June 12, 2024

On May 29, the Drexel Urban Health Collaborative and the Ubuntu Center on Racism, Global Movements, and Population Health Equity were honored to co-host Dr. Zinzi Bailey, a social epidemiologist focused on cancer health disparities, as well as the health impacts of and policy solutions for structural and institutional discrimination, especially at the intersection of public health and criminal justice. Dr. Bailey’s talk, “Structural Racism and Health: Where to Go From Here?" offered multiple considerations to help us expand our research on the pathways between racism and health to capture additional, critical dimensions.

Structural racism is a particular focus for Dr. Bailey. In fact, her definition of structural racism, first published in a 2017 article in The Lancet, has become standard, used by top health organizations including the APHA, who declared structural racism a public health crisis in 2020, and the AMA, which recently adopted policy to address discrimination, bias, and abuse in medicine:

Structural racism refers to the totality of ways in which societies foster [racial] discrimination, via mutually reinforcing [inequitable] systems…(eg, in housing, education, employment, earnings, benefits, credit, media, health care, criminal justice, etc) that in turn reinforce discriminatory beliefs, values, and distribution of resources, reflected in history, culture, and interconnected institutions.

Invoking her namesake, Zinzi Mandela, in her talk, Dr. Bailey further explained that “Racism is not an event; it is a process.” This is the basis of her approach to researching structural racism: Instead of honing in on single measurements or snapshots, she aspires to capture the multidimensionality of structural racism and its mechanisms. Dr. Bailey acknowledged the difficulty of this work but shared common approaches, such as capturing multidimensional health outcomes associated with structural racism, and considering time, and policy environment, and geographical differences in relationship to development of disease.

As an example, Dr. Bailey pointed to Jim Crow policies, many of which persisted until the Civil Rights Act of 1964. How might health outcomes differ among people affected by those policies, compared to people who weren’t affected? Dr. Bailey explored this approach in a 2017 paper co-written by UHC Affiliate Dr. Jaquelyn Jahn, which found that being born in a Jim Crow state increased the risk of a type of breast cancer only among Black women, with stronger odds among Black women born before 1965. This unique effect, she writes, “underscores why analysis of racial/ethnic inequities must be historically contextualized.”

Watch a recording of the talk for more insights from Dr. Bailey on how to enhance investigations on structural race and health and produce research that leads to action.

WATCH: Dr. Zinzi Bailey Talks “Structural Racism and Health: Where to Go From Here?” at the UHC