Race and class in big data

Main Article Content

Logan Harper
Daniel A Culver
Yvette C Cozier


Health disparities, Sarcoidosis, Racism


Social determinants of health are well-established drivers of health outcomes across a range of pulmonary diseases, from asthma to COPD to sarcoidosis. Developing interventions to address health disparities in pulmonary disease has been complicated by the wide-reaching and varied effects of structural racism and classism. In this issue of Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, Cherabuddi and colleagues present data on the effect of a range of socio-economic factors impacting access to care in sarcoidosis. This work investigates a range of potential drivers of disparity, providing valuable information regarding potential interventional targets.


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1. Perez MF, Coutinho MT. An Overview of Health Disparities in Asthma. Yale J Biol Med 2021;94(3):497–507.
2. Kuhn BT, Wick KD, Schivo M. An Update in Health Disparities in COPD in the USA. Curr Pulmonol Rep 2021;10(1):14–21.
3. Sharp M, Eakin MN, Drent M. Socioeconomic determinants and disparities in sarcoidosis. Curr Opin Pulm Med 2020;26(5):568–573.
4. Harper LJ, Gerke AK, Wang X-F, et al. Income and Other Contributors to Poor Outcomes in U.S. Patients with Sarcoidosis. Am J Respir Crit Care Med 2020;201(8):955–964.
5. Harper LJ, Kidambi P, Kirincich JM, Thornton JD, Khatri SB, Culver DA. Health Disparities: Interventions for Pulmonary Disease – A Narrative Review. CHEST 2023;164(1):179–189.
6. Cherabuddi M, Goodman B, Ayyad A, et al. Association of Area Deprivation Index with Adherence to Proposed Regimen in Patients with Sarcoidosis in Detroit, Michigan. Sarcoidosis Vasc Diffuse Lung Dis 2024;41(2):e2024031.
7. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. The Lancet 2017;389(10077):1453–1463.
8. Jones CP. Levels of racism: a theoretic framework and a gardener’s tale. Am J Public Health 2000;90(8):1212–1215.
9. Niebur H, Rookwood A, Karki B, Abresch C. Toward a new model of childhood asthma care: community needs assessment in an underserved urban population. J Asthma 2023;60(11):2064–2073.
10. Bailey Zinzi D., Feldman Justin M., Bassett Mary T. How Structural Racism Works — Racist Policies as a Root Cause of U.S. Racial Health Inequities. N Engl J Med 2021;384(8):768–773.
11. Williams DR, Lawrence JA, Davis BA. Racism and Health: Evidence and Needed Research. 2019;
12. Types of Racism: Internal, Interpersonal, Institutional, and Structural [Internet]. YWCA Seattle King Snohomish. [cited 2024 May 14];Available from: https://www.ywcaworks.org/blogs/ywca/types-racism
13. Meidert U, Dönnges G, Bucher T, Wieber F, Gerber-Grote A. Unconscious Bias among Health Professionals: A Scoping Review. Int J Environ Res Public Health 2023;20(16):6569.
14. FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics 2017;18(1):19.
15. Greenwald AG, McGhee DE, Schwartz JL. Measuring individual differences in implicit cognition: the implicit association test. J Pers Soc Psychol 1998;74(6):1464–1480.
16. Cooper JN, Newton ACI, Klein M, Jolly S. A Call for Culturally Responsive Transformational Leadership in College Sport: An Anti-ism Approach for Achieving Equity and Inclusion. Front Sociol [Internet] 2020 [cited 2024 Jun 23];5. Available from: https://www.frontiersin.org/articles/10.3389/fsoc.2020.00065
17. Brown CE, Marshall AR, Snyder CR, et al. Perspectives About Racism and Patient-Clinician Communication Among Black Adults With Serious Illness. JAMA Netw Open 2023;6(7):e2321746.
18. Lee K, Pellowski JA, Brayboy LM, Thompson KD, Dunsiger S. The Association of Racism and Discrimination in Disparities of Hypertensive Disorders of Pregnancy in the United States: An Analysis of PRAMS Data. Matern Child Health J 2024;28(5):969–978.
19. Ruiz-Narváez EA, Cozier Y, Zirpoli G, Rosenberg L, Palmer JR. Perceived Experiences of racism in Relation to Genome-Wide DNA Methylation and Epigenetic Aging in the Black Women’s Health Study. J Racial Ethn Health Disparities 2024;
20. Zestcott CA, Blair IV, Stone J. Examining the Presence, Consequences, and Reduction of Implicit Bias in Health Care: A Narrative Review. Group Process Intergroup Relat GPIR 2016;19(4):528–542.
21. Sheehy S, Aparicio HJ, Palmer JR, et al. Perceived Interpersonal Racism and Incident Stroke Among US Black Women. JAMA Netw Open 2023;6(11):e2343203.
22. Snyder JE, Upton RD, Hassett TC, Lee H, Nouri Z, Dill M. Black Representation in the Primary Care Physician Workforce and Its Association With Population Life Expectancy and Mortality Rates in the US. JAMA Netw Open 2023;6(4):e236687.
23. Understanding Stereotype Threat - CATL Instructor’s Guide to Inclusive Excellence [Internet]. UW- Crosse. [cited 2024 Jun 23];Available from: https://www.uwlax.edu/catl/guides/ie/the-context-of-inequality/stereotype-threat/
24. Spencer SJ, Steele CM, Quinn DM. Stereotype threat and women’s math performance. J Exp Soc Psychol 1999;35(1):4–28.
25. Assari S. General Self-Efficacy and Mortality in the USA; Racial Differences. J Racial Ethn Health Disparities 2017;4(4):746–757.
26. Wiltshire J, Cronin K, Sarto GE, Brown R. Self-advocacy during the medical encounter: use of health information and racial/ethnic differences. Med Care 2006;44(2):100–109.
27. Crenshaw K. Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics. Univ Chic Leg Forum 1989(1):Article 8.
28. Yudell M, Roberts D, DeSalle R, Tishkoff S. Science and society: Taking race out of human genetics [Internet]. 2016;Available from: http://science.sciencemag.org/
29. 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(5):474–480.
30. James A, Coyne-Beasley T, Cunningham S, et al. Building Community Engagement Capacity in a Transdisciplinary Population Health Research Consortium. 2024;16(2):Article 10.
31. Bullen J, Hill-Wall T, Anderson K, et al. From Deficit to Strength-Based Aboriginal Health Research—Moving toward Flourishing. Int J Environ Res Public Health 2023;20(7):5395.