While we often think of health as something that happens in the realm of health care, a holistic and research-based perspective points to health being a multifaceted state of being that is influenced by multiple interdependent factors. As noted by the World Health Organization, health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. This definition acknowledges the profound impact that our environments and social contexts have on our individual and community health. This understanding is captured in the concept of the social determinants of health, which are the non-medical factors that shape our health, and include the following categories:

Economic Stability: Such as income, employment, poverty, food insecurity 

Healthcare Access and Quality: Such as health insurance coverage, access to healthcare services, and information

Neighborhood and Built Environment: For example, access to and quality of housing, access to nature, transportation 

Policy and Law: For example, the laws and regulations related to health, social welfare, and education, as well as local and institutional policies

Education: Such as access to quality education, literacy levels 

Social and Community Context: Such as social support, neighborhood safety, community cohesion, and community levels of trust

The social determinants of health and public health’s holistic understanding of health acknowledge that humans are not merely biological creatures; we are social and spiritual beings as well. Every aspect of our lives interacts to affect our health, mental and physical. Health equity, then, is about fairness in terms of access to and distribution of resources, opportunities, and outcomes, no matter what one’s social, racial, economic, or geographic location. If you look at any health statistic in the United States, it is evident that health access and outcomes are not distributed fairly, but rather are predictably distributed according to social, economic, and geographic factors. Most notably, race is a persistent predictor of health outcomes regardless of socio-economic status, geography, or educational level. Needless to say, in the United States, we are living in a state of deep health inequity. 

Knowing that our environments and context have such a significant impact on our health, one variable that we don’t sufficiently discuss when talking about health equity is the role of the workplace and workplace culture. To start with, the average American spends approximately one-third of their life at work. That alone should draw our attention to our workplace conditions

and cultures and their impact on our individual and community health. 

Additionally, in the U.S., health care is extremely costly and fragmented, and for most people, requires health insurance. Because health insurance is primarily accessed through employment, health care access is significantly tied to the workplace. So the workplace affects our health both through health care access and the social determinants of health.

Our workplaces are microcosms of our broader society.

Our workplaces are shaped by the same social, political, philosophical, and religious beliefs that shape our broader society. Given the vast and persistent health disparities in this country, we should not be surprised that our workplaces are sites of deep inequities as well. In my book, What Your Comfort Costs Us: How Women of Color Reimagine Leadership to Transform Workplace Culture, I share stories of women of color leaders (including my own) to illustrate and bring to life the ways that current workplace culture is harmful to all of us, and particularly to those of us working to shift workplace culture to be more equitable and humane. In workplaces, we see the same inequities and disparities that we find in broader society play out in terms of pay inequity, unequal advancement opportunities, as well as the impact of work on our overall health and well-being. Additionally, in too many workplaces, there is the expectation that women of color take on cultural work and mentoring, or emotional labor work, without compensation or recognition. Specifically, some of the ways that workplaces affect our health and wellbeing and lead to health inequity include:

Chronic Stress and Physiological Wear. Unhealthy workplaces — marked by racism, sexism, microaggressions, lack of psychological safety, and inequitable power structures — produce sustained stress responses. For women of color, who often navigate both gendered and racialized stressors, this chronic exposure can lead to elevated cortisol and inflammatory responses and cumulative physiological wear from chronic stress. These, in turn, can lead to increased risk of hypertension, heart disease, and autoimmune diseases. In my research into women of color leaders, this means that even when women of color “achieve” professionally, they may be carrying disproportionate physical health burdens from simply existing in inequitable systems.

Mental Health Impacts. During my interviews with women of color leaders, it became apparent that too many of us are working in toxic or exclusionary environments. Additionally, due to barriers to leadership opportunities for people of color in general, women of color often shared stories of isolation and burnout from being “the only” or the first at a workplace, or from feeling the pressure to keep silent to avoid being labeled “angry” or “difficult.” These workplace conditions, interwoven with the broader inequitable conditions in our society, can lead to increased rates of depression and anxiety disorders. Workers of color also experience heightened racial battle fatigue, a term describing the psychological and physiological strain of

navigating constant discrimination and microaggressions. These impacts compound over time and are often unacknowledged or dismissed in traditional wellness or HR frameworks, leaving women of color without institutional support.

Add into the mix persistent pay disparities by race and gender, and this economic and professional strain deepens mental and physical health impacts, creating cycles of insecurity, exhaustion, and attrition.

Workplace harms community wellbeing

The health and wellbeing toll doesn’t stop with the individual: chronic workplace stress can spill over into family systems and broader communities. For many women of color who are community anchors, workplace harm weakens collective resilience, diminishing time and energy for cultural, familial, or civic contributions. Because of broad pay inequities, with women of color making the least compared to white men, communities of color are also harmed economically, which in turn (think social determinants of health), affects community physical and mental health. Looking at 2023 statistics on year-round full-time workers, compared to every dollar made by white men working full-time and year-round, Black women made 66.5 cents, Latinas made 57.8 cents, Asian women made 94.2 cents, and white women made 79.6 cents.

Hope and Healing

As I share in What Your Comfort Costs Us, these cultural dynamics and harms are not inevitable. We can create healthier and more equitable workplaces by centering positive values in our workplaces and being mindful and intentional about the practices and norms that we bring into our workplaces. Consistently centering care, equity, and shared power can change workplace culture over time and help create a sense of repair that can, in time, prevent health harms. Organizational cultures that honor lived experience, invest in well-being structurally (not just via self-care rhetoric), and address systemic inequities can dramatically reduce chronic stress burdens and improve workplace culture and satisfaction. Workplaces that are rated as more psychologically safe tend to have lower attrition and higher sense of loyalty from employees. 

Learning from the creative and courageous leadership of women of color, we see that there is hope to improve our work experiences, and therefore, to positively affect the health of workers, their families, and their communities.