Cross-disciplinary rapid scoping review of structural racial and caste discrimination associated with population health disparities in the 21 <sup>st</sup> Century
Bibliographic record
Abstract
ABSTRACT A cross-disciplinary rapid scoping review was carried out generally following PRIMA-SCR protocol to examine historical racial and caste-based discrimination as structural determinants of health disparities in the 21 st century. We selected 48 peer-reviewed full-text articles available from the University of Memphis Libraries database search, focusing on three selected case-study countries-the United States (US), Canada and Nepal. Authors read each article, extracted highlights and tabulated the thematic contents on structural health disparities attributed to racism or casteism. Results linked the historical racism/casteism to health disparities occurring in Blacks and African Americans, Native Americans and other ethnic groups in the US, in Indigenous peoples and other visible minorities in Canada, and in Dalits of Nepal, a population racialized by caste, grounded on at least four foundational theories explaining structural determinants of health disparities. The evidence from the literature indicates that genetic variations and biological differences (e.g., disease occurrence) occur within and between races/castes for various reasons (e.g., random gene mutations, geographic isolation, and endogamy). However, historical races/castes as socio-cultural constructs have no inherently exclusive basis of biological differences. Disregarding genetic discrimination based on pseudo-scientific theories, genetic testing is a valuable scientific means to achieve better health of the populations. Epigenetic changes (e.g., weathering – early aging of racialized women) due to DNA methylation of genes among racialized populations are markers of intergenerational trauma due to racial/caste discrimination. Likewise, chronic stresses resulting from intergenerational racial/caste discrimination cause ‘allostatic load,’ characterized by an imbalance of neuronal and hormonal dysfunction, leading to occurrences of chronic diseases (e.g., hypertension, diabetes, mental health) at disproportionate rates among racialized populations. Major areas identified for reparative policy changes and interventions for eliminating health impacts of racism/casteism include health disparity research, organizational structures, programs and processes, racial justice in population health, cultural trauma, equitable healthcare system, and genetic discrimination. Highlights Research on the relationship between structural racism and population-level health outcomes and on the health impacts of policy changes and interventions has largely overlooked caste, which is a system of racialization that pre-dates US racial categories. A cross-disciplinary global ‘caste’ approach is adopted to examine various forms of historical decent-based racial and caste discrimination in three case-study countries. Major theories and praxis explaining research and experiences of structural racial and caste discrimination impacting health disparities are consolidated to synthesize a unified body of knowledge for the 21 st century. While genetic variations occur naturally, they do not inherently contribute to the social constructs of race or caste. Reparative policy changes and interventions are necessary to eliminate deeply entrenched structural health disparities rooted in racism and casteism.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.035 | 0.125 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.035 | 0.029 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.015 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".