Oppressive systems “infect” the various social determinants of health, such as the food system and socioeconomic environment—leading to inequity and injustice. This inequity within the roots leads to communities experiencing historical and ongoing oppression, or "the trunk." While the trunk and its branches are incredibly strong and resilient*, the poor soil and its roots lead to a tree that bears impacted "fruit," or adverse health outcomes. While social determinants of health frameworks vary, the ultimate goal is to create the positive conditions in the roots for the tree to bear healthy fruit and thrive.
Examples:
The "soil" (racism, capitalism, and sexism) can affect reproductive lives of individuals leading to inequities in infant mortality rates. Systemic racism in the medical industrial system influences the quality of treatment based on race. As a result Black, American Indian, and Alaska Native people are two to three times more likely to die from pregnancy-related causes than white people.
The xenophobic policies that have lead to increased policing activities towards immigrants throughout the past two decades results in well-documented, negative effects on healthcare access for immigrants. The new immigrant health advantage phenomenon shows that new immigrants are generally healthier than medium-term and established immigrants due to lack of healthcare access and other factors that manifest with time spent in the U.S.
* A note about resiliency: Many communities are extremely resilient. However, resiliency is a survival necessity because of inequities and injustices. Many of the systems and conditions underlying poor health often exist to benefit certain groups of people (and allow them to thrive) at the cost of marginalizing historically oppressed communities. Instead of asking communities to be more resilient, we must strive to create the conditions for all people to thrive.