Journal of Community & Public Health Nursing
Open Access

Structural racism, embedded within societal systems, policies, and institutions, continues to perpetuate inequities in health outcomes across racial and ethnic groups. In nursing and healthcare, its influence extends beyond individual prejudice, shaping access to care, distribution of resources, workforce representation, and patient experiences. Structural racism manifests through discriminatory hiring practices, unequal educational opportunities, underrepresentation of minority nurses in leadership, and the persistence of health disparities among marginalized communities. Addressing this issue is critical not only to uphold the ethical foundations of nursing—justice, equity, and compassion—but also to advance public health goals that promote well-being for all. By uncovering inequities and challenging systemic barriers, nurses can play a pivotal role in advancing health justice within their practice, organizations, and communities.

Discussion

The impact of structural racism in nursing is evident in multiple dimensions of healthcare. Patients from marginalized backgrounds often experience limited access to quality care, disproportionate disease burdens, and poorer health outcomes. For example, Black and Indigenous communities face higher rates of maternal mortality, chronic illnesses, and reduced life expectancy, outcomes closely tied to social and structural inequities rather than biological differences. Nurses, positioned on the frontlines of care, witness these disparities firsthand and are uniquely situated to advocate for change.

Within the nursing profession itself, structural racism can limit opportunities for advancement. Minority nurses frequently encounter barriers such as fewer mentorship opportunities, bias in hiring and promotion, and exclusion from leadership roles. This lack of diversity in leadership perpetuates inequitable decision-making and limits the ability of healthcare systems to reflect and serve diverse populations effectively. Efforts to dismantle these barriers are essential to creating inclusive workplaces that value and amplify the voices of all nurses.

Community and public health nursing further highlight the urgency of addressing structural racism. Nurses often serve populations disproportionately affected by poverty, housing instability, and lack of access to preventive care—issues deeply rooted in systemic inequities. By incorporating cultural humility, advocacy, and awareness of social determinants of health, nurses can design interventions that directly address structural barriers rather than solely focusing on individual behaviors.

Advancing health justice requires a multifaceted approach. Nurses must engage in self-reflection and education about implicit bias, advocate for anti-racist policies in healthcare institutions, and support efforts to diversify the nursing workforce. Collaborating with communities to co-create health programs ensures that interventions align with lived experiences and address systemic barriers effectively.

Conclusion

Structural racism is deeply embedded in healthcare systems and the nursing profession, but it is not immutable. Through awareness, education, advocacy, and intentional reform, nurses can be at the forefront of creating equitable and just systems. As trusted professionals who serve diverse communities, nurses have both the power and responsibility to challenge injustice—within institutions, clinical practice, education, and policy. The future of nursing must not only be about healing individuals but also about transforming systems that impact health.

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