UNDERSTANDING STRUCTURES, BUILDING EQUITY
We all want communities where everyone has a fair opportunity to achieve their best health—no matter race, ethnicity, or income. That vision becomes reality when we understand the systems that create barriers for some communities while opening doors for others.
What is Structural Racism and Why It Matters for Health
Structural racism refers to the way policies, systems, and practices built into society create and maintain racial inequities. Unlike individual prejudice, it's embedded in how society operates, which can shape where people live, what schools they attend, whether they can access nutritious food, and how they're treated in healthcare.
These structures persist through policies like exclusionary zoning, discriminatory lending, underfunded schools, and immigration enforcement that discourage healthcare access. The result: some communities consistently face barriers to wellbeing while others benefit from systems designed to support success.
Explore how structural racism operates across three areas that shape health outcomes
Food & Housing
Where you live can influence life span, future economic prosperity, and access to quality healthcare, schools, and nutritious food. The high costs of housing make this problem worse. When families spend most of their income on rent, buying groceries becomes impossible
Education & Health Literacy
Underfunded schools limit health knowledge and system navigation skills. One’s level of education is strongly associated with more positive health outcomes, such as better health behaviors, less chronic disease, and a longer life expectancy.
Immigration & Mobilization
Immigration status affects one’s ability to access resources that create a higher quality of life. Current policy barriers restrict healthcare while organizing opens pathways to equity. Communities can learn to mobilize to challenge these barriers and create system change.
What is food insecurity?
Food insecurity is when a household does not have consistent, reliable access to enough healthy food that people need for a healthy life. It can mean limited variety, skipping desirable foods, or sometimes reducing food intake altogether because there aren’t enough money or resources.
Food Insecurity + Housing Instability
Structural racism has shaped labor markets, neighborhood investment, and housing policy so that people of color are more likely to experience both food insecurity and housing instability. When income falls short of basic needs, families must choose between housing and food. When families spend most of their income keeping a roof over their heads, buying groceries becomes an impossible choice. These are not separate problems, but two sides of the same barrier.
What is housing instability?
Housing instability includes difficulty paying rent, frequent moves, overcrowding, spending too much income on housing, or facing eviction or homelessness. These conditions leave families without a stable place to live which affects access to food, healthcare, jobs, and basic wellbeing.
Realities + Impact
For decades, banks and the government refused to lend money to people in Black and Hispanic neighborhoods. They called these areas "high risk" because of race, not actual risk. This practice, known as redlining, made it nearly impossible for families in these communities to buy homes and build wealth.
Other unfair practices made things worse. Some rules kept affordable housing out of certain areas. Some loans were designed to trap people in debt. Without investment, these neighborhoods were left behind. Grocery stores didn't want to open there. Today, Black and Hispanic families are about twice as likely as White families to struggle with affording food and housing.
The impact can be devastating for the health outcomes of our community. Food insecurity drives reliance on cheap, easier to access processed foods, increasing diabetes and heart disease. Housing instability creates chronic stress, weakening immune systems, and mental health. Families delay medical care when budgets are consumed by rent and food costs.
Education Access & Health Literacy
Health literacy is the degree to which people have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
Health literacy is shaped by policy, education systems, economic conditions, and access to culturally relevant information. It affects individuals, families, and entire communities. The concept of health literacy encompasses the materials, environments, and challenges specifically associated with disease prevention and health promotion. When educational systems are under-resourced, when language access is limited, and when digital tools are unevenly distributed, communities face barriers to developing and applying these skills.
Realities + Impact
School funding tied to property taxes means communities with less wealth have fewer resources. Discriminatory admissions and underinvestment in minority-serving institutions limit college access. Language barriers and digital divides restrict access to health information.
Only 12% of U.S. adults have proficient health literacy
41% of Hispanic adults and 24% of Black adults scored below basic health literacy
Only 40% of Black and Hispanic adults hold bachelor's degrees vs. 65% of White adults (NCES)
Limited health literacy leads to medication errors, delayed care, chronic disease mismanagement, and difficulty navigating insurance and healthcare systems.
Immigration Status & Community Mobilization
Immigration status, language barriers, and access to services all shape health outcomes for immigrant communities. Federal policies exclude many immigrants from Medicaid, SNAP, and housing assistance. Families are discouraged from seeking healthcare even when eligible, and healthcare systems often lack interpretation services and culturally competent providers.
Realities + Impact
Fear of enforcement activities, lack of in-language resources, and exclusion from safety-net programs create major disparities, yet immigrant communities can organize to protect health through mutual aid, education, and advocacy.
Being uninsured and living in fear makes it harder to get care. People skip doctor visits, miss early warning signs, and end up sicker than they need to be. The constant stress of worrying about enforcement takes a toll on mental health, leading to anxiety and depression. And when hospitals or clinics work with enforcement agencies, people stop trusting the places that are supposed to help them.
How These Issues Connect
These issues intersect and compound each other. An undocumented mother working two jobs struggles to afford rent in a neighborhood with decent schools. Housing costs consume income, forcing reliance on convenience store food. Her children attend underfunded schools limiting health education. When her daughter develops asthma—worsened by poor housing and stress—she delays care due to fear and lack of insurance.
This isn't one problem—it's multiple barriers colliding. Each barrier makes the next harder to overcome. Stress multiplies, not just adds. Health suffers while healthcare access becomes impossible.
Why Community Voices Matter
Comprehensive approaches addressing multiple barriers simultaneously create opportunities for communities to thrive. Community leaders witness these intersections daily—you are positioned to advocate for solutions addressing root causes, not symptoms.
What YOU Do
With their complexity and in today’s political and social climate, it is normal to feel overwhelmed by these issues. The good news is that research shows meaningful change can happen when just 3.5% of a population actively and consistently participates. Even small, collective actions can shift behaviors and create positive change that benefits entire communities. Here are some of the ways you contribute:
• Map local food and housing resources—identify where critical gaps exist
• Advocate for affordable housing funding, tenant protections, and nutrition assistance
• Build coalitions connecting housing advocates, food banks, and health clinics
Remember that these systems can change, and you can be that spark in your community.