Health Implications of Racism, Sexism, and Social Class: Reflections From Nearly 30 Years Ago

  • Ana V. Diez Roux
    Address correspondence to: Ana V. Diez Roux, MD, PhD, MPH, Dean's Office, Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia PA 19104.
    Dean's Office, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
    Search for articles by this author
      In 1993, when the article “Racism, Sexism and Social Class: Implications for Studies of Health, Disease and Well-Being” by Krieger et al.
      • Krieger N
      • Rowley DL
      • Herman AA
      • Avery B
      • Phillips MT.
      Racism, sexism, and social class: implications for studies of health, disease, and well-being.
      was originally published in the American Journal of Preventive Medicine (AJPM), I was working on my PhD at the Johns Hopkins University School of Hygiene and Public Health and making the case to often incredulous audiences that it was meaningful to examine the contextual impacts of neighborhood disadvantage on health even if individual-level socioeconomic data were available. As was the case with other articles by Krieger on the themes of health inequities and social causation, I could not wait to read it. I would spend hours photocopying articles in the Welch Library, and I am sure I have a copy of this article buried somewhere in my old files (yes, I still have some of them!). Back then, I would highlight in yellow marker what I viewed as the most significant statements. This would have been hard to do in an article so thoughtful and erudite and absolutely packed with observations and ideas.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Krieger N
        • Rowley DL
        • Herman AA
        • Avery B
        • Phillips MT.
        Racism, sexism, and social class: implications for studies of health, disease, and well-being.
        Am J Prev Med. 1993; 9 (suppl): 82-122
        • Ford CL
        • Airhihenbuwa CO
        Critical Race Theory, race equity, and public health: toward antiracism praxis.
        Am J Public Health. 2010; 100: S30-S35
        • Borrell LN
        • Elhawary JR
        • Fuentes-Afflick E
        • et al.
        Race and genetic ancestry in medicine – a time for reckoning with racism.
        N Engl J Med. 2021; 384: 474-480
        • Adkins-Jackson PB
        • Chantarat T
        • Bailey ZD
        • Ponce NA.
        Measuring structural racism: a guide for epidemiologists and other health researchers.
        Am J Epidemiol. 2021; (In press. Online September 25)
        • Bailey ZD
        • Krieger N
        • Agénor M
        • Graves J
        • Linos N
        • Bassett MT.
        Structural racism and health inequities in the USA: evidence and interventions.
        Lancet. 2017; 389: 1453-1463
        • Bowleg L.
        The problem with the phrase women and minorities: intersectionality-an important theoretical framework for public health.
        Am J Public Health. 2012; 102: 1267-1273
        • Bauer GR
        • Churchill SM
        • Mahendran M
        • Walwyn C
        • Lizotte D
        • Villa-Rueda AA.
        Intersectionality in quantitative research: a systematic review of its emergence and applications of theory and methods.
        SSM Popul Health. 2021; 14100798