The influence of racial-ethnic discrimination on women's health care outcomes: A mixed methods systematic review

Akinade, T (通讯作者),Icahn Sch Med Mt Sinai, One Gustave L Levy Pl,Box 1077, New York, NY 10029 USA.
2023-1
Background: In the U.S, a wide body of evidence has documented significant racial-ethnic disparities in women's health, and growing attention has focused on discrimination in health care as an underlying cause. Yet, there are knowledge gaps on how experiences of racial-ethnic health care discrimination across the life course influence the health of women of color. Our objective was to summarize existing literature on the impact of racial-ethnic health care discrimination on health care outcomes for women of color to examine multiple health care areas encountered across the life course. Methods: We systematically searched three databases and conducted study screening, data extraction, and quality assessment. We included quantitative and qualitative peer-reviewed literature on racial-ethnic health care discrimination towards women of color, focusing on studies that measured patient-perceived discrimination or differential treatment resulting from implicit provider bias. Results were summarized through narrative synthesis. Results: In total, 84 articles were included spanning different health care domains, such as perinatal and cancer care. Qualitative studies demonstrated the existence of racial-ethnic discrimination across care domains. Most quantitative studies reported a mix of positive and null associations between discrimination and adverse health care outcomes, with variation by the type of health care outcome. For instance, over three-quarters of the studies exploring associations between discrimination/bias and health care-related behaviors or beliefs found significant associations, whereas around two-thirds of the studies on clinical interventions found no significant associations. Conclusions: This review shows substantial evidence on the existence of racial-ethnic discrimination in health care and its impact on women of color in the U.S. However, the evidence on how this phenomenon influences health care outcomes varies in strength by the type of outcome investigated. High-quality, targeted research using validated measures that is grounded in theoretical frameworks on racism is needed. This systematic review was registered [PROSPERO ID: CRD42018105448].
SOCIAL SCIENCE & MEDICINE
卷号:316
ISSN:0277-9536|收录类别:SCIE
语种
英语
来源机构
Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; University of Pennsylvania; Pennsylvania Medicine; Icahn School of Medicine at Mount Sinai
被引频次(WOS)
3
被引频次(其他)
3
180天使用计数
1
2013以来使用计数
1
EISSN
1873-5347
出版年
2023-1
DOI
10.1016/j.socscimed.2022.114983
关键词
Health care Health care outcomes Life course Quality of care Racism Racial-ethnic discrimination Women ?s health Systematic reviews
WOS学科分类
Public, Environmental & Occupational Health Social Sciences, Biomedical
学科领域
循证公共卫生 循证社会科学-综合