Figure 1-2: Williams, Lavizzo-Mourey, and Warren's framework for under

Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement

The first column of the framework consists of three boxes with the following captions and text:

• Racism (racial ideology, prejudice, or discrimination).
• Macrosocial factors (historical conditions, economic structures, political order, legal codes, and social cultural institutions).
• Geographic origins & biological factors (morphological, physiological, biochemical, or genetic).

Arrows point from each of these boxes to the ones below and above it; an arrow "tree" also points from these three boxes to the two boxes in the second column of the framework:

• Social statuses (race or ethnicity, socioeconomic status, sex, social roles, geographic location, age).
• Risk factors & resources (health behaviors, stress, medical care, social ties, psychological, cultural, or religious factors).

An arrow points down from Social statuses to Risk factors & resources; an arrow "tree" also points from both these boxes to the single box in the third column of the framework:

• Biological & psychological mechanisms.

Arrows from Racism and Geographic origins & biological factors also point to Biological & psychological mechanisms.

An arrow points from Biological & psychological mechanisms to the box in the final column of the framework:

• Health status.

Source: Adapted, with permission, from Public Health Reports 2009. Copyright 1994 Public Health Reports.

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