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

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Version 3 2024-06-18, 05:56
Version 2 2024-06-06, 05:19
Version 1 2017-12-25, 22:22
journal contribution
posted on 2024-06-18, 05:56 authored by J Ben, D Cormack, R Harris, Yin ParadiesYin Paradies
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.

History

Journal

PLoS ONE

Volume

12

Article number

ARTN e0189900

Pagination

1 - 22

Location

United States

Open access

  • Yes

ISSN

1932-6203

eISSN

1932-6203

Language

English

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2017, Ben et al.

Issue

12

Publisher

PUBLIC LIBRARY SCIENCE