Understanding the Issue: Race, Ethnicity, Culture, and the Structural Determinants of Health

The emergence and refinement of assisted reproductive technologies (ART) have allowed for an ever-growing number of patients to fulfill their desire to become parents. However, the benefits of ARTs do not accrue equally to patients from all demographic groups. Although race, ethnicity, and culture are indistinct concepts without true biological significance, living as a racialized or minoritized person has a profound impact on patients’ access to and experience of healthcare. In this chapter, the concepts of race, ethnicity, culture, racism and the structural determinants of health are examined through the lens of reproductive healthcare. Setting the stage for the chapters to follow, this chapter also introduces the concepts of structural competency and cultural responsiveness in infertility care.