Religion, Culture, and Health Equity among Marginalized U.S. Populations: Pathways, Evidence, and Practice Implications

Abstract

Religion and culture are not peripheral influences on health in the United States; they shape beliefs about illness, experiences of discrimination, coping strategies, social support, care-seeking behaviors, and trust in institutions. For marginalized populations whose health is already constrained by structural racism, poverty, immigration stress, and unequal access to care religion and culture can function as both protective resources and sites of vulnerability. A growing body of peer-reviewed evidence shows that religious involvement and spirituality are associated with mental health resilience and health behaviors in Black and Latino communities across the life course, while culturally and religiously incongruent care can intensify mistrust, reduce engagement, and deepen inequities. Faith-based organizations (FBOs), including Black churches, have demonstrated capacity to deliver health promotion interventions at scale, and systematic reviews suggest such programs can improve behaviors and support equity-oriented prevention strategies. This piece argue that achieving health equity requires moving beyond generic “cultural competence” toward structural competence, humble partnership with communities, and measurable integration of spiritual and cultural needs into patient-centered care.