The 2025 Intersectional Trauma Pandemic: Reflections on Its Toll on Health and Workforce Equity

Perspective

As a global community, we are living and working in turbulent times, which can be categorized as a “Big Event”: rapid social, economic, and cultural changes and disruptions that create a widespread sense of destabilization and the perception that a generalized crisis is occurring. ¹ However, it would be a mischaracterization to suggest that the challenges we now face emerged in 2025. Today’s political and scientific landscape is part of a long continuum of systemic inequities and social and public health crises that have disproportionately impacted structurally marginalized communities, including Black communities across the world—especially those in the Global South. Historical injustices (including the atrocities of the transatlantic slave trade, Jim Crow segregation, and the ethical violations of the Tuskegee Syphilis Study) have contributed to structural inequities and collective mistrust that continue to shape our health and workforce systems. This includes our global research enterprise, which has historically conferred disproportionate benefits to majority groups and to institutions in the Global North. Acknowledging the incidents of past injustices is necessary to understanding the current moment, as well as to design forward-thinking, solution-oriented health equity research that is historically grounded and justice-oriented, which will solve contemporary social and health inequities.

The 2025 Intersectional Trauma Pandemic is a term that I have used to describe the current era marked by social instability and pervasive widespread fear, fueling a worldwide mental health crisis. The trauma pandemic has emerged from the convergence of compounded systemic inequities and crises around the world and is rooted in systemic racial discrimination, economic disruption, and continued marginalization. It is structural, ongoing, and persists across contexts, extending beyond individual or clinical experiences. Aspects include increasing political polarization and widening health inequities that disproportionately impact structurally marginalized communities. The effects of global economic turbulence (including disrupted aid flows and changing trade dynamics in the United States) have further exacerbated conditions in countries already struggling with structural inequality, especially those in the Global South. Existing health inequities, global economic crises as well as ongoing climate changes intersect with existing traumas (such as colonial legacies), resulting in this pandemic of complex and ongoing trauma across marginalized populations and geographies. In Kenya, for example, these global realities have intersected with local demands for justice with maandamanos (protests in Swahili) during the summers of 2024 and 2025 in response to the proposed 2024 Finance Bill. These protests are rooted in widespread concerns about economic inequality and demand for integrity in governance that reflect a community-driven insistence for systemic transformation.

The 2025 Intersectional Trauma Pandemic has led to worldwide health and workforce inequity. In the health domain, the trauma pandemic has significantly exacerbated health inequities. Marginalized communities, including Black and other racialized populations, sexual and gender minoritized populations, women, people with disabilities, and migrants, face greater exposure to stressors such as poverty, housing instability, and community violence, known social determinants of health. ² These stressors contribute to increased rates of mental health burdens, chronic illness, and reduced life expectancy. Moreover, many health care systems are not designed to provide trauma-informed, culturally responsive, and intersectionally competent care, further expanding health inequities.

The trauma pandemic has importantly also substantially impacted workforce equity among workers disproportionately from structurally marginalized backgrounds. For instance, it has impacted precarious economy workers, along with those in the health care, education, and social services sectors. Critically, trauma both at the individual and structural levels restricts professional advancement and retention among historically underrepresented groups in employment sectors, including physicians, nurses and professors. Employee retention in medicine, academia, and global health sectors, for example, is compounded by a lack of meaningful support that leads to high attrition rates and the ongoing lack of inclusivity in leadership roles. Similar to what was observed in the COVID-19 pandemic,^3–5 burnout is escalating globally, especially among caregivers, educators, and frontline workers who (while navigating their own trauma) bear the emotional and physical toll of caring for communities in crisis. Given this, addressing this pandemic requires moving beyond individual and clinical research studies and interventions. Across borders and institutions, this necessitates that we embrace systems-level solutions that promote equity, justice, and collective healing for structurally marginalized groups.

Meaningful multilevel trauma research and justice-oriented policy approaches are compulsory for systematic transformation of current health and workforce systems. I urge my colleagues around the world across institutions and disciplines to commit to meaningful research that responds to the realities of the 2025 Intersectional Trauma Pandemic. This moment specifically requires that we move into actionable, justice-centered health equity research that acknowledges trauma not just as an individual experience but as a structural and collective reality. As a scholar-leader, I remain deeply committed to advancing health equity for Black, queer, and other marginalized communities, who continue to bear disproportionate burdens of systemic exclusion, trauma, and poor health outcomes. Our health equity efforts are rooted in community-engaged, intersectional, and global approaches. ⁶

Recognizing that the current context requires both observational and intervention approaches, we are adopting a multilevel Observational-Intervention Hybrid Approach to our forthcoming health equity research: ⁷ an approach that I advocate for across all health equity research. One of our central initiatives is Project TUJUANE (Together Understanding Neighborhood Journeys, Unity Acceptance, Networks, and Equity through Technology), based in Nairobi, Kenya. By focusing on Black sexual minoritized men, this work aims to understand and improve the health and well-being of structurally marginalized populations in a resource-limited setting through culturally grounded, trauma-informed, and justice-based observational and interventional research. The initiative specifically seeks to address existing burdens of mental health challenges ⁸ and the lack of culturally sensitive sexual health services ⁹ among Black sexual minoritized men in Nairobi. We are proud to collaborate with Kenyan scholars, community leaders, and grassroots organizations to ensure that the work is responsive to local realities and global inequities. At the same time, we have launched the Black Professors Study (BPS)—a national research effort designed to document, support, and elevate the productivity and well-being of Black professors across the United States. This work recognizes that workforce equity is health equity. Black professors often face cumulative stressors, including racial discrimination, tokenization, and institutional neglect, which contribute to both professional barriers and professional biases ¹⁰ that cause inequities in promotion and tenure^11,12 and may cause adverse health outcomes like mental health burdens and poor sleep health. ¹³ BPS seeks not only to generate data but to catalyze institutional and policy change that protects and advances the flourishing of Black scholars. Traditionally, public health research, including health equity research, has prioritized obtaining observational data on individual-level risk factors from marginalized populations, oftentimes comparing them with majority populations. Through a multilevel integrative approach combining observational and intervention methods and by focusing on specific populations, the pathway from research to practice is accelerated.

As we implement this research, we employ the Health Equity Research Production Model, ¹⁴ a framework I developed to guide equitable, inclusive, and community-centered research processes. This model prioritizes equity in the: (1) engagement with and centering of communities studied in research in all phases; (2) identities represented within research teams; (3) consideration of identities and groups awarded research grants; and (4) consideration of identities and groups considered for research products, such as peer-reviewed publications. It is particularly well-suited for research in under-researched communities and settings. The model explicitly centers the researcher’s positionality, recognizing how one’s social location, identity, and institutional power shape the research enterprise. As an accountability framework, it promotes research production by structurally marginalized populations, dismantling our current system based on inequity. The model prioritizes empowerment and more specifically empowering marginalized communities, avoiding extractive research methods, and focusing on real-world solutions. This under-utilized approach is especially important for under-researched regions, especially across the Global South.

Our lab’s intentional initiatives were developed to address multilevel intersectional trauma at the current moment through research, by centering structurally marginalized populations. As we navigate this new trauma pandemic, I call on my colleagues to integrate intersectional trauma frameworks into their work as well, as well as to join in building a world where health and justice are guarantees for all, not privileges. To my colleagues, bear in mind that this calls for purpose-driven knowledge production through mission-driven research and purposeful dissemination through teaching, publishing and policy transition. We must be boldly strategic in connecting rigorous scholarship to resolute service for real-world, meaningful interventions and policies. While this will require new initiatives, it also allows us to expand on our existing systems and infrastructures. For example, expanding existing studies like the Black Women’s Health Study^15–18 and the Jackson Heart Study^19–22 facilitates a cost-effective approach to already powerful research structures.

My concluding recommendations are that colleagues around the world should: (1) ensure research is representative and avoid and report recruitment bias; (2) bolster retention and discourage differential attrition; (3) measure social determinants and multilevel measures (centering contextual measures) as key exposures; (4) harmonize data across research networks and studies; (5) strive to connect data collection efforts to existing administrative and clinical data; (6) promote causal and life-course modeling; and (7) promote equity in data access and stakeholder engagement. Through these intentional approaches, we can collectively address the 2025 Intersectional Trauma Pandemic for global equity and for collective health and well-being.