Racial and ethnic health inequities are an ongoing problem in the United States, with racially and ethnically minoritized populations experiencing higher rates of infectious diseases, chronic illnesses, infant and maternal mortality, and premature death compared to their White counterparts. Researchers have identified racism as a root cause of racial and ethnic health inequities.

Racism operates at the interpersonal, cultural, and structural levels, marginalizing or excluding minoritized racial and ethnic groups from the social, economic, and political resources and opportunities that represent important social determinants of health—and exposing these groups to higher levels of social, economic, environmental, and psychosocial harms throughout the life course. Earlier research has primarily focused on the interpersonal dimension of racism, but in recent years, public health researchers have increasingly explored the impact of structural racism on population health outcomes—which W.E.B. DuBois examined more than a century ago in his groundbreaking study of the interplay between social, economic, and environmental conditions and the health of Black Philadelphians.

U.S. state laws have constituted and continue to form a significant component of structural racism, including historical and contemporary discriminatory banking laws and mortgage lending policies, criminal justice laws and practices, abortion coverage laws, Medicaid expansion legislation, voting rights laws, and state mandates in public education. Many of these laws explicitly or implicitly disadvantage, exclude, or exploit Black, Native American, and Hispanic people, resulting in unequal access to socioeconomic resources and opportunities as well as to essential social services and high-quality healthcare. However, there has been relatively little research investigating how these laws specifically influence the health of marginalized racial and ethnic groups and their effects on racial and ethnic health inequities.

As part of her ongoing work on the impact of health and social policies on health inequities, Dr. Madina Agénor, social epidemiologist and Assistant Professor of Behavioral and Social Sciences at Brown University School of Public Health, along with a team of public health researchers and legal scholars, has developed a first-of-its-kind database of structural racism-related state laws to advance health equity research and practice in the U.S. Through the use of primary and secondary sources, the team identified state laws related to structural racism, developed a coding scheme for critical features and categories of each law, and systematically applied this coding scheme to laws in all 50 states and the District of Columbia. Their work ultimately identified 843 contemporary U.S. state laws explicitly or implicitly linked to structural racism. Learn more about the team's methods and results here. 

“Our goal with this database is to facilitate public health research and practice that foregrounds what critical legal and race scholars have shown through their scholarship and activism for centuries: that the laws that shape the structural conditions of Black and other racially and ethnically marginalized groups’ lives harm their health,” says Professor Agénor. “Through our work, we hope to contribute to public health interventions that address how the legal and social context in which racially and ethnically minoritized people live shapes their health outcomes, behaviors, and services use and, in turn, help advance population health equity in the long term.”

Funded by a Harvard Catalyst grant awarded to Dr. S. Bryn Austin at Harvard Medical School and Boston Children‘s Hospital, this database equips public health researchers, social scientists, policy makers, and advocates with comprehensive, detailed data on structural racism-related state laws and provides essential evidence with which to assess states’ racial equity climates and evaluate and address their effect on racial and ethnic health inequities in the U.S.