Structural Racism and its Role in Propagating Racial Health Inequities through Systems of Higher Education and Public Health Surveillance

Health inequities by race are ubiquitous and persistent in the U.S., and structural racism is understood to be the cause. However, there has been relatively little research on structural racism as an exposure. This dissertation will describe three ways to conceptualize and measure structural racism with the end goal of intervening to reduce health inequities. First, it will examine structural racism in surveillance data. The Sudden Unexpected Infant Death (SUID) Case Registry is a public health surveillance system created to prevent SUIDs. This study assesses the quality of data collection by rurality and by race to examine bias within the surveillance system. Second, it will discuss exposure distributions and structural racism. Research about causes of racial health inequities often favor using an interaction term with race rather than also considering unequal distributions of exposures by race. This study provides the first estimates for Hispanic Americans, Asian Americans, and Native Americans on an understudied exposure -- death of a sibling or a parent -- and its effect on attaining a Bachelor's degree. Third, it will delve into education policy and structural racism. Historically Black Colleges or Universities (HBCUs) were founded on anti-racism while predominantly white institutions (PWIs) were often founded on white supremacy. This contrast provides an opportunity to study effects of structural racism on the health of Black students who attended college in the U.S. This study measures the long-term effect of attending an HBCU on depressive symptoms among Black people compared to Black people who attended PWIs. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]