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24 November 2025

Weathering the STORM and Forecasting Equity for Older Black Women: Expanding Social Determinants of Health

and
1
Department of Psychology, Fordham University, Bronx, NY 10458, USA
2
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work
This article belongs to the Special Issue 3rd Edition: Social Determinants of Health

Abstract

A strong body of evidence indicates that social determinants impact health. While this research has identified a range of risk factors for health, health equity goals require recalibration further “upstream” towards structural drivers of health and aging inequities. Recognizing how systems of power and chronic exposures are embodied and facilitate differential risks and opportunities is important for expanding research at the gender–race–age nexus. Specifically, adopting a structural aging approach can help contextualize health outcomes for older Black women. Drawing from previous research, we explore how structural drivers shape health, examine their impact on Black women’s life experiences, stress exposures, and present a model for interpreting social trajectories of oppression, resistance, and marginalization (i.e., the STORM model) across the lifespan. Extending research on strength, resistance, resilience, and coping may open new opportunities to reframe and understand older Black women’s health. Importantly, developing structural competence can facilitate “seeing structures” and advocating for structural interventions leading to critically minded theory, practice, and policy that properly situate aging processes within broader, intersectional contexts.

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