Health Disparities
Association between a novel database of local policies and structural racism in Solano County, CA Tracy Lam-Hine* Tracy Lam-Hine Ángel Mendiola Ross Nafeesa Andrabi Tainayah Whitney Thomas Lesley Sept David Rehkopf
Intro: Legal epidemiology offers methods for identifying and coding policies as exposures in epidemiologic studies. Structural racism can operate through policy to affect racial health inequities, but to date, legal epidemiologists studying structural racism have mostly focused on the state level. However, localities implement state laws and also create policy. We aimed to create a local policy index and estimate associations with structural racism in Solano County, CA.
Methods: We reviewed administrative sources and consulted domain-specific experts to identify Solano County city policies adopted as of 2023, hypothesized to impact structural racism. We created a policy index by taking city-level differences in progressive and regressive policy counts. For structural racism, we averaged five tract-level measures: Black/White (B/W) rate ratios in college graduation, employment, and homeownership, B/W dissimilarity index; B/W index of concentration at the extremes with income. We regressed structural racism against the policy index in a crude hierarchical model to estimate cross-sectional mean differences.
Results: We identified 13 policies: 12 progressive and 1 regressive. Policy index scores ranged from 0 in unincorporated areas to 4 in Dixon and Vallejo. Tract-level structural racism ranged from -1.36 to 1.88; tract population-weighted city means were highest in Benicia (0.04) and lowest in Rio Vista (-0.05) (Fig 1). The association between the policy index and structural racism was null (mean difference: -0.003, 95% CI: -0.114, 0.107).
Discussion: Policies create an operating medium for structural racism. Our null findings may reflect the small number of locations in a single county and a lack of temporal data, as policies may take many years to influence measures of structural racism. Future research should extend this work to other localities and examine historical data to help fully characterize the place-based impact of (anti)racist policy exposures.
