How Structural Racism Works: Racist Policies as a Root Cause of U.S. Racial Health Inequities

In the 5 years since one of us published “#Black LivesMatter — A Challenge to the Medical and Public Health Communities” in the Journal, 1 we have seen a sea change in the recognition of racism as a durable feature of U.S. society and of its high cost in Black lives. Elected officials, corporate leaders, and academics alike use the slogan “Black Lives Matter,” which has also been widely adopted by members of the public, who by the millions protested the extrajudicial killing of George Floyd.2 With this change comes growing recognition that racism has a structural basis and is embedded in long-standing social policy. This framing is captured by the term “structural racism.