Krieger's conceptualization and measurement of discrimination and internalized oppression in studies of adverse health outcomes
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abstract
Embodiment is a central concept in Krieger's ecosocial theory, and is said to be of relevance to the understanding of the relationship between social conditions and a variety of adverse health outcomes. The most detailed empirical investigation of this in Krieger's work is to be found in her studies of the relationship between racial discrimination and high blood pressure. Of especial relevance here is the idea of internalized oppression which is said to explain the observed association between self-reports of no racial discrimination and increased levels of blood pressure among working-class African Americans. Here we critically examine the empirical evidence pertaining to internalized oppression. Specifically, we focus on the measurement of the construct and the quality of the empirical evidence that has been presented in support of the hypothesis that there is an association between internalized oppression and adverse health outcomes. We argue that the validity of the concept has yet to be established and that the available data linking it to poor health outcomes are open to alternative explanations, notably measurement error and misclassification. 2009 Springer Science+Business Media B.V.
