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The biological embedding of structural inequities: new insight from neuroscience

Neuropsychopharmacology volume 49, pages 337–338 (2024)Cite this article

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Neuropsychopharmacology often fails to appropriately consider the impact of race-related structural inequities which perpetuates inequity in mental health research and treatment [1]. Although race is not a biologically meaningful construct, neuroscience studies often include racial categories in analyses without considering potential impacts of racial inequity on mental health. In the United States, structural inequities created and reinforced by structural racism - such as economic hardship, neighborhood disadvantage, and trauma exposure - disproportionately affect Black and Hispanic individuals [2]. Rather than reflective of inherent differences, race-related differences in neurobiology are likely due to biological embedding of structural inequities.

Trauma and stress-related disorders, such as posttraumatic stress disorder, are thought to be driven by dysfunction of core threat neurocircuitry, such as the amygdala, hippocampus, and prefrontal cortex (PFC) [3]. The amygdala is central to learning cue-threat relationships and threat response expression. Emergent work, however, suggests that structural inequities can lead to race-related variability in amygdala and physiological reactivity (e.g., skin conductance responses; SCRs) to threat. Black individuals exhibit lower threat-elicited amygdala reactivity and SCRs to threat compared to White individuals, but this difference is predominately driven by the greater exposure to violence, lower income, and more disadvantaged neighborhoods for Black individuals [4]. Thus, chronic exposure to structural inequities plays a role in shaping the amygdala’s response to threat.

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References

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Funding

This research was supported by the National Institute of Mental Health grants K01MH119603 (NGH) and T32MH017119 (EKW). There are no known direct conflicts related to this manuscript.

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Authors and Affiliations

  1. Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA

    E. Kate Webb & Nathaniel G. Harnett

  2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    E. Kate Webb & Nathaniel G. Harnett

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  1. E. Kate Webb
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  2. Nathaniel G. Harnett
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Drafting of the paper: EKW and NGH. All authors revised the paper critically for important intellectual context and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Nathaniel G. Harnett.

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Webb, E.K., Harnett, N.G. The biological embedding of structural inequities: new insight from neuroscience. Neuropsychopharmacol. 49, 337–338 (2024). https://doi.org/10.1038/s41386-023-01655-8

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