Levels of racism: a theoretic framework and a gardener's tale

Am J Public Health. 2000 Aug;90(8):1212-5. doi: 10.2105/ajph.90.8.1212.


The author presents a theoretic framework for understanding racism on 3 levels: institutionalized, personally mediated, and internalized. This framework is useful for raising new hypotheses about the basis of race-associated differences in health outcomes, as well as for designing effective interventions to eliminate those differences. She then presents an allegory about a gardener with 2 flower boxes, rich and poor soil, and red and pink flowers. This allegory illustrates the relationship between the 3 levels of racism and may guide our thinking about how to intervene to mitigate the impacts of racism on health. It may also serve as a tool for starting a national conversation on racism.

MeSH terms

  • Disease / ethnology
  • Health Status
  • Humans
  • Models, Theoretical
  • Power, Psychological
  • Prejudice*
  • Racial Groups*
  • Social Class*
  • Social Perception
  • United States