Blaming, Claiming . . .

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              Systemic racism and U.S. health care.

              This article draws upon a major social science theoretical approach-systemic racism theory-to assess decades of empirical research on racial dimensions of U.S. health care and public health institutions. From the 1600s, the oppression of Americans of color has been systemic and rationalized using a white racial framing-with its constituent racist stereotypes, ideologies, images, narratives, and emotions. We review historical literature on racially exploitative medical and public health practices that helped generate and sustain this racial framing and related structural discrimination targeting Americans of color. We examine contemporary research on racial differentials in medical practices, white clinicians' racial framing, and views of patients and physicians of color to demonstrate the continuing reality of systemic racism throughout health care and public health institutions. We conclude from research that institutionalized white socioeconomic resources, discrimination, and racialized framing from centuries of slavery, segregation, and contemporary white oppression severely limit and restrict access of many Americans of color to adequate socioeconomic resources-and to adequate health care and health outcomes. Dealing justly with continuing racial "disparities" in health and health care requires a conceptual paradigm that realistically assesses U.S. society's white-racist roots and contemporary racist realities. We conclude briefly with examples of successful public policies that have brought structural changes in racial and class differentials in health care and public health in the U.S. and other countries. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Public Health Reports
                Public Health Rep
                SAGE Publications
                0033-3549
                1468-2877
                April 03 2018
                May 2018
                April 03 2018
                May 2018
                : 133
                : 3
                : 240-249
                Affiliations
                [1 ]Division of Health Policy &amp; Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
                [2 ]Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA
                Article
                10.1177/0033354918760574
                5958385
                29614234
                © 2018

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