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

. American Journal of Public Health, 90 (8): 1212-1215 (August 2000)
DOI: 10.2105/AJPH.90.8.1212

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.

Description

Cited by US CDC director in April 2021 https://www.cdc.gov/healthequity/racism-disparities/index.html in her CDC post, Racism is a Serious Threat to the Public’s Health, in the following context: "Racism—both interpersonal and structural—negatively affects the mental and physical health of millions of people, preventing them from attaining their highest level of health, and consequently, affecting the health of our nation. A growing body of research shows that centuries of racism in this country has had a profound and negative impact on communities of color. The impact is pervasive and deeply embedded in our society"

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