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Racism and health service utilisation: A systematic review and meta-analysis

Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical stud...

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Autores principales: Ben, Jehonathan, Cormack, Donna, Harris, Ricci, Paradies, Yin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734775/
https://www.ncbi.nlm.nih.gov/pubmed/29253855
http://dx.doi.org/10.1371/journal.pone.0189900
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author Ben, Jehonathan
Cormack, Donna
Harris, Ricci
Paradies, Yin
author_facet Ben, Jehonathan
Cormack, Donna
Harris, Ricci
Paradies, Yin
author_sort Ben, Jehonathan
collection PubMed
description Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical studies that report associations between self-reported racism and various measures of healthcare service utilisation. Data were reviewed and extracted from 83 papers reporting 70 studies. Studies included 250,850 participants and were conducted predominately in the U.S. The meta-analysis included 59 papers reporting 52 studies, which were analysed using random effects models and mean weighted effect sizes. Racism was associated with more negative patient experiences of health services (HSU-E) (OR = 0.351 (95% CI [0.236,0.521], k = 19), including lower levels of healthcare-related trust, satisfaction, and communication. Racism was not associated with health service use (HSU-U) as an outcome group, and was not associated with most individual HSU-U outcomes, including having had examinations, health service visits and admissions to health professionals and services. Racism was associated with health service use outcomes such as delaying/not getting healthcare, and lack of adherence to treatment uptake, although these effects may be influenced by a small sample of studies, and publication bias, respectively. Limitations to the literature reviewed in terms of study designs, sampling methods and measurements are discussed along with suggested future directions in the field.
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spelling pubmed-57347752017-12-22 Racism and health service utilisation: A systematic review and meta-analysis Ben, Jehonathan Cormack, Donna Harris, Ricci Paradies, Yin PLoS One Research Article Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical studies that report associations between self-reported racism and various measures of healthcare service utilisation. Data were reviewed and extracted from 83 papers reporting 70 studies. Studies included 250,850 participants and were conducted predominately in the U.S. The meta-analysis included 59 papers reporting 52 studies, which were analysed using random effects models and mean weighted effect sizes. Racism was associated with more negative patient experiences of health services (HSU-E) (OR = 0.351 (95% CI [0.236,0.521], k = 19), including lower levels of healthcare-related trust, satisfaction, and communication. Racism was not associated with health service use (HSU-U) as an outcome group, and was not associated with most individual HSU-U outcomes, including having had examinations, health service visits and admissions to health professionals and services. Racism was associated with health service use outcomes such as delaying/not getting healthcare, and lack of adherence to treatment uptake, although these effects may be influenced by a small sample of studies, and publication bias, respectively. Limitations to the literature reviewed in terms of study designs, sampling methods and measurements are discussed along with suggested future directions in the field. Public Library of Science 2017-12-18 /pmc/articles/PMC5734775/ /pubmed/29253855 http://dx.doi.org/10.1371/journal.pone.0189900 Text en © 2017 Ben et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ben, Jehonathan
Cormack, Donna
Harris, Ricci
Paradies, Yin
Racism and health service utilisation: A systematic review and meta-analysis
title Racism and health service utilisation: A systematic review and meta-analysis
title_full Racism and health service utilisation: A systematic review and meta-analysis
title_fullStr Racism and health service utilisation: A systematic review and meta-analysis
title_full_unstemmed Racism and health service utilisation: A systematic review and meta-analysis
title_short Racism and health service utilisation: A systematic review and meta-analysis
title_sort racism and health service utilisation: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734775/
https://www.ncbi.nlm.nih.gov/pubmed/29253855
http://dx.doi.org/10.1371/journal.pone.0189900
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