Researchers developed a conceptual map that demonstrates connections between mental models that guide how society thinks and acts, inequitable structures, and racial and ethnic disparities in healthcare experiences and outcomes.
The Issue
Racial and ethnic disparities in the U.S. healthcare system contribute to inequitable and unjust health outcomes. Racial oppression is embedded in and across our organizations and systems and maintains inequitable structures. Efforts to account for structural racism in healthcare require an understanding of the structures and connections that reinforce disparities and must be changed to produce equitable health outcomes.
Key Findings
- Health disparities are the result of structural racism. Targeting disparities and not their drivers lead to solutions that fail to create long-term change.
- Structural racism is perpetuated not only by historical and contemporary race-based laws and policies, but also by race-neutral policies that fail to consider and correct inequitable conditions.
- Policymakers, practitioners, advocates, and communities can use information about how specific policies and practices contribute to healthcare disparities to target structural change.
- Different structures within healthcare practice and policy connect in a web-like structure. Healthcare structures are also connected to and supported by the practices and policies of other domains, such as education, employment, immigration, and more.
- Efforts to advance health justice must focus both within and outside of healthcare to ensure structural change.
Conclusion
This map highlights how structural racism is a driver of health disparities, how disparities stem from inequitable norms, values, and mental models, and how addressing structural drivers will require multipronged policy efforts.
Understanding the web-like nature of structural racism in healthcare can help inform root-cause interventions, effective policy solutions, and more rigorous research analysis.
About the Author/Grantee
The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.
