The Immune System Is a Complex System: Inflammatory Morbidity and Systemic Racism

This article examines the relationship between social inequity and the immune system, emphasizing some of the many ways that systemic racism and other forms of marginalization can undermine health. Of much sociological concern, chronic stressors increase inflammation and consequent susceptibility to health morbidities and, ultimately, mortality by burdening marginalized group members in ways that adversely affect immune regulation and functioning. As with social systems more generally, the immune system is a cross-scale complex system of many regulating, coordinating, and interacting parts, within both itself and the other bodily systems it protects. Along these lines, we thus propose that to properly conceptualize how social conditions undermine immune functioning and health, it is important to consider the immune system beyond its component mechanisms and parts. This view is akin to the way critical race theory proposes that “systemic racism” in the United States is a collaborative arrangement of social structures whose explanatory richness and historical durability can only be fully understood as a gestalt. We therefore seek, where possible, to emphasize the systems nature of the immune system similarly to the sociological insight that society comprises complex systems whose interrelated structures interact in dynamic and sometimes unpredictable ways. We scaffold this discussion within the literature on systemic racism in the United States, emphasizing inflammation as a key marker of immune demand and dysregulation and highlighting some implications for health inequities among marginalized populations more generally.