IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2025i5p703-d1645593.html
   My bibliography  Save this article

Health Disparities at the Intersection of Racism, Social Determinants of Health, and Downstream Biological Pathways

Author

Listed:
  • Roland J. Thorpe

    (Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Baltimore, MD 21205, USA
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Marino A. Bruce

    (Faith, Justice and Health Collaboratory, University of Houston Population Health, University of Houston, Houston, TX 77204, USA
    Department of Behavioral and Social Sciences, University of Houston, Tilman J. Fertitta Family College of Medicine, Houston, TX 77204, USA)

  • Tanganyika Wilder

    (School of Allied Health Sciences, Division of Health Sciences, Florida A&M University, Tallahassee, FL 32317, USA)

  • Harlan P. Jones

    (Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
    Institute for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX 76107, USA)

  • Courtney Thomas Tobin

    (Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA 90995, USA)

  • Keith C. Norris

    (Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA)

Abstract

Despite overall improvements in the accessibility, quality, and outcomes of care in the U.S. health care system over the last 30 years, a large proportion of marginalized racial and ethnic minority (minoritized) groups continue to suffer from worse outcomes across most domains. Many of these health disparities are driven by inequities in access to and the scope of society’s health-affirming structural resources and opportunities commonly referred to as structural drivers or social determinants of health—SDoH. Persistently health-undermining factors in the social environment and the downstream effects of these inequities on neurocognitive and biological pathways exacerbate these disparities. The consequences of these circumstances manifest as behavioral, neurohormonal, immune, and inflammatory and oxidative stress responses, as well as epigenetic changes. We propose a theoretical model of the interdependent characteristics of inequities in the SDoH driven by race-based discriminatory laws, policies, and practices that eventually culminate in poor health outcomes. This model provides a framework for developing and validating multi-level interventions designed to target root causes, thereby lessening health disparities and accelerating improved health outcomes for minoritized groups.

Suggested Citation

  • Roland J. Thorpe & Marino A. Bruce & Tanganyika Wilder & Harlan P. Jones & Courtney Thomas Tobin & Keith C. Norris, 2025. "Health Disparities at the Intersection of Racism, Social Determinants of Health, and Downstream Biological Pathways," IJERPH, MDPI, vol. 22(5), pages 1-11, April.
  • Handle: RePEc:gam:jijerp:v:22:y:2025:i:5:p:703-:d:1645593
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/5/703/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/22/5/703/
    Download Restriction: no
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2025:i:5:p:703-:d:1645593. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.