Integrating Racism as a Sentinel Indicator in Public Health Surveillance and Monitoring Systems

Abstract

Objectives. To evaluate public health surveillance and monitoring systems’ (PHSMS) efforts to collect, monitor, track, and analyze racism. Methods. We employed an environmental scan approach. We defined key questions and data to be collected, conducted a literature review, and synthesized the results by using a qualitative description approach. Results. We identified 125 PHSMS; only 3—the Behavioral Risk Factor Surveillance System, Pregnancy Risk Assessment and Monitoring System, and California Health Interview Survey—collected and reported data on individual-level racism. Structural racism was not collected in PHSMS; however, we observed evidence for linkages to census and administrative data sets or social media sources to assess structural racism. Conclusions. There is a paucity of PHSMS that measure individual-level racism, and few systems are linked to structural racism measures. Public Health Implications. Adopting a standard practice of racism surveillance can advance equity-centered public health praxis, inform policy, and foster greater accountability among public health practitioners, researchers, and decision-makers. Failure to explicitly address racism and the insufficient capacity to support a robust health equity data infrastructure severely impedes efforts to address and dismantle systemic racism.