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

Milbank Quarterly, Journal Year: 2023, Volume and Issue: 101(S1), P. 36 - 60

Published: April 1, 2023

Policy Points Policies that redress oppressive social, economic, and political conditions are essential for improving population health achieving equity. Efforts to remedy structural oppression its deleterious effects should account multilevel, multifaceted, interconnected, systemic, intersectional nature. The U.S. Department of Health Human Services facilitate the creation maintenance a national publicly available, user-friendly data infrastructure on contextual measures oppression. Publicly funded research social determinants be mandated (a) analyze inequities in relation relevant (b) deposit available repository.

Language: Английский

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Structural Racism and Health Stratification: Connecting Theory to Measurement

Journal of Health and Social Behavior, Journal Year: 2024, Volume and Issue: 65(1), P. 141 - 160

Published: Feb. 3, 2024

Less than 1% of studies on racialized health inequities have empirically examined their root cause: structural racism. Moreover, there has been a disconnect between the conceptualization and measurement This study advances field by (1) distilling central tenets theories racism to inform approaches, (2) conceptualizing U.S. states as racializing institutional actors shaping health, (3) developing novel latent measure in states, (4) using multilevel models quantify association five individual-level outcomes among respondents from Health Retirement Study (N = 9,020) Behavioral Risk Factor Surveillance System 308,029), (5) making our publicly available catalyze research. Results show that is consistently associated with worse for Black people but not White people. We conclude highlighting this study’s contributions (theoretical, methodological, substantive) important avenues future research topic.

Language: Английский

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Structural racism in primary schools and changes in epigenetic age acceleration among Black and White youth

Social Science & Medicine, Journal Year: 2024, Volume and Issue: 347, P. 116724 - 116724

Published: March 2, 2024

Language: Английский

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Racialized Health Inequities: Quantifying Socioeconomic and Stress Pathways Using Moderated Mediation

Demography, Journal Year: 2023, Volume and Issue: 60(3), P. 675 - 705

Published: May 23, 2023

Abstract Racism drives population health inequities by shaping the unequal distribution of key social determinants health, such as socioeconomic resources and exposure to stressors. Research on interrelationships among race, resources, stressors, has proceeded along two lines that have largely remained separate: one examining differential effects stressors across racialized groups (moderation processes), other role in contributing racial (mediation processes). We conceptually analytically integrate these areas using race theory a novel moderated mediation approach path analysis formally quantify extent which an array stressors—collectively individually—mediate sample older adults from Health Retirement Study. Our results yield theoretical contributions showing how status–health gradient stress processes are (24% associations examined varied race), substantive quantifying (approximately 70%) relative importance various factors, methodological commonly used simple approaches ignore moderation overestimate—by between 5% 30%—the collective roles status accounting for health.

Language: Английский

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A State-Level Examination into Structural Racism and Racialized Disparities in Sexually Transmitted Infections

Spatial Demography, Journal Year: 2025, Volume and Issue: 13(1)

Published: Feb. 10, 2025

Abstract The population health literature recognizes structural racism as a fundamental determinant of racialized disparities. However, the role in continued persistence disparities sexually transmitted infections (STIs) has not been investigated despite Black Americans’ disproportionate experience STIs comparison to White Americans. Past research largely individual racial/ethnic identity an individual-level factor predictive STIs, failing engage with multitude racially structured contexts which likely shape STI rates. This study combines multiple datasets, including data from Centers for Disease Control and Prevention, American Community Survey, Current Population conduct state-level analysis investigating contributing Black–White between 2010 2020. Random effects spatial autoregressive models suggest that contributes STIs. literatures on by better understanding how institutions contraction infections. results have important implications states institutional actors relevant patterns geography racism.

Language: Английский

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Criminal Justice, Arrests Data, and Structural Racism Measurement for Health Equity Research: Promises and Pitfalls

Health Services Research, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 11, 2025

The authors declare no conflicts of interest.

Language: Английский

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Weighing the benefits and risks of collecting race and ethnicity data in clinical settings for medical artificial intelligence

The Lancet Digital Health, Journal Year: 2025, Volume and Issue: 7(4), P. e286 - e294

Published: March 27, 2025

Language: Английский

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COVID-19 and All-Cause Mortality by Race, Ethnicity, and Age Across Five Periods of the Pandemic in the United States

Population Research and Policy Review, Journal Year: 2023, Volume and Issue: 42(4)

Published: Aug. 1, 2023

Abstract Racial/ethnic and age disparities in COVID-19 all-cause mortality during 2020 are well documented, but less is known about their evolution over time. We examine changes age-specific across five pandemic periods the United States from March to December 2022 among four racial/ethnic groups (non-Hispanic White, non-Hispanic Black, Hispanic, Asian) for ages 35+. fit Gompertz models death rates by 5-year construct ratios an Initial peak (Mar–Aug 2020), Winter (Nov 2020–Feb 2021), Delta (Aug–Oct Omicron 2021–Feb 2022), Endemic period (Mar–Dec 2022). then compare patterns observed 2019. The steep gradients shifted peak, with substantial increases at working ages, before gradually returning older pattern subsequent periods. find a disproportionate burden on racial ethnic minority populations early pandemic, which led increase temporary elimination of Hispanic advantage certain groups. Mortality narrowed time, inequalities generally pre-pandemic levels. Black populations, however, faced younger gradient relative 2019, adults slightly disadvantageous position advantageous position, pandemic.

Language: Английский

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Legislating Inequity: Structural Racism In Groups Of State Laws And Associations With Premature Mortality Rates

Health Affairs, Journal Year: 2023, Volume and Issue: 42(10), P. 1325 - 1333

Published: Oct. 1, 2023

Most evaluations of health equity policy have focused on the effects individual laws. However, multiple laws' combined better reflect crosscutting nature structurally racist legal regimes. To measure laws, we used latent class analysis, a method for detecting unobserved "subgroups" in population, to identify clusters US states based thirteen structural racism–related domains 2013. We identified three classes states: one with predominantly harmful laws (n=29), another protective (n=15), and third mix both (n=7). Premature mortality rates overall—defined as deaths before age seventy-five per 100,000 population—were highest which included eighteen past Jim Crow This study offers new measuring racism basis how groups are associated premature rates.

Language: Английский

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Methods for studying structural oppression in quantitative family research

Journal of Marriage and Family, Journal Year: 2024, Volume and Issue: 86(5), P. 1272 - 1304

Published: May 28, 2024

Abstract Researchers have long documented the impact of social inequalities on family life. Most research has focused at individual and levels, extant studies macro‐level conditions primarily examined economic specific family‐focused policies. Yet, an emerging body largely conceptual suggests that structural inequities also enormous power to shape families. Structural racism, sexism, sexual gender minority oppression, other forms injustice operate across various levels (macro, meso, micro) systems (e.g., educational, economic, political, criminal‐legal, etc.), influence individuals' environments everyday lives in ways may how, when, where people form moreover, relationship quality, caregiving patterns, child outcomes, aspects consequences these forces for families not yet been thoroughly examined. In this article, we (1) develop a framework linking oppression characteristics (2) outline innovative approaches conceptualizing measuring describe how incorporating can move field science forward, (3) make several recommendations regarding best practices fruitful avenues future research.

Language: Английский

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