Table 5 Full description of the included studies

Agénor et al. (2021) [19]

To develop a comprehensive, longitudinal database of state laws that are explicitly or implicitly related to structural racism for various marginalized racial/ethnic groups (e.g., Black, Indigenous, and Latinx populations)

Legal systems, structural racism

Health outcome

State laws

Quantitative/ Policy Surveillance 

10 contemporary legal domains (voting rights (33), stand your-ground laws (34), racial profiling laws (35), mandatory minimum prison sentencing laws (36), immigrant protections (37), fair-housing laws (38), minimum-wage laws (39), predatory lending laws (40), laws concerning punishment in schools (41), and stop-and identify laws (42)

Health Outcome (1)

Legal Coding Scheme (39)

843 US state laws were found explicitly or implicitly related to structural racism across the 10 contemporary legal domains (ie, voting rights laws, stand-your-ground laws, racial profiling laws, mandatory minimum prison sentencing laws, immigrant protections, fair-housing laws, minimum wage laws, predatory lending laws, laws concerning punishment in schools, and stop-and-identify laws) in all 50 states and the District of Columbia from 2010 through 2013

Alang (2019) [83]

To characterize unmet need by identifying characteristics of blacks that are associated with reporting different reasons of perceived unmet need for mental health care

Racism

mental health

African American adults

Mixed method/ Sequential quantitative and qualitative

Cost (54), stigma (55), Minimization (56), low perceived effectiveness of treatment (57), accessibility barriers (12)

Unmet need of healthcare (2)

NA

Higher education was associated with greater odds of reporting stigma and minimization of symptoms as reasons for unmet need and racism causes mistrust in mental health service systems.

Benson et al. (2019) [71]

To examine reported experiences of discrimination against African American, Asian American, Native Americans, women and LGBTQ adults

Experience of discrimination

Health outcome

African American, Asian American, Native Americans, women and LGBTQ adults

Quantitative/ Cross-sectional

Institutional and interpersonal discrimination (58)

Identity based discrimination (3)

Survey Instrument (69)

In healthcare settings, 32% of African American, 23% native Americans, 20% Latinos, 13% Asian Americans, 38% native Americans reported identify based discrimination.

Bishop-Royse et al. (2021) [84]

To examine associations between infant mortality rates (IMRs) and measures of structural racism and socio-economic marginalization in Chicago, Illinois

Structural racism, economic marginalization

Infant mortality

Community residents

Quantitative/ Ecological

incarceration (61), educational attainment (11), income (15), and occupational status (81)

Infant mortality (4)

Index of Concentration at the Extremes (ICE) (11), Hardship Index (31)

Community areas with the lowest ICERace scores (those with the largest concentrations of Black residents, compared with White) had IMRs that were 3.63 times higher than those communities with the largest concentrations of White residents.

Boeck et al. (2021) [85]

To examine deaths attributable to violence and chronic diseases by area based social factors

Structural social factors

Deaths

Residents

Quantitative/ Non-experimental survey

Age (24), sex (23), race/ ethnicity (22), education level (11), employment status (14), median household income (MHI) (74), and percent below poverty level (PBPL) (60)

Years of life loss (5)

Census tract neighborhood crosswalk (6)

For chronic diseases and homicides, AYLLs increased as a neighborhood’s percent Black, below poverty level, unemployment, and below high school education increased

Bor et al. (2018) [17]

To estimate the impact of police killings of unarmed black Americans on self-reported mental health of black American adults in the US general population.

Police killing

mental health

African American

Quantitative/ Quasi-experimental

Number of police killing of unarmed black Americans in the 3 months prior BFRSS interview (63)

Number of days with 'not good' mental health status (6)

Geographical location index (29)

Each additional police killing of an unarmed black American was associated with 0·14 additional poor mental health days (95% CI 0·07–0·22; p=0·00047) among black American respondents.

Chambers et al. (2020) [67]

To describe pregnant and early post-partum Black women's exposure to structural racism and self-reported experiences of racial discrimination, and the extent to which these factors are related

Structural racism, racial discrimination

Neonatal health

Black women

Quantitative/ Cross-sectional

Race (22), Experiences of discrimination (45) and income (15)

Preterm birth (7) and Low birth weight (8)

Concentration of Extremes Index (11) & Experience of Discrimination Scale (21)

Living in highly deprived race and income neighborhoods was associated with experiencing racial discrimination in three or more situational domains. Black women are exposed to high levels of racism that may have negative impacts on maternal health outcomes.

Chantarat et al. (2021) [45]

To examine the multidimensional measures of structural racism using a latent class model

Structural racism

Covid 19 vaccination

PUMA Residents

Quantitative/ Cross sectional

Residential segregation (48), education inequity (11), Employment inequity (14), home ownership inequity (18), income inequity (15)

covid 19 vaccination rates (9)

Index of dissimilarity

Statistically significant differences due to structural racism by vaccination rates were observed between PUMAs with high and low Black-White income inequity only (7.2% vs 5.3%, p=.001)

Cheng et al. (2015) [80]

To describe levels of perceived lifetime discrimination among young adults and determine its role in understanding this racial/ethnic disparity

Perceived lifetime discrimination

Depression

African American 5-12 graders

Quantitative/ Longitudinal cohort

Race (22) and Parental Education (82)

Depression (10)

Perceived lifetime discrimination scale (51), Epidemiological Studies Depression Scale (17)

Black students from professionally educated families had the greatest discrimination scores, 1.8 times greater than among their white peers (mean Black = 42.1 vs mean White = 22.8; P < .0001);  Greater parental education was associated with lower depressive symptoms in all regression models.

Clay et al. (2021) [65]

To explore racial differences in influential sociodemographic, economic, and environmental factors in women with a low-birth-weight infant

Sociodemographic, economic, and environmental factors

Low Birth Weight (LBW)

Non-Hispanic Black and White women

Quantitative/Cross-sectional 

Marital Status (10), Educational level (11), access to healthcare during pregnancy (12), health status (13), employment (14), income (15), government help for rent (16), residence in public housing (17), homeownership (18), car ownership (19), neighborhood safety (20), length of residence in the neighborhood (21)

Low Birth Weight (8)

NA

For non-Hispanic Blacks, being married (OR=.55, P=0.003), having health care coverage (OR=.35, P<0.001), and living in public housing (OR=.64, P=0.031) were associated with a decreased likelihood of having LBW infants were 1.54 times (P=0.010) more likely to have LBW infants, as compared to NH Whites

Conklin (2011) [86]

To examine the association between perceived racism and mental health

Perceived racism

mental health

African American adults

Review/ Systematic Review and Meta Analysis

Perceived racism (58)

Mental health (11)

Higher instances of perceived racism were associated with lower levels of mental health

Cunningham et al. (2011) [87]

To examine the differential item functioning related to race, gender, age and educational attainment

Socio demographic factors

Experiences of Discrimination (EOD)

Young adult

Quantitative/ Prospective Study

Race (22), Gender (23), Age (24), Educational attainment (11)

Everyday Experiences of Discrimination (12)

Experiences of Discrimination Index (21)

Race and Gender were statistically significantly associated with EOD at school, getting a job, getting a house and in public place.

Dallaire et al. (2018) [88]

To examine the impact of mother or partner incarceration during pregnancy on neonatal outcomes and home environments

Parental incarceration

Adverse childhood experience

African American Mothers

Quantitative/ Case Control

Parental Incarceration (49)

Neonatal outcome (13) and home environments (25)

NA

The women who experienced incarceration of themselves or their husband/partner were significantly less likely to deliver an LBW infant and more likely to live in a home with a loaded firearm in the home.

Dawson et al. (2019) [28]

To examine the ‘causes of the causes’ of maternal inequity specific to New Zealand, and explain factors underlying continuing disparity, despite a free, women centered, continuity of care maternity system.

Social contributors

Maternal health inequity

African American Mothers

Review/ Integrative Review

Ethnicity- Race- Cultural factors (25), Geographical access (26), political context (27), maternity care system (28), acceptability (29), colonialism (30)

Maternal health (11)

NA

Six integrated factors – Physical Access, Political Context, Maternity Care System, Acceptability, Colonialism, and Cultural factors – were identified as barriers to equitable maternal health in Aotearoa New Zealand. A complex set of underlying structural and systemic factors, such as institutionalized racism, serve to act as barriers to equitable maternity outcomes and experiences.

de Mendoza et al. (2018) [89]

To examine the influence of perceived racism and discrimination on DNAm in a sample of African American mothers enrolled in the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure (InterGEN) study

Perceived racism & discrimination

DNA methylation (DNAm)

Mother/child dyads

Quantitative/ Longitudinal cohort 

Major Life Discrimination [MLD] (87) & Race-Related Events [RES] (22)

DNAm (epigenome-wide association study [EWAS]) (14)

Major Life Discrimination [MLD] Scale (42) & Race-Related Events [RES] scales)

After controlling for age, smoking, and cell composition, MLD was significantly associated with DNAm at nine CpG (regions of DNA where a cytosine nucleotide is followed by a guanine nucleotide) sites (false discovery rate [FDR]-corrected p < .05). significant epigenetic associations between disease-associated genes (e.g., schizophrenia, bipolar disorder, and asthma) and perceived discrimination as measured by the MLD Scale.

Dougherty et al. (2020) [70]

To examine the association between the structural racism and BMI for black and white men and women

Structural racism, obesity

BMI

White and black adults

Quantitative/ Cross-sectional 

Housing (52), education (11), employment (14), health care (12), and criminal justice (51)

Body mass index (BMI) (15)

County structural racism index (13)

County structural racism was associated with larger increases in BMI among black men than black women. County structural racism was associated with reduced BMI for white men and no change for white women

Feldman & Bassett (2021) [63]

To measure inequality in COVID-19 mortality jointly by race and ethnicity and educational attainment

Educational attainment, race/ethnicity

inequality in covid 19 mortality

Persons aged 25 years or older

Quantitative / Cross-sectional

Education (11) and Race (22)

COVID 19 mortality (16)

NA

Age-adjusted cumulative mortality rates for the overall population were highest among persons with the lowest educational attainment (208.1 per 100 000 population; Racial and ethnic minority women  died at higher rates than non-Hispanic White men of the same age group, with the exception of non-HispanicAsian women. [95% CI, 207.3-208.9 per 100 000 population]).

Fryer et al. (2020) [81]

To investigate the prevalence of self-reported discrimination and its association with the prevalence of spontaneous preterm birth

Racial discrimination

Preterm birth

African American women, Latina women

Quantitative/ Cohort

Racial discrimination (2)

Preterm birth (7)

NA

Adjusting for multiple risk factors, African American and Latina women who experienced the highest tertile of discrimination had a higher prevalence of preterm birth compared with those who experienced discrimination less than once per year, adjusted hazard ratio (aHR) = 1.5 (0.7–3.1) and 3.6 (0.9–14.4), respectively

Garcia et al. (2019) [58]

To document racial/ethnic and nativity differences by gender in cognitive life expectancies among older adults in the United States.

Racial differences

Cognitive life expectancies

White, Black, Hispanic adults

Quantitative/ cross-sectional

Race (22), Age (24) 50 or more

Dementia (16)

Cognitive function score index (8)

Minority and foreign-born women are expected to spend a significantly lower proportion of their remaining years after age 50 in a cognitively normal state compared to White women.

Geronimus et al. (2020) [64]

To examine whether diverse residents of same neighborhoods exhibited different levels of allostatic load (AL) across race/ethnicity and poverty

Race/ethnicity, poverty level

Allostatic load

White, Black, and Mexican with age 15 and above

Community based participatory Quantitative/ Cross-sectional

Race/Ethnicity (22) and Poverty to Income Ratio (PIR) (60)

Allostatic load (17)

Everyday Unfair Treatment Scale (20), Negative Social Interaction Scale (47), Neighborhood Satisfaction Scale (48), Anger and Hopelessness Scale (3)

AL is statistically significantly associated with Poverty to Income Ratio (PIR) across the races

Groos et al. (2018) [32]

To summarize the ways in which researchers have quantified measures of structural racism for the purposes of empirical, quantitative investigation of its associations with physical and mental health outcomes.

Structural racism

Health inequity

People of color adults

Review/ Systematic review

Residential housing pattern (52), Socioeconomic status (53), criminal justice (51), immigration and border enforcement (52), home mortgage discrimination (53)

Health outcomes (1)

Generic survey index (28), Census Track based Redling Index (5), Census tract socioeconomic disadvantage index (7) and index of dissimilarity, Deferred Action for Childhood Arrivals (DACA) status (14), Dissimilarity Index, Felony Incarcerations (23), Institutional racism subscale of the Index of Race-Related Stress (IRRS) (34), Institutional racism subscale of the Index of Race-Related Stress-Brief Version (IRRS-B) (36), Isolation index, Racial bias in mortgage lending index and residential redlining index (53), Redlining index of mortgage discrimination (59)Relative Proportion Index (60), Self- Reported Scale (66)

Articles included measures of structural racism within the following domains, in order of frequency: residential neighborhood/housing, perceived racism in social institutions, socioeconomic status, criminal justice, immigration and border enforcement, political participation, and workplace environment.

Hall et al. (2015) [73]

To examine the relationships between health care professionals’ implicit attitudes about racial/ethnic groups and health care outcomes

Implicit bias, healthcare providers

Health outcome

Healthcare providers

Review/ Systematic review

Implicit bias of healthcare providers (50)

health care outcomes (18)

NA

Although some associations between implicit bias and health care outcomes were nonsignificant, results also showed that implicit bias was significantly related to patient–provider interactions, treatment decisions, treatment adherence, and patient health outcomes.

Hankerson et al. (2015) [78]

To explore socio-cultural factors that contribute to low treatment rates among depressed African American men in outpatient mental health care

Factors of treatment disparities

Depression

African American men

Review/ Narrative review

Cultural mistrust of healthcare providers (83) and misdiagnosis (84) and clinician bias (85)

Low treatment rate on depression (19)

NA

A complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias and use of informal support networks contribute to treatment disparities.

Hansen (2015) [30]

To examine associations between self-reported ethnic discrimination and health outcomes in the rural Sami population of Central and North Norway

Ethnic discrimination

Health outcome

Sami people

Quantitative/ Cross-sectional

Ethnic discrimination (2)

Waist circumference (20), blood pressure (21), total cholesterol (22), HDL cholesterol (23), triglycerides and glucose (24)

Dichotomized Scale (15)

For Sami people living in minority areas, self-reported ethnic discrimination is associated with all the negative health indicators; discrimination to be associated with several chronic conditions, such as chronic muscle pain, diabetes and metabolic syndrome.

Harnois et al. (2019) [69]

To assess the extent to which the everyday discrimination scale (EDS) produces estimates of perceived discrimination that are comparable across age, gender, education, and racial/ethnic-based groups

Everyday discrimination, education

Income

White, Black and Latinx adults

Quantitative/ Cross-sectional 

Race (22)

Perceived discrimination (26)

Everyday Discrimination Scale (19)

Neither version of the scale generates estimates of discrimination that can be meaningfully compared across all racial/ethnic, age, gender, and education-based groups.

Heard-Garris et al. (2018) [74]

To summarize and discuss the current literature describing the associations between vicarious racism and child health to better inform practice and policy discussions in public health, medicine, and social science.

Vicarious Racism

Child health

African American Infant and Elementary school kids

Review / Systematic review

Perceived maternal discrimination/Perceived caregiver discrimination (86)

Infant health outcomes (Preterm birth (7), Cortisol reactivity (27), Birth weight (8)),  Mental health (Depressive symptoms (10), Anxiety (28), Substance Use (29), Well-being (30), Depressive Symptoms (10)),  Socioemotional health (Externalizing behavior (31), Internalizing behavior (32), Internalizing behavior Socioemotional difficulties (33), Self-esteem (34), Positive behavior(35)), Healthcare Utilization (Frequency of sick-child visits (36)), Physical Health (BMI (15), General Child illness (37), Weight-for-age (38)), Cognitive Development (Spatial ability (39)), Youth Health Outcomes (Depressive Symptoms (10))

Experiences of Discrimination (EOD) Scale,  Everyday Discrimination Scale (EDS) (19), Measurement Instrument (43)

While all studies examined racism indirectly experienced by children, there was no standard definition of vicarious racism used.

Hearst et al. (2008) [62]

To examine whether residential segregation plays an independent role in high black infant mortality rates

Residential segregation

Infant mortality

Black women

Quantitative/ Cross-sectional

Residential Segregation (48)

Infant Mortality (4)

Isolation Index (37)

There were 1.12 excess infant deaths per 1,000 livebirths among black infants due to living in a segregated city compared with a nonsegregated city, although the difference was not statistically significant.

Kendall et al. (2020) [26]

To elucidate incarcerated Aboriginal women’s experiences of prison healthcare, investigate equity of access to culturally safe healthcare in prison, and identify pathways for improving the accessibility of culturally safe healthcare.

Targeted discrimination, intergenerational trauma

Access to healthcare

Incarcerated aboriginal women

Community collaborative participatory action research methodology/ Grounded theory

Race (22)

Access to healthcare (40)

NA

Aboriginal women experienced institutional racism and discrimination in the form of not being listened to, stereotyping, and inequitable healthcare compared with non-Indigenous women in prison and the community.

Kephart (2021) [72]

To summarize the relationship between racial residential segregation and greenness, provide an overview of the measures used, and suggest for practices for recontextualization

Racial residential segregation, access to green space

Health outcome

Black and white residents

Review/ Systematic review

Racial segregation (48), structural racism (2)

Green space in the neighborhood (41)

Dissimilarity Index (16)

Studies consistently demonstrate an association between racial residential segregation and less exposure to tree canopy coverage, vegetation, and parks. When residents of color do enjoy greater access to parks, these parks tend to be more congested and contain less amenities than parks located in areas with predominately White residents

Krieger (2012) [47]

To inform the methods of scientific study of discrimination and health

Discrimination

Health

White, Black, Asian, Hispanic, and Native American adults

Quantitative/ Narrative review

Wealth (59), Poverty (60), Unemployment (14), Incarceration of men (61), political parity ratio (62), No health insurance (47)

Infant mortality (4), Persons Year Lost (42), Mental Health (11)

Experiences of Discrimination (EOD) scale, Everyday Discrimination Scale (EDS) (19)

Socially patterned exposure-induced pathogenic pathways, mediated by physiology, behavior, and gene expression, that affect the development, growth, regulation, and death of our body’s biological systems, organs, and cells, culminating in disease, disability, and death.

Lane et al. (2004) [24]

to examine ecological-level risk factors leading to disparate rates in heterosexually transmitted HIV among women of color

Structural violence

HIV Infection Rates

 Men and Women of color

Quantitative/ Cross-sectional 

Disproportionate incarceration rates of African American men (61), residential segregation (48), gang turf (82), constraints on access to sexually transmitted diseases (STD) services (12)

HIV infection rates (43)

NA

The cumulative effect of the three pathways is to create a context that increases greatly African American women’s exposure to HIV and heightens the risk of its transmission. Rather than resulting from individual choices, this risk is mainly the result of the institutional and socio-structural patterns that result from the ecological model described

LaVeist (2003) [90]

To test the relationship between racial segregation and mortality using a multidimensional questionnaire-based measure of exposure to segregation

Racial segregation

Longevity

African American adults

Quantitative/ Cohort

Residential segregation (48)

Number of chronic condition (44)

Segregation index (65)

Respondents who were exposed to racial segregation were significantly less likely to survive the study period

Lo & Cheng, (2018) [60]

To measure minority individual's social status factors and frequency of discrimination experiences and impact on mental health

Racism, social status

Mental health

Asians, Latinx and African American adult

Quantitative/ Cross-sectional

Immigration status (76), gender (23), marital status (10), education (11), Income to needs ratio (76)

Mental health (11)

Frequency of Discrimination Experience Index (26)

Across races better mental health was associated with male, gender, higher income, marriage, more education, and less frequent discrimination experiences among blacks.

Malcome (2021) [91]

To examine difference in symptoms of depression and its relation with age and community experience

Racial discrimination, sense of community belonging

Depression

Black mothers

Mixed Method/ Longitudinal randomized controlled trial 

Community Violence (4), Racism (2)

Depression (10)

Community violence scale (10), Beck Depression Inventory Scale (4), racial discrimination scale (54), Community Belonging scale (9)

Exposure to community violence, fear of violence victimization, structural racism negatively affects the mental health of low-income black mothers

Martin et al. (2019) [25]

To document lived experience of dislocation, poor health, and homelessness of western Australian aboriginal people

Homelessness and housing

Health and wellness

Aboriginal people

Community based Participatory Qualitative/ Exploratory qualitative

Homelessness (1)

Health and wellbeing (30)

NA

Participants experienced disconnection from kin and country, are likely to have serious risk to personal safety, homelessness, and problematic health due to colonization, dispossession, and racism.

Mehra (2020) [92]

To determine the extent to which structural stigma is associated with racial disparities in adverse birth outcomes

Structural stigma, interpersonal stigma

Birth outcomes

Black, White and Hispanic mothers with preterm and low birth weight infant

Mixed Method/ Systematic review & meta-analysis 

Residential segregation (48)

Preterm birth (7) and Low birth weight (8)

Five dimensions of segregation

Among the black mothers, exposure and hypersegregation were associated with increased risk of multiple adverse birth outcomes and greater black-white and white-Hispanic disparities in preterm birth in racially isolated counties.

Mobley et al. (2017) [93]

To assess the association between a measure of social cohesion/support (residential segregation) and health outcomes (late-stage colorectal cancer stage (CRS) diagnosis)

Residential segregation

likelihood of late-stage CRC diagnosis

Persons with CRC diagnosis

Quantitative/ Non-experimental survey

Residential segregation (48)

Late-stage CRC diagnosis (45)

Isolation Index

Living in highly segregated Asian communities is highly associated with higher likelihood of late CRC diagnosis.

Neblett Jr (2019) [77]

To discuss three pressing challenges in the study of racism as a social determinant of health and identifies ideas to guidefuture psychological and behavioral research

Racism

Racial health inequity

People of color adults

Review/ Narrative review

Status-related stressors (e.g., sexism heterosexism (64), religious discrimination (65), disability discrimination (66), ageism (22), classism (67), and sociocultural variables (e.g., worldview (68), spirituality (69), racial/ethnic identity (22), acculturation (70)

Psychological (e.g., anger (46), fear (47)) and physiological (e.g., immune (48), neuroendocrine (49), and cardiovascular (50)) stress responses

Index of Race-Related Stress (IRRS) (34)

Institutional, cultural, and structural racism, the incorporation of developmental health and resilience perspectives, the use of diverse methods and transdisciplinary approaches, and improved education and training should be considered.

Nikolova et al. (2015) [68]

To identify factors that predict the circumstances people with disabilities face, including poverty.

Disability, geo-social disparity

Health outcome

People with disability

Quantitative/ Cross-sectional

Household characteristics and conditions (46), education (11), employment (14) and health coverage (47)

Disability pattern (51)

The Global Moran Index (I) (30) and The Local Moran's Index (LISA) (41), Akaika Information Criteria (AICc) (2)

People with disabilities living below the poverty line experience high segregation levels in the semi central zones of Dallas. In Monterrey, people with disabilities clustered in central areas of the city.  High goodness of fit (R > 0.8 for Dallas data and R > 0.7 for Monterrey data, respectively and predictability of disability prevalence when social disadvantage factors such as unemployment, housing insecurity, household living conditions, and lack of education were present.

Nyika & Murray-Orr (2017) [29]

To examine the importance of critical race theory (CRT) - social constructivist hybrid approach in race research

Health promoting schools (HPS)

Constructivism

African immigrant students

Qualitative/ Narrative review

Race (22), Gender (23), Culture (25), Language (31) and Legal System (32),

Health Outcome (1)

NA

CRT and social constructivist approach can be integrated in HPS framework

Pabayo et al. (2019) [61]

To determine whether indicators of structural racism are associated with the individual odds for infant mortality among white and black infants in the US.

Structural racism

Infant mortality

Black and white mothers

Quantitative/ Cross-sectional

prison incarceration (77) and juvenile custody rates (78); sentencing rates (79) and capital punishment (80); educational attainment (11) (proportion of population aged 25+ with bachelor’s degree or higher); unemployment (14) (proportion of civilian labor force not currently employed); professional occupational status (81) (proportion employed in management, business, science, and arts occupations); and median household income (74)

Neonatal and Infant mortality (4)

Index of concentration at the extremes (ICE) (11)

Compared to the lowest tertile ratio of relative proportions of blacks to whites with a bachelor’s degree or higher— indicative of low structural racism—black infants, but not whites, in states with moderate (OR = 1.12, 95% CI = 0.94, 1.32) and high tertiles (OR = 1.25, 95% CI = 1.03, 1.51) had higher odds of infant mortality

Palacio et al. (2020) [94]

To create a weighed Social Determinants of Health (SODH) score and to test the impact of each SDOH factor on the Framingham risk score (FRS) and on individual traditional CVD risk factors

Social determinants of health (SODH)

Cardiovascular Disease

All patients

Quantitative/ Retrospective cohort 

SODH Exposure (75)

10-year Framingham risk score (FRS) for CVD (51)

Framingham risk score (FRS) (25)

An increasing SDOH score correlated with being a member of a racial/ethnic minority group, not being employed, having an education of high school or less, residing in a community with lower household income according to Census data, and having a higher prevalence of baseline CVD risk factors (P < .01); Increasing quartile of SDOH score was significantly associated with higher systolic blood pressure, FRS, glycated hemoglobin, and smoking pack-years (P < .05)

Paradies et al. (2015) [2]

To review the literature focusing on the relationship between reported racism and mental and physical health outcomes

Racism

Mental and Physical health outcomes

Adults of people of color

Review/Systematic review 

Reported racism (58)

Mental health (11), Physical Health (52) and General Health (53)

Schedule of Racist Events (SRE) (64), Racism and Life Experience Scales (RaLES) (57), Experiences of Discrimination (EOD), Perceived Racism Scale (PRS), Everyday Discrimination Scale (EDS) (19), Perceived Ethnic Discrimination Questionnaire (PEDQ) (50), Multidimensional Inventory of Black Identity (MIBI): public regard subscale (45), Nadanolitization scale (46)

Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50).

Paradies et al. (2014) [27]

To systematically review and appraise evidence of healthcare provider racism and assess current approaches to measuring racism amongst healthcare providers

Interpersonal Racism

Healthcare inequity

Healthcare providers

Quantitative/ Systematic review 

Race of healthcare providers (3)

Quality of healthcare (54)

Social distance scale (68), Affective racial attitude (1), Contemporary racism awareness scale (12), Ethnic attitude scale (18), Feelings of warmth scale (22), Implicit Association Test-IA (32), Knowledge and attitude towards immigrants scale (38), Multicultural counseling knowledge and awareness scale (44), New racism scale (49), Racial preference scale (55), Scale on Beliefs about race related policies (61), scale on race-based meritocracy (62), Scale on self-perception on racism among providers (63), Semantic differential situational attitude scale (67), Vignettes (70), Visible Racial (71), Ethnic identity attitude scale (72)White racial identity attitude scale

Statistically significant evidence of racist beliefs, emotions, or practices among healthcare providers in relation to minority groups was evident in 26 of these studies. Although a number of measurement approaches were utilized, a limited range of constructs was assessed.

Prasannan et al. (2021) [59]

To determine how social determinants of health are associated with severe acute respiratory syndrome and severity of coronavirus illness

Social determinants of health

acute respiratory coronavirus syndrome

Pregnant women

Quantitative/ Cross-sectional 

Household income (74), unemployment (14) and high school education (11)

Acute respiratory syndrome (55)

Zone Improvement Plan (ZIP) (73)

Pregnant patients who had a positive test result were more likely to be younger or higher parity, belong to minorized racial and ethnic groups and reside in low-income neighborhoods with less educational attainment. Obesity, income and education were associated with coronavirus disease 2019 severity.

Prioleau (2021) [95]

To explore intersectional experiences of black women in relation to gendered-racism, race-related stress, socioeconomic status (SES), and its impacts on total wellness factors

Gendered racism, race related stress and socioeconomic status

Health Wellness

 Black women

Quantitative/ Non-experimental survey

Gendered racism (23), race-related stress (22), socioeconomic status (SES) 53,

Wellness score (56)

Gendered racial microaggression scale (27), Index of race related stress-brief and five factor wellness inventory (35)

More gendered racial microaggression on certain domains were associated with higher wellness scores. Higher scores on race related stress and the lowest SES status group score were associated with lower overall wellness scores.

Pursch et al. (2020) [31]

To explore the provision of health services to migrants in Calais and La Linière, through a structural violence lens

Structural violence

Provisions of health services

NGO professionals

Qualitative/ Exploratory qualitative

Structural violence (2)

Access to healthcare (40)

NA

Structural realities including violence appeared to negatively affect migrant social determinants of health, reducing healthcare access, social inclusion, and sense of empowerment.

Ricks et al. (2021) [75]

To explore what research methods are being used to ascertain the training healthcare workers are receiving post-licensure and to identify the goals and outcomes of this training

Racism, implicit bias

Racial health inequity

Healthcare providers

Review/ Systematic review 

Race of healthcare providers (3)

Increased self-awareness (57), Racial attitudes (58), Knowledge attainment (59), Self-reported skills like decision-making (60), Number of PEH receiving COVID test (61), Length of stay (62)

NA

Reported outcomes included increased self-awareness of implicit bias.

Ryus et al. (2021) [96]

To examine the utility of community based participatory research approach (CBPR) to address structural racism

People experiencing homelessness (PEH)

Homeless people

Qualitative/ Exploratory qualitative 

Homelessness (1)

Number of PEH receiving COVID test in ED (61), Length of Stay (62)

NA

Community based participatory research approach (CBPR) was found to be effective in designing need addressing interventions for PEH.

Singer et al. (2021) [82]

To examine the association between student, school and neighborhood factors with chronic absenteeism

Student, school and neighborhood factors

Chronic absenteeism

People of color K to 12 grade students

Quantitative/ Ecological 

Math and English Test Score (5), Violent Crime Rate (6), Residential Vacancy rate (7), School stability rate (8), Asthma rate (9)

Chronic absenteeism (63)

Index of macro-level factors (33)

Ecological factors were significantly associated with chronic absenteeism

Tester et al. (2010) [79]

Is the term “structural violence” appropriate to describe the health outcomes of the housing provided to Inuit in the 1950s and 1960s?

Structural violence

TB Outbreak

Eskimo

Review/ Case

Poor housing (52)

TB outbreak (64)

NA

While prior viral epidemics were relevant, living conditions at Eskimo Point contributed significantly to development and spread of the disease.

VanPuymbrouck et al. (2020) [66]

To explore disability attitudes of health care providers

People with disability (PID), bias

Access to quality healthcare

Healthcare providers

Quantitative/ Cross-sectional 

Disability (44)

Providers' attitude (65)

Likert Scale (40)

Despite majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased.

White et al. (2012) [76]

To develop a conceptual framework for investigating the role of racial/ethnic residential segregation on health care disparities.

Racial/ethnic residential segregation

Healthcare disparities

Healthcare providers

Review/ Narrative review

Geographical segregation (26) and Health facility-based segregation (43)

Health inequity (66)

Five segregation scale (24)

Racial/ethnic residential segregation is a key factor driving place-based healthcare inequities.

Williams et al. (2019) [10]

To review the evidence linking primary domains of racism to mental and physical health outcomes

Structural racism, Cultural racism & individual level discrimination

mental and physical health outcomes

African American adults

Qualitative/ Narrative review 

Residential segregation (48), ideology of inferiority in the values (71), language (72), symbols (73), unstated assumptions (74), discrimination (2)

Health outcomes (1)

NA

Segregation was associated with increased risk of low birth weight and preterm birth for blacks. Individual level unconscious bias is associated with inferior medical care for minor ethnic groups. Self-reported discrimination is associated with negative health outcomes.