Now you see it, now you don’t - A literature-based study on identifying normative whiteness in relation to structural racism and social determinants of health

Abstract: Background: Structural racism is increasingly regarded as a central issue for disparities in social determinants of health. Eliminating such structure can be seen as central for achieving racial health equity. What remains invisible in the scope of Public Health is, however, the role that normative whiteness plays in the process of creating and sustaining racial disparities in health and how this contributes to unequal access to those social determinants that may positively influence health. Aim: The aim of this explorative literature-based study was to research how whiteness manifests itself in structural and institutional contexts, to identify which intersectional perspectives were used to problematise whiteness, and to discuss its relevance for understanding inequalities in social determinants of health. Method: A literature-based review on whiteness in relation to structural and institutional racism was conducted based on the guidelines for a systematic literature review. Articles were selected through a systematic search. The identified literature was analysed guided by the framework of qualitative content analysis and the findings were discussed in relation to intersectionality theory, Critical Race and Whiteness theories and Public Health practice. Results: The systematic article search identified 12 articles. Main themes were located within the identified literature and further divided into subcategories based on findings. The results identified whiteness in relation to three categories: whiteness as embedded in language, whiteness in relation to segregation, and experiential differences of whiteness between people of colour and white people. Discussion: As a result of the explorative study method and lack of evidence-based literature, the results of the study were non-conclusive, but suggestive. More research is required on how whiteness may impact Public Health issues related to racial and ethnic segregation, racism and discrimination. Despite the challenges associated with studying whiteness, such research could provide an alternative framework for analysing racial inequities. Further, such research should consider applying the frameworks of intersectionality and Critical Race theories in order to better understand how whiteness affects the social determinants of health through multiple factors.