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The development, evolution, and maintenance of structural racism for the study of health inequities: An expanded framework for Asian, Black, Hispanic, Indigenous, and White Americans

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  • Dennis, Alexis C.
  • Martinez, Rae Anne M.
  • Chung, Esther O.
  • Lodge, Evans K.
  • Wilbur, Rachel E.

Abstract

Evaluating the relationship between structural racism and health inequity is conceptually and empirically complex. This critical review of policies and events extends a previously published framework for understanding structural racism in health research across ethnoracial groups from 1400 to present. We apply this framework for Asian, Black or African American, Hispanic/Latinx, Native Hawaiian/Pacific Islander, and White groups and reflect on, compare, and contrast the overarching patterns within and across groups. Our findings illustrate the utility of our framework as a tool for conceptualizing and operationalizing structural racism in future health research. We suggest that health scholars can advance the field by: (1) recognizing multiple, reinforcing domains of structural racism; (2) expanding research beyond a Black-White binary to include other ethnoracial groups; (3) emphasizing the role of time and its different manifestations as exposure across the life course and cohorts; (4) highlighting the implications of collective resistance and agency as alternatives to deficit models; and (5) disaggregating data, whenever possible, to avoid rendering smaller ethnoracial groups invisible.

Suggested Citation

  • Dennis, Alexis C. & Martinez, Rae Anne M. & Chung, Esther O. & Lodge, Evans K. & Wilbur, Rachel E., 2025. "The development, evolution, and maintenance of structural racism for the study of health inequities: An expanded framework for Asian, Black, Hispanic, Indigenous, and White Americans," Social Science & Medicine, Elsevier, vol. 383(C).
    • Handle: RePEc:eee:socmed:v:383:y:2025:i:c:s0277953625007142
    DOI: 10.1016/j.socscimed.2025.118383
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    References listed on IDEAS

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    1. Margaret T. Hicken & Lewis Miles & Solome Haile & Michael Esposito, 2021. "Linking History to Contemporary State-Sanctioned Slow Violence through Cultural and Structural Racism," The ANNALS of the American Academy of Political and Social Science, , vol. 694(1), pages 48-58, March.
    2. Jones, C.P., 2000. "Levels of racism: A theoretic framework and a gardener's tale," American Journal of Public Health, American Public Health Association, vol. 90(8), pages 1212-1215.
    3. Gee, G.C. & Walsemann, K.M. & Brondolo, E., 2012. "A life course perspective on how racism may be related to health inequities," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 967-974.
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