Structural competency describes the ability to recognize structural factors that affect health disparities, such as inequity and stigma. These structural factors can alter a patient's symptoms and risk for certain diseases. The purpose of this study was to describe baccalaureate nursing students' attributions of the effects of structural factors on health. Participants in this study attributed structural factors as being relevant to adverse health outcomes. Findings demonstrated differences in attribution of structural factors by academic level. Given the shifting demographics in the United States and gaps in health care access, further research is needed on the development of structural competence in nursing students.