The examination of racism as a determinant of health is an emerging area of research. This paper examines and expands on existing research approaches in relation to three levels at which coherence and conceptual clarity can be improved: in defining and theorizing racism, in conceptualizing how racism may relate to health and in characterizing racism as an exposure that can be operationalized and measured. A definition of racism in relation to the broader concept of privilege/oppression is detailed along with a discussion of the implications of this definition in relation to the concept of power, the perpetration of privilege/oppression, intention vs. effect and objective vs. subjective racism. This is followed by a conceptualization of the relationship between racism and health, which incorporates both previous approaches in health research and pertinent social theory and is designed to aid in organizing and synthesizing knowledge, defining concepts and variables, generating specific research questions and determining appropriate analytical approaches. The range of dimensions across which perceived racism (as experienced by oppressed racial groups) can be characterized, operationalized and measured as a health-risk condition is then detailed. It is hoped that through improved conceptual and theoretical tools this nascent area of study will be better equipped to explain how racism relates to the distribution and determinants of population health. Such improved knowledge will better guide policies and actions aimed at improving the health of those who suffer from this invidious phenomenon.