Measures of Racism, Sexism, Heterosexism, and Gender Binarism for Health Equity Research: From Structural Injustice to Embodied Harm—An Ecosocial Analysis

Abstract

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.