Journal
ANNUAL REVIEW OF PUBLIC HEALTH, VOL 41
Volume 41, Issue -, Pages 37-62Publisher
ANNUAL REVIEWS
DOI: 10.1146/annurev-publhealth-040119-094017
Keywords
gender identity; health equity; heterosexism; racism; sexism; structural injustice
Categories
Funding
- American Cancer Society, Clinical Research Professor Award
- Harvard T.H. Chan School of Public Health (Boston, Massachusetts)
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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.
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