Racism Measurement Framework: A Tool for Public Health Action and Accountability

Racism has long been recognized as a principal determinant of health inequity,1,2 but recent events have galvanized local and state leaders across the United States to declare racism a public health emergency,3,4 with at least 23 resolutions across the state of Ohio, including Franklin, Cuyahoga, Hamilton, Lorain, Summit, and Montgomery counties, along with the cities of Akron, Canton, Columbus, Cleveland, Dayton, and Youngstown, among others.5–17 Such declarations coincide with reports highlighting the disproportionate impact of COVID-19 on communities of color and the Black Lives Matter protests that were catalyzed by recent deaths at the hands of law enforcement.18–20 The dual crises of COVID-19 and long-standing racism have put health inequities into the center of our collective awareness, further supporting the Columbus City Council’s demand for a “data-driven focus on poverty, economic mobility, and other factors that impact the social determinants of health (SDoH).”6 Several proposed conceptual models of SDoH address racism,21–23 but in the absence of a measurement framework there remains a gap in applying a data-driven approach that will enable health systems, government agencies, academic centers, community organizations, and public health professionals to combat racism.