Paula A. Braveman, Elaine Arkin, Dwayne Proctor, Tina Kauh, and Nicole Holm

Racism is not always conscious, explicit, or readily visible— often it is systemic and structural. 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. Examples include residential segregation, unfair lending practices and other barriers to home ownership and accumulating wealth, schools’ dependence on local property taxes, environmental injustice, biased policing and sentencing of men and boys of color, and voter suppression policies. This article defines systemic and structural racism, using examples; explains how they damage health through many causal pathways; and suggests approaches to dismantling them. Because systemic and structural racism permeate all sectors and areas, addressing them will require mutually reinforcing actions in multiple sectors and places; acknowledging their existence is a crucial first step.

February 2022 41:2 Health Affairs

By Sanjiv Lingayah

A new report by Dr Sanjiv Lingayah and ROTA shines a light on systemic racism. It takes a system provides a clear definition of this slippery concept and outlines an agenda for dismantling systemic racism. This includes creative efforts to bring to life how systems function as well as the development, by advocates and activists, of blueprints to show what a system that centres racial and other justice looks like.

Finally, to move towards a system that advances racial justice, we need proper funding for both the ‘fast’ work to deal with the crises of racial injustice and the ‘slow’ work of addressing systemic causes.

London: Beyond Race/Race on the Agenda , 2021. 20p.