Structural Discrimination is the power used by dominant groups to organize systems that provide life sustaining resources in a manner that prioritizes their needs, protects their rights, values their beliefs, helps them thrive and prosper, and sustains their power. One form of structural discrimination is structural racism, which has been used to organize systems in a way that limits racial and ethnic minority individuals’ access to life sustaining resources, resulting in health inequities. Policy and law (political process, statutes, regulations, policies, guidance, advisory opinions, cases, budgetary decisions, as well as the process of or failure to enforce the law) are some of the tools used to create these differ­ential conditions by structuring systems in a racially discriminatory way.

For example, structural racism in employment facilitated by laws and policies has not only relegated many racial and ethnic minority individuals to low-wage jobs, but it has also allowed employers to pay racial and ethnic minority individuals less for doing the same work as white individuals. Research has shown these practices are associated with health inequities experienced by racial and ethnic minority individuals. To address these racism health inequities, the government (federal and state) should adopt the health justice framework, which provides a systems-level approach to reform that is guided by three principles: 1) truth and reconciliation; 2) engagement and empowerment of racial and ethnic minority individuals; and 3) structural remediation and financial supports.