Structural violence, population health, and health equity

Structural violence (SV) systemically marginalizes individuals and populations through embedded policies and economic structures that cause harm. Unequal social structures create inequities that impact social, emotional, and physical well-being over generations. SV includes four components: (a) broad in geographical nature, (b) correlated with power differentials, (c) grounded in histories of oppression and marginalization, and (d) rooted in an inegalitarian social structure. SV disproportionately harms minoritized and marginalized people.

The purpose of this paper is threefold: to (a) examine social structures, policies, and processes that contribute to SV; (b) spark policy discussions highlighting these connections; and (c) offer engagement strategies that prioritize the health of populations impacted by SV.

Using Bronfenbrenner's socioecological model (SEM), we propose multi-level legislative strategies to mitigate SV by addressing its root causes and impacts on individuals and populations.

Nurses, as global citizens, have insights into societal influences that shape health and should recommend policy actions that foster health equity. SV harms marginalized groups by influencing economic stability, neighborhood conditions, and access to food, healthcare, and education. Advancing health equity requires addressing both the social determinants of health and the structural forces that shape them.

Understanding SV and recognizing its omnipresence enable nurses to detect the often invisible forces that shape outcomes and to intervene effectively. Civically engaged nurses recognize that achieving equitable health outcomes requires confronting systemic forces, including inequitable policies and the unjust distribution of resources, that continually constrain population health.