There is compelling evidence that racial discrimination is a risk factor for illness and disease. But what are health scientists measuring—and what do they think they are measuring—when they include measures of racial discrimination in health research? We synthesize theoretical conceptualizations of racial discrimination in health research and critically assess whether and how these concepts correspond (or not) to widely used measures of racial discrimination. In doing so, we show that while researchers often use terms such as ‘self-reported discrimination', ‘perceptions of discrimination', and ‘exposure to discrimination' interchangeably, these concepts are indeed unique, with each holding a distinct epistemological position and theoretical and methodological capacity to uncover the impact of racial discrimination on health and health disparities. Importantly, we argue that commonly used measures of self-reported or perceived racial discrimination are just the ‘tip of the iceberg' in terms of revealing the ways in which discrimination shapes health inequities. Scientists and practitioners must be cognizant of and intentional in their measurement choices and language, as the framing of these processes will inform policy and intervention efforts aimed at eliminating discrimination.

中文翻译：

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冰山一角：衡量健康研究中的种族歧视

有令人信服的证据表明种族歧视是疾病的危险因素。但是，当健康科学家在健康研究中纳入种族歧视的衡量标准时，他们衡量的是什么——他们认为他们在衡量的是什么？我们综合了健康研究中种族歧视的理论概念，并批判性地评估了这些概念是否以及如何与广泛使用的种族歧视衡量标准相符（或不相符）。在这样做时，我们表明虽然研究人员经常交替使用诸如“自我报告的歧视”、“歧视的看法”和“歧视的暴露”等术语，但这些概念确实是独一无二的，每个人都拥有独特的认识论立场以及理论和方法论能力，以揭示种族歧视对健康和健康差异的影响。重要的是，我们认为，就揭示歧视如何塑造健康不平等的方式而言，常用的自我报告或感知种族歧视的措施只是“冰山一角”。科学家和从业者必须在他们的测量选择和语言中意识到并有意为之，因为这些过程的框架将为旨在消除歧视的政策和干预工作提供信息。