Racism and health: evidence and needed research
Open accessAbstract
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism—structural racism, cultural racism, and individual-level discrimination—to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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Based on broader research in sociology of mental health, patterns of inequality and suicide are likely complex and not distillable to individual experiences with discrimination or prejudice.
“Based on broader research within the sociology of mental health – which does take up this issue – the patterns are likely to be complex and again not distillable to individual experiences with discrimination or prejudice (McLeod, 2015; Williams et al., 2019; Laster Pirtle, 2020).”
From The Social Roots of Suicide: Theorizing How the External Social World Matters to Suicide and Suicide Prevention (2021) · cites this paper as Williams et al., 2019
In “Recommendations for Research on Discrimination and Health” (page unavailable), the paper says individual reports of discrimination do not capture all racism-related stressors or their contribution to health inequities. “Addressing Institutional Racism” (page unavailable) also reports an association between community cultural empowerment and lower youth suicide. The paper supports looking beyond individual prejudice, but does not directly analyze the broader patterns of inequality and suicide described in the citing sentence. (LLM, conf=0.82)
Experimental — accuracy not yet measuredNon-biological social and physical environmental factors mediate the link between race and health, as illustrated by health equity problems among US racial and ethnic minority groups.
“The connection between race and health is also mediated by non-biological factors that encompass the social and physical environment, as illustrated by the health equity challenges faced by racial and ethnic minority groups in the United States.3,4”
From Culturally Informed Digital Behavioral Intervention Development for Inflammatory Bowel Disease: A Qualitative Study (2025) · cites this paper as [4]
Fundamental cause theory holds that health disparities persist due to underlying social factors that disadvantage certain groups in accessing resources for protecting health and avoiding disease.
“According to fundamental cause theory, health disparities persist due to underlying social factors that disadvantage certain groups in accessing resources for protecting health and avoiding disease (Gee and Ford, 2011; Link and Phelan, 1995; Williams et al., 2019).”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Williams et al., 2019
Racism is an organized societal system in which the dominant racial group categorizes and ranks people into races and uses power to devalue, disempower, and differentially allocate resources and opportunities to groups defined as inferior.
“Racism is an organized societal system, in which the dominant racial group, based on a hierarchy of human value, categorizes and ranks people into social groups called “races”, and uses its power to devalue, disempower, and differentially allocate societal resources and opportunities to groups defined as inferior [8,9].”
From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [9]
Racism interacts with other social institutions, shaping their values, policies and practices and being re-shaped by them.
“As a structured system, racism interacts with other social institutions, such as the political, legal, and economic institutions, shaping the values, policies and practices within these institutions and being re-shaped by them.”
From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [9]
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References 143 · Cited by 2,398
Research works printed but not linked: 2
- [55]Jones JM. 1997 Prejudice and racism 2nd ed. New York: McGraw Hill
- [112]Smedley BD, Stith AY, Nelson AR. 2003 Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Washington, DC: National Academy Press 25032386
- Authors
- Williams, D. R., Lawrence, J. A., & Davis, B. A.
- Affiliations
- Harvard University (US)
- Venue
- Annual Review of Public Health
- Publisher
- Annual Reviews
- Published
- 2019-04-01
- Volume
- 40
- Issue
- 1
- Pages
- 105-125
- ISSN
- 0163-7525 (ISSN-L)
- 1545-2093
- PMC
- PMC6532402
- OpenAlex
- W2907260560
- Cited by
- 2,398
- References
- 143
- Citations by year
- 2026: 249 · 2025: 336 · 2024: 419 · 2023: 412 · 2022: 398 · 2021: 374 · 2020: 166 · 2019: 38 · 2013: 1 · 2012: 1
- FWCI
- 62.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual Review of Public Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (acceptedVersion)
- Funders
- National Institute on Aging (U19AG051426)
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Gender, Health, and Social Inequality
- Keywords
- racism, structural racism, cultural racism, mental health outcomes, physical health outcomes, racial and ethnic minorities, socioeconomic factors
- MeSH terms
- Delivery of Health Care, Ethnicity, Humans, Research Design, Socioeconomic Factors, United States, Biomedical Research, Racism
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