Conceptual Model of Racism and Health [Colour figure can be viewed at wileyonlinelibrary.com]
Abbreviations: HPA, hypothalamic–pituitary–adrenal; SAM, sympathetic–adrenal–medullary.
The dimensions depicted in this figure are not exhaustive. For example, structural racism encompasses the involvement of the institutions depicted here and others not shown (e.g., banking). The boxes representing individuals’ identities and life stages illustrate individual‐level factors that may modify the effect of racism on health. They do not correspond to the orientation or sequencing of the columns above (fundamental causes, risk and protective factors, responses, and health inequities). The biologic responses box is characterized by accelerated dysregulation of these, and other, systems, a process referred to as “weathering.”
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The Buckyball graphic is adapted from Gee and Hicken,
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who used this image to illustrate the “inter‐institutional” connections that characterize structural racism.