Deconstructing Inequities — Transparent Values in Measurement and Analytic Choices

Last year was marked by a once-in-a-generation scourge that focused renewed attention on the long history of structural racism in the United States. By March 2021, more than 500,000 Americans had died of Covid-19, and certain subpopulations have been disproportionately burdened: Black, Latinx, and Native American people account for greater proportions of Covid-19 deaths than of the U.S. population. Concurrently, we have faced the pandemic of Racism-20, brought to light by the murder of George Floyd by a Minneapolis police officer. In the United States, a Black person is roughly five times as likely as a White person to be stopped by the police without just cause, to be incarcerated, or to be killed by the police while unarmed.

In response to these injustices and to spur systemic change across sectors, a growing number of state and local governments have declared racism a public health crisis. These declarations are an important first step in the advancement of racial and health equity — a movement on social, political, and economic fronts that requires expanding the power of groups who are most affected by systemic racism and other structural inequities so that they can organize both people and resources, set agendas, shift narratives, and influence decisions and the people who make them.6 Another important step, as we in the public health field know, is accurate measurement of progress necessary to hold ourselves collectively accountable and to ensure lasting change.