The Influence of Racism on Social Determinants of Health and Health Disparities

Utilizing the Nell Hodgson School of Nursing Four-Pillar SDOH Framework, this chapter describes the ways in which social, cultural, environment (physical and social), and policy conditions are shaped by structural racism and subsequently disparities in health outcomes. Although these Four-Pillars are explored separately for their contribution to disparities in health outcomes, in reality they are interwoven like puzzle pieces. That is, although one pillar may emerge and prominent in the promotion of health or alleviation of disease, an imbalance in one is likely to influence the other three SDOH pillars. Moreover, it is important to consider that at any given time, any one or more of these four pillars can be protective or place individuals at risk for illness and health inequities.