# Developing an Index to Measure Structural Racism: Methodological Process, Challenges, and Considerations

## TL;DR

This paper outlines a method to create an index for measuring structural racism affecting Black and Hispanic populations, highlighting challenges and offering guidance for public health research.

## Contribution

A five-step methodological framework for developing ecological measures of structural racism using public datasets.

## Key findings

- Limited availability of granular geographic data hinders index development.
- Transparency and adaptability are crucial for creating valid structural racism measures.
- Improved public data infrastructure is needed to support equity-focused research.

## Abstract

Public health relevance—How does this work relate to a public health issue?

Examines methodological challenges in developing ecological measures of structural racism affecting Black and Hispanic populations.

Provides methodological guidance for developing ecological measures of structural racism to support research on social determinants of health.

Public health significance—Why is this work of significance to public health?

Offers a replicable, consensus-driven approach for identifying indicators of structural racism using public datasets.

Presents a five-step approach for extracting and harmonizing geographic-level datasets for structural racism index development.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?

Strengthens researchers’ capacity to develop measures to assess structural determinants of health disparities and inform equity-focused interventions.

Highlights the need for improved public data infrastructure to support equity monitoring.

Access to valid and reliable measures of structural racism is essential for addressing health inequities, yet few validated ecological-level indices exist for assessing structural racism affecting Black and Hispanic populations in the United States. Guided by the National Institute on Minority Health and Health Disparities framework, our interdisciplinary team undertook the development of an ecological-level structural racism index. In the process, we encountered substantive methodological and data-related challenges that warrant explicit documentation. This paper describes the methodological process used to identify and select indicators of structural racism, including a modified Delphi consensus process involving social epidemiologists, health inequality researchers, community members, economic inequality specialists, and psychometricians. We outline a five-step approach for extracting and harmonizing geographic-level data from publicly available sources and discuss key challenges encountered, including limited availability of granular geographic data, insufficient data documentation guidelines, inconsistent reporting frequencies, and difficulties in adapting publicly available datasets for structural racism measurement. Rather than presenting a finalized index, this paper serves as a methodological guide and cautionary account for researchers seeking to develop ecological measures of structural racism, emphasizing the importance of transparency, adaptability, and rigorous data selection in advancing public health equity research.