The C2DREAM framework: Investigating the structural mechanisms undergirding racial health inequities

Kene Orakwue, Anna K. Hing, Tongtan Chantarat, Derek E Hersch, Ebiere Okah, Michele Allen, Christi A. Patten, Felicity T. Enders, Rachel Hardeman, Sean M. Phelan

Research output: Contribution to journalArticlepeer-review


Racism shapes the distribution of the social determinants of health (SDoH) along racial lines. Racism determines the environments in which people live, the quality of housing, and access to healthcare. Extensive research shows racism in its various forms negatively impacts health status, yet few studies and interventions seriously interrogate the role of racism in impacting health. The C2DREAM framework illuminates how exposure to racism, in multiple forms, connects to cardiovascular disease, hypertension, and obesity. The goal of the C2DREAM framework is to guide researchers to critically think about and measure the role of racism across its many levels of influence to better elucidate the ways it contributes to persistent health inequities. The conceptual framework highlights the interconnectedness between forms of racism, SDoH, and the lifecourse to provide a greater context to individual health outcomes. Utilizing this framework and critically contending with the effects of racism in its multiple and cumulative forms will lead to better research and interventions.

Original languageEnglish (US)
Article numbere80
JournalJournal of Clinical and Translational Science
Issue number1
StatePublished - Apr 16 2024

Bibliographical note

Publisher Copyright:
© The Author(s), 2024. Published by Cambridge University Press on behalf of Association for Clinical and Translational Science.


  • Clinical translational research
  • cardiovascular disease
  • hypertension
  • obesity
  • racism
  • social determinants of health

PubMed: MeSH publication types

  • Journal Article


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