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Measures of Racism, Sexism, Heterosexism, and Gender Binarism for Health Equity Research: From Structural Injustice to Embodied Harm-an Ecosocial Analysis.
Annual Review of Public Health ( IF 21.4 ) Pub Date : 2020-04-02 , DOI: 10.1146/annurev-publhealth-040119-094017
Nancy Krieger 1
Affiliation  

Racism. Sexism. Heterosexism. Gender binarism. Together, they comprise intimately harmful, distinct, and entangled societal systems of self-serving domination and privilege that structure the embodiment of health inequities. Guided by the ecosocial theory of disease distribution, I synthesize key features of the specified "isms" and provide a measurement schema, informed by research from both the Global North and the Global South. Metrics discussed include (a) structural, including explicit rules and laws, nonexplicit rules and laws, and area-based or institutional nonrule measures; and (b) individual-level (exposures and internalized) measures, including explicit self-report, implicit, and experimental. Recommendations include (a) expanding the use of structural measures to extend beyond the current primary emphasis on psychosocial individual-level measures; (b) analyzing exposure in relation to both life course and historical generation; (c) developing measures of anti-isms; and (d) developing terrestrially grounded measures that can reveal links between the structural drivers of unjust isms and their toll on environmental degradation, climate change, and health inequities. Expected final online publication date for the Annual Review of Cancer Biology, Volume 4 is March 4, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

中文翻译:

用于健康公平研究的种族主义,性别歧视,异性恋和性别二元主义的量度:从结构性不公正到具体的危害性生态社会分析。

种族主义。性别歧视。异性恋。性别二元主义。它们共同构成了有害的,截然不同且相互纠缠的自我服务的统治和特权社会体系,构成了健康不平等的体现。在疾病分布的生态社会理论的指导下,我综合了特定“主义”的关键特征,并提供了一种测量方案,并参考了“全球北方”和“全球南方”的研究。讨论的指标包括:(a)结构性的,包括明确的规则和法律,非明示的规则和法律,以及基于区域或机构的不规则措施;(b)个人层面的(暴露和内在化)措施,包括明确的自我报告,隐含的和实验性的。建议包括:(a)扩大结构性措施的使用范围,以超出目前对心理社会个人一级措施的主要重视;(b)分析与生命历程和历史产生有关的暴露;(c)制定反恐措施;(d)制定基于地面的措施,以揭示不公正行为的结构驱动因素与其对环境退化,气候变化和健康不平等造成的损失之间的联系。《癌症生物学年鉴》(第4卷)的最终最终在线发布日期为2020年3月4日。有关修订的估算,请参见http://www.annualreviews.org/page/journal/pubdates。(d)制定基于地面的措施,以揭示不公正行为的结构驱动因素与其对环境退化,气候变化和健康不平等造成的损失之间的联系。《癌症生物学年鉴》(第4卷)的最终最终在线发布日期为2020年3月4日。有关修订的估算,请参见http://www.annualreviews.org/page/journal/pubdates。(d)制定基于地面的措施,以揭示不公正行为的结构驱动因素与其对环境退化,气候变化和健康不平等造成的损失之间的联系。《癌症生物学年鉴》(第4卷)的最终最终在线发布日期为2020年3月4日。有关修订的估算,请参见http://www.annualreviews.org/page/journal/pubdates。
更新日期:2020-04-21
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