Race is a social construct rather than a biological reality. The term race is used to describe any person who is not white and encompasses all non-white groups. Racism is the form of oppression operationally defined as the beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals or groups because of race or ethnic group affiliation (Scott-Jones, & Kamara, 2020). Racism, particularly at the institutional and structural level, is a fundamental social determinant of long-standing, widespread racial disparities in population health (American Public Health Association, 2020). More comprehensively, racism refers to a variety of practices, beliefs, social relations, and phenomena that work to reproduce a racial hierarchy and social structure that yield superiority, power, and privilege for some, and discrimination and oppression for others.
Racism has been woven tightly into the fabric of American society to establish and reinforce the racial hierarchy. From 1619, when the first enslaved Africans arrived in the land of America, to the deliberate failures of Reconstruction to Jim Crow and the Civil Rights Movement and beyond, racist beliefs about Black people have been codified into law and the policies and practices of social institutions (American Public Health Association, 2020). In the 17th century, millions of Africans were shipped from Africa to the Americas as slaves and lived in the diaspora. Most Africans were separated from their families, stripped of their names and identities, beaten, raped, tortured, and, in many cases, lynched or hanged at the whims of their White masters. The psychological, physical, sexual, and emotional abuse Africans experienced during enslavement in the United States had long-lasting traumatic effects. Since then, the marginalization of individuals based on race has been normalized across systems and institutions of the United States and continues to impact Black Americans today. (Scott-Jones & Kamara, 2020). ). Douglas Massey and Nancy Denton noted that the institutionalization of racial discrimination occurred within large sectors of American society, including the labor market, the educational system, and the welfare bureaucracy (Massey & Denton, 1993).
Systemic and structural racism are forms of racism that are pervasively and deeply embedded in systems, laws, written or unwritten policies, and entrenched practices and beliefs that produce, condone, and perpetuate widespread unfair treatment and oppression of people of color, with adverse health consequences. More specifically, systemic racism occurs when racially unequal opportunities and outcomes are intrinsic to the operation of a society’s structures. Simply put, systemic racism refers to the processes and outcomes of racial inequality and inequity in life opportunities and treatment (National Equity Project, 2025). Braveman et al. (2022) noted that systemic racism systematically and pervasively puts Black people, Indigenous people, and other people of color at compounded disadvantage within society. Once in place, systemic racism is often self-perpetuating, with persistently damaging effects on Black well-being even after the explicitly discriminatory measures are no longer in effect (Braveman et al., 2022). Structural Racismrefers to biased laws, policies, or practices that restrict people’s access to services, opportunities, and resources because of their race. This structural bias has compounding effects on people’s families, employment, mental and physical health, interactions with the criminal justice system, and beyond (Rodriguez-Knutsen, 2023). It entails entrenched societal patterns and institutional practices that perpetuate racial discrimination and inequality. It manifests across sectors, including education, health care, housing, and law, often through the unequal distribution of resources and opportunities. Structural racism is not simply the result of private prejudices held by individuals, but is also produced and reproduced by laws, rules, and practices sanctioned and implemented by various levels of government, as well as by the economic system and cultural and societal norms (Rodriguez-Knutsen, 2023).
