Measuring Racism

Photo University of Minnesota School of Public Health

On the morning of April 13, the day after the police killing of Daunte Wright, Dr. Rachel Hardeman, founding director of the Center for Antiracism Research for Health Equity at the University of Minnesota School of Public Health, spoke with me. Neither of us knew how to greet the other; the simple “How are you?” felt too deep and raw for us, two Black women, showing just how pervasive racism can be — impacting even the most mundane of greetings. Just months before, the Center had been founded as a place to explore the question: “How is racism working now, in this system, structure, and interaction?”

Racism has lifelong health impacts. In Minnesota, 26 percent of police-related deaths have been of Black people, who make up eight percent of the population. The maternal death rates of Black and Indigenous mothers are two and four times higher than that of white counterparts in Minnesota. Black Minnesotans are more likely to die from the pandemic and die at younger ages. COVID-19 has put a spotlight on race-based health inequities in a way we have not seen before, underscoring what many have always known: racism kills.

Q: Tell us how your background led to co-founding an antiracism research center.

When my twin sister and I were high school students, we kept our grandmother company during her dialysis treatments several times a week for kidney failure. My grandmother struggled to get care and be heard, leading to her eventual choice to discontinue life-sustaining dialysis care and enter into hospice. That led me to think about what health care can do better to be responsive to the needs of patients like my grandmother.

Years later, for the pregnancy and birth of my daughter, I had a wonderful experience with a team that cared for, listened to, and respected me. This emboldened me, because I recognized this is not the reality for most Black women, which is heartbreaking. It also was uplifting, because I saw what was possible in the maternal and child health space. My experience with this does not have to be the exception and has me focused on how we do this better for all women.

Q: Can you describe the vision and focus you have for the Center?

My dream is to have a public and accessible data repository of measures of structural racism so that we can measure the impact of racism on health.

I envision a place where academic researchers, policy makers, funders, practitioners, and whoever wants to be a part of the conversation and work can come together to convene and address the root causes of racial health inequities.

I want us to think about the question: “How do we drive real action in our communities to solve these huge challenges related to racial health equity?”

One of the major goals is to develop an evidence base for antiracism research and drive action to address antiracism in health and other domains.

We will center those who are impacted by structural and systemic racism, not as an afterthought but as the stakeholder. We will provide training for academic and non-academic audiences to help figure out how to better collaborate with those this work is designed to serve. This will ensure we push against the old framework — [lack of accountability] to the groups providing the lived experience used as data points.

Allowing community members to drive the work, based on what questions they want asked, will get us to answers a lot quicker.

Racism is pervasive. Having the data to objectively show what has been hidden for so long gives power back to the communities that are harmed by the system.

We cannot change what we don’t measure, and we measure what we value. Structural racism requires a multidimensional measurement tool.

So often we frame the question as: “What is wrong with Black people to make them sick?” Instead of: “What systems and structures are causing Black people to get sicker at higher rates?” Or: “In the face of inequities, how have Black communities remained resilient?”

We have started to test a racial index measurement on jail and recidivism, police violence, home mortgages, and education. This measures the amount of structural racism operating in a community, a neighborhood, a city, a state. It will allow us to have robust conversations with policy makers to answer the question: “How is racism operating here?”

The work I do as an antiracism scholar is to make sure folks understand we all have a role to play in dismantling the systems and structures that have created and perpetuated inequity for over 400 years. The Center is a step in showing how we got here and how we can address it.

It is important to me that others are not forced to make life-or-death decisions based on not being heard, cared for, and valued by our systems.

Find data related to the Center for Antiracism Research for Health Equity