Structural Racism and Chronic Stress The Root Cause of Disparities

Abstract

This article details the elements and origins of structural racism, illustrates the resultant impact chronic stress has on African Americans, and poses a new paradigm for the Social Determinants of Health (SDoH). Our thesis is that structural racism is the proximate cause of health disparities. My daughter and I found ourselves on similar paths of discovery while she was attending Bryn Mawr College as a psychology and neuroscience major. She was working on her undergraduate thesis regarding the use of fingernail sample assays for cortisol levels. The underlying research was evaluating stress and cortisol levels in minority, specifically African American communities. At the same time, I was interested in mental health and chronic stress in the African American community. As she described her research, I thought we should collaborate on our intersecting interests. Our joint thesis is that structural racism is the proximate cause of health disparities. Structural racism permeates every aspect of American Life making it simultaneously pervasive and elusive. Chronic stress in the African American community leads to disparities in mental and physical health. We identify race as an independent SDoH in the following model.