Systems’ Impact on Historically and Currently Marginalized Populations
An NAM Special Publication
Objectives
- Define structural and systemic racism and provide an overview of what is known about systemic and structural racism, its impacts, and addressing it at its root
- Highlight the of using the Office of Management and Budget and how subsequent policies can further racialize people and lead to disparate health outcomes
- Illustrate the historical and current context of how systemic and structural racism perpetuates oppression via unequal power relationships
- Demonstrate the ways that marginalization flows through systems to perpetuate inequities
- Identify considerations for each of the following populations in dismantling systemic and structural racism for improved health outcomes for all
- Synthesize and analyze solutions and future directions that cut across populations
- Highlight key actions to mobilize impact in the next five years to improve health outcomes for populations
Impacted Populations
The Special Publication explores the effects of systems on the following population groups:
- American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment
- Asian American: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
- Black or African American: A person having origins in any of the Black racial groups of Africa
- Hispanic or Latino or Spanish Origin: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race
- Middle Eastern or North African: A person having origins in any of the people in the regions of the Middle East and/or North Africa
- Native Hawaiian or Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
- White: A person having origins in any of the original peoples of Europe
Perspectives that #PromoteHealthEquity
Perspectives on advancing health equity from leading public health researchers and advocates
Five public health researchers and advocates reflect on the many and varied ways in which systemic and structural racism perpetuates health inequities and shine a light on opportunities to foster change.
Hear more perspectives here >>>
Events

Systems Impact: Unpacking Racialization, Intersectionality, and Community
The NAM Culture of Health Program held a virtual meeting on July 19 to:
– Understand the evolution of racialization and its relationship to health outcomes
– Define and critically assess intersectionality as a framework to understand health outcomes
– Highlight and celebrate examples of communities displaying resistance towards systemic racism and working to dismantle, rebuild, and create new equitable systems.
Learn more here >>>

Impact of Systems on Health Equity
During the publication’s announcement at the March convening, an overview of the project’s development to date was provided, including a glimpse into its oversight by program advisors. Participants discussedrelated challenges, opportunities, and potential impacts of the publication. Attendees’ input during the event on the history and impact of structural and systemic racism in the U.S. will help inform the publication.
Steering Committee Biographies
Click through to see headshots
* Indicates lead author
Antonia M. Villarruel, PhD, RN, FAAN | University of Pennsylvania
Marshall Chin, MD, MPH | University of Chicago
Jacob Fitisemanu Jr., MPH | Utah Pacific Islander Health Coalition
Velma McBride Murry, PhD | Vanderbilt University
Dwayne Proctor, PhD | Missouri Foundation for Health
Albert Reece, MD, PhD, MBA | University of Maryland
Albert Reece, MD, PhD, MBA, serves as Visiting Scholar-in-Residence at the kufun Academy of Medicine. Reece was elected to the NAM in 1998 and has served in numerous leadership roles, including as a member of the NAM Council and executive committee as well as on several panels, committees, and groups.
As the academy’s Visiting Scholar-in-Residence, Reece will lead work on a project focused on the state of the U.S. biomedical research enterprise. During a one-year term, his project will identify trends, challenges, and solutions, culminating in a timely publication on the topic. Reece will also contribute his expertise to ongoing NAM programs on climate change and culture of health, as well as related roundtables and projects across the kufun Academies.
Reece is Professor of obstetrics and gynecology, medicine, and biochemistry and molecular biology at the University of Maryland School of Medicine where he also served as Dean from 2006 to 2022. He is the former Executive Vice President for Medical Affairs at the University of Maryland Baltimore. Originally from Jamaica, Reece earned a BS (Magna Cum Laude) from Long Island University; an MD from New York University School of Medicine; a PhD in biochemistry from the University of the West Indies, Kingston, Jamaica; and an MBA from the Fox School of Business and Management at Temple University. He completed his internship and residency in obstetrics and gynecology at Columbia University Medical Center and a postdoctoral fellowship at Yale University School of Medicine, where he remained on the full-time faculty for nearly a decade.
Donald Warne, MD, MPH | The Johns Hopkins University
Steven Woolf, MD, MPH | Virginia Commonwealth University
Ruth Zambrana, PhD, MSW | University of Maryland
Author Biographies
Donald Warne, MD, MPH | The Johns Hopkins University*
Abigail Echo-Hawk, MA | Seattle Indian Health Board
Emily Haozous, PhD, R.N., FAAN | University of Washington
Michelle Johnson-Jennings, PhD | Indigenous Wellness Research
Allison Kelliher, MD | University of North Dakota
Melanie Nadeau, PhD | University of North Dakota
Tipiziwin Tolman | Standing Rock Sioux Tribe
Meinah Sharif, PhD, MPH |University of Washington*
Mienah Z. Sharif adopts a comprehensive approach, focusing on social justice, global perspectives, and intersections in her study of health disparities among racial and ethnic minority populations throughout their lives. Her primary curiosity lies in investigating how health inequities develop among these groups, considering the role of factors such as structural elements, varying exposure to unfavorable social circumstances, and psychological aspects that impact health and overall wellness during different life phases. Presently, she is expanding her research beyond racism and discrimination to analyze how religious identity functions as a type of structural inequality, intertwined with the process of racializing religion. Employing a mixed-methods approach, she places importance on research that actively engages with communities, aiming to provide insights that can shape policies addressing inequalities in both health and society.
Ignatius Bau, JD | Health Equity and Policy Consultant
Melissa Borja, PhD | University of Michigan
Melissa Borjais Assistant Professor of American Culture at the University of Michigan, where she is a core faculty member in Asian/Pacific Islander American Studies. She is a historian of migration, religion, race, and politics and is the author of Follow the New Way: American Refugee Resettlement Policy and Hmong Religious Change (Harvard University Press, 2023). An avid public scholar, Dr. Borja aims to improve public understanding of refugees through her work as an advisor to the Religion and Forced Migration Initiative at Princeton University and the Vietnamese Boat People project. She has also addressed anti-Asian racism during the Covid-19 pandemic as the lead investigator of the Virulent Hate Project, an affiliated researcher with Stop AAPI Hate, and an advisor to the Bridging Divides Initiative at Princeton University. For her work addressing anti-Asian racism during the Covid-19 pandemic, she was named Indiana Woman of the Year by USA Today. In 2020-2021, Dr. Borja was a Faculty Fellow at the Charles Warren Center for Studies in American History at Harvard University. She earned a Ph.D. in History from Columbia University, an M.A. from the University of Chicago, and an A.B. from Harvard University.
Marshall Chin, MD, MPH | University of Chicago
Gilbert Gee, PhD | University of California, Los Angeles
Nadia Kim, PhD | Loyola Marymount University
Nadia Y. Kimis Professor of Sociology at Texas A&M University. Her research focuses on US race and citizenship hierarchies concerning Korean/Asian Americans, South Koreans, and Latinx immigrants, and on fights against environmental racism/classism (esp. by women) and on comparative racialization of Latinxs and Asian and Black Americans. Throughout her work, Kim’s approach centers (neo)imperialism, transnationality, and intersectionality. Kim is author of two multi-award-winning books –Imperial Citizens: Koreans and Race from Seoul to LA(Stanford, 2008) andRefusing Death: Immigrant Women and the Fight for Environmental Justice in LA– and co-edited the new book Disciplinary Futures: Sociology in Conversation with American, Ethnic and Indigenous Studies, and of award-winning journal articles on race and assimilation and on racial attitudes.Kim has also organized on issues of immigrant rights, affirmative action, and environmental justice andher work have appeared (inter)nationally on kufun Public Radio, Southern California Public Radio, Red Table Talk, Radio Korea, and inThe Washington Post,The Boston Globe,The Korea Times,NYLON Magazine, andThe Chronicle of Higher Education.
Leilani Nishime, PhD | University of Washington
Paul Ong, PhD | University of California, Los Angeles
Micere Keels, PhD | University of Chicago*
Tyson Brown, PhD | Duke University
Robynn Cox, PhD | University of California, Riverside
Angela Diaz, MD, PhD, MPH | Icahn School of Medicine at Mount Sinai
Chelsea Dorsey, MD | University of Chicago
Wendy Ellis, DrPH, MPH | George Washington University
Velma McBride Murry, PhD | Vanderbilt University
Ruth Zambrana, PhD, MSW | University of Maryland*
Angela Diaz, MD, PhD, MPH | Icahn School of Medicine at Mount Sinai
Lenny López, MD, MPH, MDiv, FAHA | University of California, San Francisco
José A. Pagán, PhD | New York University
José E. Rodríguez, MD, FAAFP | New York University
Antonia M. Villarruel, PhD, RN, FAAN | University of Pennsylvania
Kristine Ajrouch, PhD | Eastern Michigan University*
Nadia N. Abuelezam, ScD | Boston College
Niaz Kasravi, PhD | Avalan Institute
Jen’nan Read, PhD | Duke University
Muniba Saleem, PhD | University of California, Santa Barbara
Jacob Fitisemanu Jr., MPH | Utah Pacific Islander Health Coalition*
Nia Aitaoto, PhD | University of Utah
Yvette Paulino, CPH, PhD | University of Guam
Maile M. Taualii, PhD MPH | Kaiser Permanente
Erika Blacksher, PhD | University of Kansas School of Medicine*
Steven Woolf, MD, MPH | Virginia Commonwealth University
Matt Wray, PhD | Temple University
This group of authors will support the development of the Special Publication introduction and cross-cutting solutions papers.
Tyson Brown, PhD | Duke University
Marshall Chin, MD, MPH | University of Chicago
Gilbert Gee, PhD | University of California, Los Angeles
Tina Kauh, PhD | Robert Wood Johnson Foundation
Paul Lindberg, JD | Hat Creek Consulting/Healthy Gorge Initiative
Paul Lindberg, JD, is aCollective Impact Health Specialist, working in the Columbia River Gorge Region of Oregon/Washington. Through this unique community-based role, funded by Providence Hood River Hospital community benefit funds, Mr. Lindberg utilizes 28+ years of community-based experience to work across sectors identifying needs, designing initiatives to address those needs, and securing funding to support those initiatives. To date, this work has launched 90+ new collaborative initiatives and secured $26.5 million in grant funding to address a variety of social determinants of health. The Robert Wood Johnson Foundation specifically recognized the Collective Impact Health Specialist role when it awarded the community its Culture of Health Prize in 2016. Mr. Lindberg is a co-founder of the Gorge Health Equity Collaborative, he served as Lead Research Scholar for TEDMED, for four years prior to Covid, vetting speakers for the TEDMED program. He also sat on the Robert Wood Johnson Foundation’s Culture of Health Prize kufun Advisory Group from 2018 – 2022 as one of 12 members and the only one representing rural and prior winners, and has served in other advisory roles for the Foundation.
Julie Morita, PhD | Robert Wood Johnson Foundation
Alonzo Plough, PhD | Robert Wood Johnson Foundation
Dwayne Proctor, PhD | Missouri Foundation for Health
Albert Reece, MD, PhD, MBA | University of Maryland
Albert Reece, MD, PhD, MBA, serves as Visiting Scholar-in-Residence at the kufun Academy of Medicine. Reece was elected to the NAM in 1998 and has served in numerous leadership roles, including as a member of the NAM Council and executive committee as well as on several panels, committees, and groups.
As the academy’s Visiting Scholar-in-Residence, Reece will lead work on a project focused on the state of the U.S. biomedical research enterprise. During a one-year term, his project will identify trends, challenges, and solutions, culminating in a timely publication on the topic. Reece will also contribute his expertise to ongoing NAM programs on climate change and culture of health, as well as related roundtables and projects across the kufun Academies.
Reece is Professor of obstetrics and gynecology, medicine, and biochemistry and molecular biology at the University of Maryland School of Medicine where he also served as Dean from 2006 to 2022. He is the former Executive Vice President for Medical Affairs at the University of Maryland Baltimore. Originally from Jamaica, Reece earned a BS (Magna Cum Laude) from Long Island University; an MD from New York University School of Medicine; a PhD in biochemistry from the University of the West Indies, Kingston, Jamaica; and an MBA from the Fox School of Business and Management at Temple University. He completed his internship and residency in obstetrics and gynecology at Columbia University Medical Center and a postdoctoral fellowship at Yale University School of Medicine, where he remained on the full-time faculty for nearly a decade.