Structural interventions that affect racial inequities and their impact on population health outcomes: a systematic review
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Racism unfolds at all levels of society. It is deeply embedded within systems and institutions, with profound implications for the health and wellbeing of racialized populations. Existing research tends to focus on individual and interpersonal forms of racism, while structural racism, interventions to address it, and their health impacts, remain underexamined.
The purpose of this systematic review was to analyze the effects of structural-level interventions on determinants of health and health outcomes for racialized populations.
Twenty nine (29) studies were included in this review of the literature, identified through searches of peer-reviewed and grey literature. Study selection was guided by the World Health Organization’s Commission on the Social Determinants of Health 2010 framework. Study designs of the included literature were quasi-experimental, natural experiments and randomized controlled trials. The included studies addressed various policy domains, which the authors grouped into six categories:
- Financial policies
- Nutrition safeguards
- Immigration
- Family and reproductive policies
- Policies for Indigenous populations
- Environment
Overall, the authors found mixed effects of interventions on the structural determinants of health and health outcomes. While some studies reported positive effects, for example, several studies found that minimum wage policies decreased HIV incidence and improved birth outcomes for Black populations, others noted no effects on health inequities.
The authors call for comprehensive ‘all-policy’ approaches that simultaneously act on multiple domains to address racial health inequities. They also emphasize the need for further research on structural-level interventions, co-designed with those with lived experience of structural racism.
Use this resource to:
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Understand how structural racism impacts the health and wellbeing of racialized populations
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Distinguish between individual-level and structural-level public health action
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Guide action on structural interventions to address racial health inequities
Related Resources:
Let’s Talk: Racism and Health Equity
Let’s Talk: Whiteness and Health Equity
Key public health resources for anti-racism action: A curated list
See other resources on racism, health and equity.
Reference
Clark, E., Cranston, E., Polin, T., Ndumbe-Eyoh, S., MacDonald, D., Betker, C. & Dobbins, M. (2022). Structural interventions that affect racial inequities and their impact on population health outcomes: a systematic review. BMC Public Health, 22, 2162. https://doi.org/10.21203/rs.3.rs-1769321/v1
Tags: Racism/racialization, Structural determinants, Partner with other sectors, Academic Institution, Journal Article