Frontiers in measuring structural racism and its health effects

The use of race terms in epigenetics research: considerations moving forward

“…Disproportionate health outcomes are driven by factors associated with structural racism, not race itself ( Phelan et al, 2010/03 ; Bailey et al, 2017 ; Bailey et al, 2021 ). Structural racism involves the “systemic racial exclusion from power, resources, opportunities, and wellbeing that is embedded in societal institutions” ( Brown and Homan, 2022 ). A good example comes from the field of birth outcomes, in which a great deal of research indicates that race itself is not the driving risk ( Chantarat et al, 2022 ; Ross, 2014 ; McAfee, 2017 ; Collier et al, 2021 ).…”

The Future of Social Determinants of Health: Looking Upstream to Structural Drivers

“…Although life course perspectives on health underscore the importance of timing, research on the health consequences of structural oppression has largely ignored the role of temporality. 56,81 Consequently, many key questions about how exposure to structural oppression over the life course affect health remain unanswered, including the following questions:what are the direct and indirect effects of historical oppression on contemporary health? How does structural oppression affect health trajectories across the life course?…”

“…Incorporating temporality into studies of structural oppression is critical for understanding dynamic population health equity processes. Although life course perspectives on health underscore the importance of timing, research on the health consequences of structural oppression has largely ignored the role of temporality 56,81 . Consequently, many key questions about how exposure to structural oppression over the life course affect health remain unanswered, including the following questions:what are the direct and indirect effects of historical oppression on contemporary health?…”

“Outside the Skin”: The Persistence of Black–White Disparities in U.S. Early-Life Mortality

“…These frame works are com pre hen sive and com pel ling in explaining per sis tently worse health out comes among racial minor i ties in the United States. By con cep tu al iz ing rac ism as an all encompassing and life long insti tu tion, they empha size the many cumu la tive social and indi vid ual mech a nisms per pet u at ing Black-White health disparities across time and place and through out the life course (Brown and Homan 2022;Goosby et al 2018;Hicken et al 2018;Phelan and Link 2015). This large body of research documenting the cumu la tive, biophysiological pro cesses through which insti tu tional and inter per sonal rac ism gets "under the skin" has proved invalu able for explaining Black-White disparities in mor bid ity and mor tal ity later in life, wherein chronic dis ease and the cumu la tive, life time con se quences of del e te ri ous health behav iors and expo sures con trib ute to poor health and pre ma ture death (Ferraro and Shippee 2009;Geronimus et al 2010).…”

“…Additionally, our ana ly ses are not mul ti var i ate, so we are unable to deter mine what spe cific con trib u tors (e.g., socio eco nomic sta tus, neigh bor hood effects, crime, emer gency response time) might affect observed racial dif fer ences and thus help bring causal, rac ismrelated mech a nisms to light. Recent work by Brown, Homan, and col leagues brings muchneeded atten tion to the impor tance of mea sur ing struc tural rac ism as a per va sive con tex tual deter mi nant of racial disparities (Brown and Homan 2022;Homan et al 2021). We con tend that these struc tural con di tions are par tic u larly impor tant for mor tal ity at youn ger ages, wherein min i miz ing the avail abil ity of fire arms and harm ful sub stances could avert numer ous deaths.…”