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Whiteness

A Fundamental Determinant of the Health of Rural White Americans

Bibliographic Data

ID11035845
AuthorsCaroline R Efird (0000-0001-7258-463X, Caroline R. Efird is with the Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC. Derek M. Griffith is with the Department of Family and Community Health, School of Nursing, and Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Both authors were affiliated with the Racial Justice Institute and Center for Men’s Health Equity at Georgetown University during the initial development of this essa), Derek M Griffith (0000-0003-0018-9176, Caroline R. Efird is with the Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC. Derek M. Griffith is with the Department of Family and Community Health, School of Nursing, and Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Both authors were affiliated with the Racial Justice Institute and Center for Men’s Health Equity at Georgetown University during the initial development of this essa)
Year2025
Volume115
Issue2
Pages152-160
Publication date2025-02-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2024.307904
PMID39637331
OpenAlexW4405050233
LanguageEN
Citations received1
References cited59

Because residents of rural areas in the United States experience a persistent disadvantage in life expectancy relative to their urban counterparts, it is critical to consider the structural and social determinants that affect the health of rural populations. White Americans constitute 3 out of every 4 (76%) rural residents, and there is growing evidence that rurality is a predictor of poor health status for White Americans in ways that are not present for racially minoritized populations or nonrural White populations. We offer a framework to describe Whiteness as a fundamental determinant of the health of rural White Americans, which is useful to more precisely characterize and address the heterogeneous yet unique factors that drive their health. While Whiteness is a dynamic system that typically upholds White Americans’ social supremacy, we provide examples of intermediate (e.g., rural culture, environment) and intrapersonal (e.g., psychosocial) factors through which Whiteness can harm rural White Americans’ health (e.g., chronic disease, mental health). We conclude with a discussion of implications and recommendations that may help to advance research to promote health and well-being among rural White Americans. ( Am J Public Health. 2025;115(2):152–160. https://doi.org/10.2105/AJPH.2024.307904 )

Disadvantage · Environmental health · Harm · Health equity · Life expectancy · Mental health · Political science · Population · Psychiatry · Psychosocial · Public health · Racism · Rural area · Rural health · Rurality · Sociology · White (mutation) · Gender Studies · Global Health Workforce Issues · Health disparities and outcomes · Medicine · Psychology · Racial and Ethnic Identity Research · Social Psychology · Gerontology

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Unique citing works1
Citations per year1
Citation span2026 - 2026 (1)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 1

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