Analyzing structural racism and its health impacts: it’s about time

Abstract It’s about time. Since 2020, new work on structural racism and health has erupted in the United States, with 93% of the 1655 PubMed articles indexed by “structural racism” as of April 4, 2024 having been published during or since 2020. Among the 310 review articles included, most have focused either on improving conceptual, substantive, and methodologic clarity and precision about measuring and modeling structural racism, or reviewing evidence about its impacts on specific exposures or outcomes. However, only 2.5% of these 1655 articles are also indexed by the term “lifecourse” and its variants, and among the reviews considered here, none explicitly discuss issues involving etiologic period. Informed by ecosocial theory’s temporal theorizing about pathways of embodiment, and also Latin American social medicine-collective health framings of “health-illness-disease processes,” lifecourse models, and the construct of the “cancer control continuum,” in this brief commentary I consider how time matters in relation to concrete examples involving structural racism and cancer, and also inconsistent results reported by several studies using latent measures of structural racism. When it comes to structural racism and health, it truly is about time – and it is time for this work to tackle issues of time.