Racism, sexism, heterosexism, and gender binarism (the idea that there are only two genders) can lead to health inequities. A new paper from Harvard T.H. Chan School of Public Health’s Nancy Krieger offered concepts and methods for characterizing these “isms” and measuring their impact on health.
In the paper, published November 25, 2019 in the Annual Review of Public Health, Krieger, professor of social epidemiology, synthesized key features of these “isms,” suggested methods to measure how they harm health, and made recommendations about how to analyze exposure to them.
Examples of the “isms” Krieger included in her paper included explicit laws and rules, such as past and now illegal U.S. Jim Crow laws which continue to affect health across generations, and current U.S. federal policies that discriminate against transgender persons (e.g., prohibit them from enlisting in the military); nonexplicit laws and rules, such as voter suppression policies targeted against people of color but which do not directly mention race because it is illegal to do so; and unjust behavior in public or private settings that people experience on an individual basis, such as interpersonal racism, heterosexism, or sexual harassment.
“The reason to study how injustice harms health is … to deepen understanding of how injustice shapes population health, for whose benefit at whose expense; to contest narratives that naturalize inequities; and to generate evidence for accountability,” she wrote.