Implications of institutional racism in the therapeutic itinerary of people with chronic renal failure

Abstract

Objective. To understand the implications of institutionalracism in the therapeutic itinerary of patients withchronic renal failure (CRF) in the search for diagnosis andtreatment of the disease.
 Methods. Descriptive, qualitativestudy developed with 23 people with CRF in a regionalreference hospital for hemodialysis treatment in NortheastBrazil. Two techniques of data collection were used: semistructured interview and consultation to the NEFRODATAelectronic medical record. For systematization andanalysis, the technique of content analysis was used.
 Results. Black and white people with CRF showedsignificant divergences and differences in their therapeuticitineraries: while white people had access to diagnosisduring outpatient care in other medical specialties, blackpeople were only diagnosed during hospitalization. Inaddition, white people had more access to private health plans when compared to black people, which doubles the possibility of access tohealth services. Moreover, even when the characteristics in the itinerary of blackand white people were convergent, access to diagnosis and treatment proved tobe more difficult for black people.
 Conclusion. The study showed the presence ofinstitutional racism in the therapeutic itinerary of people with kidney disease inwhich black people have greater difficulty in accessing health services. In this sense,there is a need to create strategies to face institutional racism and to consolidate theNational Policy for Comprehensive Health Care of the Black Population.

Racism in healthcare: a scoping review

“…Other articles examine experiences of racism within specific illnesses or healthcare contexts. These include qualitative articles looking at hypertension care in the USA [ 66 ], decision making processes in diabetes care in the USA [ 67 ], depression care in USA [ 68 ], HIV-care in USA [ 69 – 72 ], mental care in USA [ 73 ], cardiovascular disease care in USA [ 74 ], reproductive, maternal and perinatal healthcare in USA [ 75 – 78 ], and chronic renal failure care in Brazil [ 79 ]. Quantitative articles examine how experiences of racism in HIV-care [ 80 , 81 ], sickle cell disease management in the USA [ 82 ] mental healthcare in UK [ 83 ] and in USA [ 8 , 84 ], diabetes care in USA [ 85 – 89 ], dental care in the USA [ 90 , 91 ] and maternal care in USA [ 92 ].…”

Institutional procedural discrimination, institutional racism, and other institutional discrimination: A nursing research example

“…These specialties included public health (de Valpine & Lewis, 2021 ; Waite & Nardi, 2019 ), perinatal and neonatal (Scott et al, 2019 ), geriatric (Medina‐Walpole, 2021 ), and academic nursing (Murray & Loyd, 2020 ; Nardi et al, 2020 ). Addressing bias in institutions was highlighted as an area of importance, especially institutional racism (Agyepong, 2021 ; Santos Ferreira et al, 2020 ; Thurman et al, 2019 ).…”