The impact of racism and the racial structure on health: challenges of addressing racial health inequalities in a 'post-racial' United States

This research centers itself in a paradigm shift from conceptualizing race as a biologically significant concept to identifying its relationship to the social determinants of health drawing much from sociology. This study builds on a new wave of research that looks at how the stress of racism- institutionalized, personally mediated, and internalized (Jones 2002)- is a core determinant of the racial health inequality structure of the United States. This study highlights the advantage of analyzing theory based racial breakdown models over traditional atheoretical "race effect" models of health. Findings from the traditional "race effect" model indicate that controlling for behavioral risk factors, health status and access, age, gender, SES, and exposure to racism, no racial health disadvantage exist in the form of number of unhealthy days. By comparison, findings from six race*sex breakdown models, reflecting a Critical Race framework based upon race equity and social justice principles, indicate that controlling for risk factors, health status and access, age, SES, socially assigned race, and exposure to racism the number of unhealthy days for Black males, Black females, and Latino males are significantly higher. These findings argue for theory based health effect models when conducting health research, but more importantly a discontinuation of one size fits all solutions for health inequalities. Keywords: Race, CRT, Social Determinants of Health, Public Sociology