This study addresses the gap in empirical research on the health consequences of structural racism by developing a novel latent measure of state-level structural racism and examining its impact on health outcomes among Black and White adults. The study draws on theoretical tenets of structural racism, conceptualizes U.S. states as racializing institutional actors, and uses multilevel models to analyze data from the Health and Retirement Study (HRS) and the Behavioral Risk Factor Surveillance System (BRFSS). Key findings include: 1. **Theoretical and Methodological Contributions**: The study advances the field by distilling central tenets of structural racism theories into measurement approaches, conceptualizing states as racializing institutional actors, and developing a latent measure of structural racism. 2. **Empirical Findings**: Structural racism is consistently associated with worse health outcomes for Black people but not White people. Specifically, higher levels of structural racism are linked to worse self-rated health, higher BMI, more functional limitations, more depressive symptoms, and more poor mental health days among Black individuals. 3. **Methodological Contributions**: The study uses confirmatory factor analysis to develop a reliable and valid latent measure of structural racism, accounting for the interconnectedness of various indicators across domains. 4. **Public Availability**: The study makes its measure of structural racism publicly available to facilitate further research on its etiology and consequences. The study highlights the importance of addressing structural racism to improve health equity and provides a comprehensive framework for understanding and measuring its impact on population health.This study addresses the gap in empirical research on the health consequences of structural racism by developing a novel latent measure of state-level structural racism and examining its impact on health outcomes among Black and White adults. The study draws on theoretical tenets of structural racism, conceptualizes U.S. states as racializing institutional actors, and uses multilevel models to analyze data from the Health and Retirement Study (HRS) and the Behavioral Risk Factor Surveillance System (BRFSS). Key findings include: 1. **Theoretical and Methodological Contributions**: The study advances the field by distilling central tenets of structural racism theories into measurement approaches, conceptualizing states as racializing institutional actors, and developing a latent measure of structural racism. 2. **Empirical Findings**: Structural racism is consistently associated with worse health outcomes for Black people but not White people. Specifically, higher levels of structural racism are linked to worse self-rated health, higher BMI, more functional limitations, more depressive symptoms, and more poor mental health days among Black individuals. 3. **Methodological Contributions**: The study uses confirmatory factor analysis to develop a reliable and valid latent measure of structural racism, accounting for the interconnectedness of various indicators across domains. 4. **Public Availability**: The study makes its measure of structural racism publicly available to facilitate further research on its etiology and consequences. The study highlights the importance of addressing structural racism to improve health equity and provides a comprehensive framework for understanding and measuring its impact on population health.