Discrimination and health inequities

Area of Science:

• Public Health
• Epidemiology
• Social Sciences

Background:

• Empirical investigations on discrimination and health have rapidly increased since 1999, exceeding 500 studies.
• Research scope has broadened globally, examining various discrimination types (race, gender, sexuality, disability, age) individually and combined.
• A significant gap exists in research on structural discrimination and its health impacts, mirroring limited epidemiologic study of political systems and population health.

Purpose of the Study:

• To review definitions of discrimination with U.S. examples.
• To discuss theoretical frameworks for understanding how discrimination impacts health and creates inequities.
• To summarize existing evidence linking discrimination to health outcomes and address methodological challenges.

Main Methods:

• Updated review of the literature on discrimination and health.
• Analysis of definitions, theoretical insights, empirical evidence, and methodological controversies.
• Focus on interpersonal versus structural discrimination and their respective health impacts.

Main Results:

• While research volume has grown exponentially, the focus remains predominantly on interpersonal discrimination.
• Limited research addresses the health consequences of structural discrimination.
• Evidence linking discrimination to health is robust but sometimes inconsistent, highlighting methodological complexities.

Conclusions:

• The field needs to expand research beyond interpersonal discrimination to include structural factors for a comprehensive understanding of health inequities.
• Addressing methodological challenges related to domains, pathways, level, and spatiotemporal scale is crucial for advancing research.
• Further investigation into the embodiment of discrimination and its impact on population health is warranted.