The latest issue of the Revista Española de Salud Pública features an article that provides a diagnosis of how structural racism affects the health of racialized and migrant populations and warns about the lack of institutional and scientific attention this issue receives compared to other social determinants. The article is authored by professionals from the University of La Laguna (Santa Cruz de Tenerife), the University of Alicante, the University of the Basque Country, the Platform for Racial Equity in Health (PERSA), the Catalan Health Institute, and IDIAPJGol.

The study highlights that, although the covid-19 pandemic exposed the impact of racial inequalities on incidence and mortality, Spain remains stagnant in recognizing racism as a public health problem.

A structural problem

The research team points out that racialized people face greater barriers in accessing healthcare services and receive lower-quality care, a situation linked to several structural mechanisms: residential segregation, discriminatory migration policies, unequal school environments, and higher exposure to environmental risks. These circumstances result in higher rates of illness, poorer mental health, and an increased risk of premature death.

According to the authors, the invisibility of this phenomenon occurs when inequalities derived from racism are attributed solely to cultural or socioeconomic factors, instead of acknowledging their structural origins, which prevents the identification of the true underlying causes of inequality.

Roadmap

In this context, the authors propose a roadmap with urgent measures to reverse the invisibilization of racism in health in Spain, including:

• Recognizing race as a valid analytical category, distinct from ethnicity.
• Addressing structural and institutional racism as a fundamental cause of health inequalities.
• Improving data collection and its disaggregation by race to measure inequalities reliably.
• Ensuring the active participation of racialized people in the design and evaluation of public policies.

Towards an antiracist public health approach

The article emphasizes that integrating racism as a social determinant of health is essential to ensure equity.

Constanza Jacques Aviñó, researcher at the Transversal Research Unit of IDIAPJGol and author of the article, calls on institutions, public bodies, and professionals to recognize “the structural origins of racism and to take its impact on health into account in health and research planning, with the aim of reducing inequalities and improving the health of the entire population.”

Article reference

Bee Nchama M, Manzano J, Pajunen MG, Zhang Yim JI, González-Rábago Y, Jacques-Aviñó C, La Parra-Casado D. Racismo: el determinante social de la salud invisibilizado en España [Racism: the invisible social determinant of health in Spain]. Rev Esp Salud Publica. 2025 Nov 3;99:e202511071. Spanish. PMID: 41200953.