Black Americans often face chronic exposure to racism, which can undermine psychological safety and alter neural function in regions implicated in processing emotions and regulating the body, potentially contributing to severe health inequities. This review explores the neural mechanisms through which systemic racism may perpetuate chronic stress, influencing physiological dysregulation and exacerbating health inequities. Addressing these deep-rooted issues necessitates dismantling systemic barriers and embedding safety-promoting cues in environments historically shaped by anti-Black racism—particularly within the healthcare and economic sectors. Recommended policies include (1) expanding access to quality healthcare, (2) enhancing cultural representation in healthcare to foster psychological safety, and (3) implementing socioeconomic initiatives aimed at building generational wealth and alleviating chronic stress. This paper presents a range of policy recommendations, spanning from immediate local actions to long-term federal goals, all designed to comprehensively address these challenges comprehensively. Recognizing the varying degrees of feasibility and support, these recommendations are crafted to offer both practical solutions and innovative, evidence-based strategies to significantly advance health equity.
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