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Structural Racism

Linking anti-black structural racism and poor health. CVD indicates cardiovascular disease. 

Structural racism is racism that is normalized and legitimized by the policies, institutions, and systems that govern our society (e.g., in housing, education, employment, healthcare, criminal justice, etc.).1,2 It is racial discrimination maintained by, within, and across institutions. Due to a history of slavery and genocide, the U.S. social, political, and economic systems have consistently afforded advantage to white Americans and excluded those of other racial groups. 

Although we’ve made great progress towards achieving racial equality, outdated rules and norms of the past remain engrained in our institutions, and their harmful effects continue to persist. For example, Bailey et al. describe redlining and residential segregation, policing and incarceration, and unequal health care as root causes of racial health inequities. See the included figure for an example of how inequities in cardiovascular disease outcomes result from anti-Black structural racism.3 We should also consider other health outcomes we might substitute in this figure, which illustrates the pervasive and often unappreciated depth of the issues.  As part of our journey of raising awareness, we should examine these issues closely and seek a more comprehensive understanding of our collective past so we can frame a more perfect future.

Take a moment to learn and get involved in ways the NIH is working to dismantle structural racism:

For continued learning and reading:


  1. Bailey, Z.D. (2021) How Structural Racism Works—Racist Policies as a Root Cause of U.S. Racial Health Inequities. New England Journal of Medicine
  2. APHA (2020) Structural Racism is a Public Health Crisis: Impact on the Black Community.
  3. Churchwell, K. (2020) Call to Action: Structural Racism as a Fundamental Driver of Health Disparities: A Presidential Advisory From the American Heart Association. Journal of the American Heart Association.
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