Structural Racism and Health Inequities

Abstract

Racial minorities bear a disproportionate burden of morbidity and mortality. These inequities might be explained by racism, given the fact that racism has restricted the lives of racial minorities and immigrants throughout history. Recent studies have documented that individuals who report experiencing racism have greater rates of illnesses. While this body of research has been invaluable in advancing knowledge on health inequities, it still locates the experiences of racism at the individual level. Yet, the health of social groups is likely most strongly affected by structural, rather than individual, phenomena. The structural forms of racism and their relationship to health inequities remain under-studied. This article reviews several ways of conceptualizing structural racism, with a focus on social segregation, immigration policy, and intergenerational effects. Studies of disparities should more seriously consider the multiple dimensions of structural racism as fundamental causes of health disparities.

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“…This composition is dramatically different from that found among the homeless studied here, with 78.6% self-declared mixed race or black. In addition, in our country and elsewhere 28,29,30 , the black population is subject to greater economic and social vulnerability, which can contribute to disproportionate susceptibility to infectious diseases. Our findings reinforce these assumptions, since ethnicity was predictive of HBV infection (adjusted PR: 1.70; p = 0.024).…”

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“…The first cultural barrier is our narrow focus on the individual, which makes the systems and structures that drive inequities either invisible or irrelevant. 4,16 Self-interest becomes narrowly defined, sometimes not even encompassing extended family. There is a limited sense of inter-dependence and a limited sense of collective efficacy.…”