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Structural Interventions to Reduce and Eliminate Health Disparities
Open accessAbstract
Health disparities research in the United States over the past 2 decades has yielded considerable progress and contributed to a developing evidence base for interventions that tackle disparities in health status and access to care. However, health disparity interventions have focused primarily on individual and interpersonal factors, which are often limited in their ability to yield sustained improvements. Health disparities emerge and persist through complex mechanisms that include socioeconomic, environmental, and system-level factors. To accelerate the reduction of health disparities and yield enduring health outcomes requires broader approaches that intervene upon these structural determinants. Although an increasing number of innovative programs and policies have been deployed to address structural determinants, few explicitly focused on their impact on minority health and health disparities. Rigorously evaluated, evidence-based structural interventions are needed to address multilevel structural determinants that systemically lead to and perpetuate social and health inequities. This article highlights examples of structural interventions that have yielded health benefits, discusses challenges and opportunities for accelerating improvements in minority health, and proposes recommendations to foster the development of structural interventions likely to advance health disparities research.
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“When abusers fight for and obtain custody, what they are often looking for is not more meaningful involvement with their children, but rather acknowledgement of their status and importance (Bancroft et al., 2002; Brown et al., 2019; Silverman et al., 2004; Slote et al., 2005).”
From Post‐separation abuse: A concept analysis (2023) · cites this paper as Brown et al., 2019
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Roles of Drug Court Staff in Providing Trauma-Informed Care
Tamburo-Trevino, N. (2024) · SpringerBriefs in offending populations & correctional psychotherapy · doi:10.1007/978-3-031-72368-1_5
Brzoska, P. (2025) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.70060
“Furthermore, efforts to address social determinants of health, such as poverty, education, and housing, are essential for achieving health equity and reducing disparities in chronic disease outcomes [27].”
Darko, M. V., Tangel, V. E., Gilman, A., Cumbermack, M., Kelleher, D. C., Tedore, T. R., & White, R. S. (2025) · Population Health Management · doi:10.1089/pop.2024.0194
“Given the intersectionality of the different SDOH and their synergistic effect on patient outcomes and experiences, 6,18,19 this current study will further assess how patient-and hospital-level factors in fl uence the relationship between hospital safety-net status and THA peri-operative outcomes.”
Chehade, M., McLean, K., Ashmawi, S. M., Cajavilca, M. F., Phung, B. T., Clark‐Cutaia, M. N., & Campbell, B. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-087916 · Cited by 1
Patro, P. S., Awasth, S., Jamuna, K. V., & Sharma, M. (2022) · Health Leadership and Quality of Life · doi:10.56294/hl2022127
Yousefi, M., Etemadi, S., Mehri, M., Pour, M. H., & Behzadi, A. (2025) · Journal of Archives in Military Medicine · doi:10.5812/jamm-158770
Tuitt, N. R., Hall, A., Dominguez, Y. M., Hill, A., Samuels, O., Weiden, A., Duncan, D. T., Sánchez, B. N., Moore, R. S., Whitesell, N. R., et al. (2025) · BMJ Public Health · doi:10.1136/bmjph-2024-001465
“15 16 Public health interventions that move beyond the individual and interpersonal levels have been recommended for years, as multilevel approaches that combine social, physical and environmental aspects are likely to have cumulative and enduring effects on health.”
Acompañamiento as a Latine critical race theory approach to community public health research
Malagon, J. C. R. (2025) · Latino Studies · doi:10.1057/s41276-025-00520-7
“…to say that public health does not have scholars who add knowledge to the field that provides resistance to the dominant Western epistemologies (see Brown et al. 2019; Came and Griffith 2018; Ford and Airhihenbuwa 2010, 2018; Gee et al. 2009; Graham et al. 2011; LeBrón et al. 2023; Nichols et al.…”
The Role Of Cross-Sector Collaboration In Reducing Racial And Social Disparities In Healthcare
Lal, S. (2025) · American journal of student research. · doi:10.70251/hyjr2348.331724
Bhawra, J., Ibrahim, S. T., Patel, J., Khadilkar, A. V., & Katapally, T. R. (2025) · medRxiv · doi:10.1101/2025.05.25.25328322
“Since many adult-onset NCDs and their determinants originate in childhood and adolescence, it is also imperative to take a life course perspective to minimize intergenerational transmission of NCDs [38,41–43].”
Driver, R., Tesoriero, J. M., Shengelaia, T., & Pannell, K. (2025) · LGBT Health · doi:10.1089/lgbt.2024.0209 · Cited by 1
“33 SGM health-related structural barriers and social isolation also demonstrated signi fi cant indirect paths for overall health and QOL.”
Barksdale, C. L., Stinson, N., & Pérez-Stable, E. J. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-23750-8.00031-x
Structural inequalities and chronic disease health outcomes: Implementing evidence-based strategies
Ekwunife, O. I., & Nwanne, G. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-23750-8.00027-8
Economic factors associated with county-level mental health – United States, 2019
Bolduc, M. L. F., Saberi, P., Neilands, T. B., Mercado, C. I., Battle, S., Freggens, Z. R. F., Banks, D., Njai, R. S., & Bullard, K. M. (2025) · PLoS ONE · doi:10.1371/journal.pone.0300939 · Cited by 1
Metadata
- Authors
- Brown, A. F., Ma, G. X., Miranda, J., Eng, E., Castille, D., Brockie, T., Jones, P., Airhihenbuwa, C. O., Farhat, T., Zhu, L., & Trinh-Shevrin, C.
- Affiliations
- Fox Chase Cancer Center (US)
- Arleen F. Brown is with General Internal Medicine and Health Services Research, University of California Los Angeles (UCLA) and Olive View-UCLA Medical Center, Los Angeles, CA. Grace X. Ma is with Center for Asian Health, Fox Chase Cancer Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Jeanne Miranda is with the Department of Psychiatry and Biobehavioral Sciences, Jonathan and Karin Fielding School of Public Health, UCLA. Eugenia Eng is with the Gillings School of Global...
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2019-01
- Volume
- 109
- Issue
- S1
- Pages
- S72-S78
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC6356131
- OpenAlex
- W2912527863
- Cited by
- 465
- References
- 45
- Citations by year
- 2026: 52 · 2025: 97 · 2024: 86 · 2023: 79 · 2022: 58 · 2021: 53 · 2020: 30 · 2019: 9
- FWCI
- 36.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- TUScholarShare (Temple University) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR001881)
- National Cancer Institute (U54CA153513)
- National Institute of Neurological Disorders and Stroke (U54NS081764)
- National Center for Chronic Disease Prevention and Health Promotion (U58 DP005828, U48DP005008)
- National Center for Advancing Translational Sciences
- National Institute on Minority Health and Health Disparities (U54MD000538)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Public Health Policies and Education
- Keywords
- health disparities, structural interventions, structural determinants of health, minority health, health care access, socioeconomic factors, environmental factors, health policy, multilevel interventions, evidence-based interventions
- MeSH terms
- Health Status, Humans, Minority Groups, Socioeconomic Factors, United States, Healthcare Disparities
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