Levels of racism: a theoretic framework and a gardener's tale

TLDR

The framework can generate new hypotheses about race‑associated health disparities and inform interventions to eliminate them. The author proposes a theoretical framework that categorizes racism into institutionalized, personally mediated, and internalized levels. An allegory of a gardener with two flower boxes—rich and poor soil, red and pink flowers—illustrates the framework. The allegory demonstrates how the three racism levels interrelate and can guide interventions and spark national dialogue on racism.

Abstract

The author presents a theoretic framework for understanding racism on 3 levels: institutionalized, personally mediated, and internalized. This framework is useful for raising new hypotheses about the basis of race-associated differences in health outcomes, as well as for designing effective interventions to eliminate those differences. She then presents an allegory about a gardener with 2 flower boxes, rich and poor soil, and red and pink flowers. This allegory illustrates the relationship between the 3 levels of racism and may guide our thinking about how to intervene to mitigate the impacts of racism on health. It may also serve as a tool for starting a national conversation on racism.