This dissertation examines how the field of public health addresses the impact of systemic racism on health and how that informs public health’s approach to youth violence prevention. Beginning with an overview of youth violence, it breaks down the concepts of race and racism and how they are addressed within the science. It also reviews concepts that contribute to risk and protective factors of youth violence. The dissertation is written from a Critical Race Theory approach, argues that the social environment contributes to why youth violence is pervasive in certain neighborhoods, and promotes action from a macro-level approach. Seven chapters cover systemic racism, public health, youth violence, and the impact of neighborhood. Chapter One overviews youth violence in the United States, as well as the social construction of race. Chapter Two explores several areas of interest relevant to understanding the theoretical underpinnings and conceptualization of the study based on current literature. A discussion of the existing literature and gaps around the topics of risk and protective factors of violence, systemic racism, social norms of youth violence, sociopolitical development in youth, racial/ethnic identity development, and engagement in violent behavior are presented. Chapter Three outlines the methodology utilized to answer the research questions of the study. Chapters Four, Five, and Six are distinct manuscripts providing context on how public health approaches systemic/institutional/structural racism, the impact of residential segregation on youths’ participation in violent behaviors, and additional factors contributing to youth violence. Results show that the Public Health literature does not explicitly address systemic racism, and though recognized as a social determinant of health, it is not a substantial focus throughout the field. Using poverty rate or neighborhood grades do not show differential effects of youth participation in violent behaviors, and other institutional-level characteristics need to be explored. According to local Louisville youth, racism at the individual and institutional levels is a factor contributing to youth violence (Chapter Six). Overall, this dissertation addresses the gap in incorporating the topics of systemic racism in Public Health practice and research and provides evidence of the impact of racism and the social environment on youth violence.
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Attending to systemic racism : advancing public health's approach to youth violence prevention.