Structural Violence in Practice: Examining How Harm Is Purveyed to Communities of Color Via Disparities in the Youth Legal and Healthcare Systems

Structural Violence serves as a critical framework in social work research to examine social problems. Referring to the preventable and avoidable harm incurred on individuals and groups by structural and systemic forces, structural violence draws attention to macro-level oppression/advantage and results in more well-rounded analysis. Although closely aligned with ecological theory--a foundational theory in social work training and education--scholarship on structural violence primarily exists in the fields of medicine, public health, medical anthropology, and psychology. The authors argue for greater integration of a structural violence framework into social work scholarship, research, and education. Seven forms of structural violence are proposed as analytical scaffolding for advancing social work research: displacement/housing violence, carceral/police violence, medical/health violence, gender identity violence, age-based violence, ability violence, and immigration violence.

Building from two examples--the disproportionate representation of youth of color in the legal system, and race-based health disparities, coupled with the how the COVID-19 pandemic exacerbated and further highlighted existing inequities in caused by both systems (health and legal)--the authors will highlight the value of such framing for advancing anti-racist and anti-oppressive research.

A structural violence perspective highlights how systemic discrimination, poverty, unstable and unsafe housing, and inadequate access to quality health/mental health care make up some of the inequities that place young people of color at greater risk for legal system involvement. Further, aggressive policing in neighborhoods of color has been associated with over-involvement in the legal system. Strategies including Broken Windows policing and Stop and Frisk in major urban centers have exclusively been enforced on Black and Latinx youth ushering them into the legal system at high numbers. Legal system involvement has been linked to negative outcomes including physical, sexual, and emotional, trauma, and even early death.

Similarly, race-based health inequities in the US are rooted in the White supremacist ideology and structural racism baked in US society and cannot exclusively be attributed to differences in behavior or lifestyle. When compared to White counterparts, people of color: experience higher incidences of preventable chronic illness and rates of premature death; and, reflect poorer health outcomes and higher mortality rates from these preventable conditions. For example, African Americans in the US: experience a rate of infant mortality more than twice that of Whites; experience death rates 15-27% higher than Whites for the diagnoses representing the top three disease-causing deaths; receive poorer quality screenings for disease-prevention; are provided less aggressive treatment for cancer; are 77% more likely than Whites to have a limb amputated for a vascular ailment; and, when presenting with chest pain to emergency departments, are less likely than White patients receive pain medication or appropriate cardiac screening. Prevailing scholarship suggests the need to address the structural root causes producing such systematic harm.

Participants of this roundtable will have the opportunity to overlay a structural violence framework on to their respective areas of interest--in social work research, education, and practice--and workshop how to integrate such an analysis into their work.