Structural and health system determinants of health outcomes in systemic lupus erythematosus: Understanding the mechanisms underlying health disparities

• DOI: 10.3389/fpubh.2022.980731
• Publication Date: 2022-09-30T13:57:36Z
• Authors: Jerik Leung; Lily McMorrow; Rhonda BeLue; Elizabeth A. Baker
• Keywords: Race and health; Subordination

Chronic diseases are increasingly responsible for the burden of health outcomes across world. However, there is also increasing recognition that patterns chronic disease (e.g., mortality, quality life, etc.) have inequities race, gender, and socioeconomic groups cannot be solely attributed to these determinants. There a need an organizing framework which centers fundamental causes disparities may better guide future work in centering mechanisms moving beyond acknowledgment disparities. In this paper, we synthesize several concepts from literature into conceptual understanding interplay patients' lived experiences, care system structural Our suggests (1) factors influence system, patient, provider, provider-patient relationship through process subordination (2) structurally competent actions critical reducing inequities. The addition theoretical frameworks involving equity social determinants health, along with engagement competency suggest systems level changes improve outcomes.