State- and Provider-Level Racism and Health Care in the U.S.

Volpe, Vanessa V.; Schorpp, Kristen M.; Cacace, Sam; Benson, G. Perusi; Banos, Noely C.

doi:10.1016/j.amepre.2021.03.008

Cited by 11 publications

(9 citation statements)

References 38 publications

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“…12,[30][31][32] The aforementioned events highlight a more sinister process that may add to the disparities seen-racism. Racism can be seen on a systemic 33,34 or institutional level as well as on an interpersonal 35,36 level. On a systemic level, patients of color battle a system run by predominantly white health care policymakers and providers who may have more difficulty understanding or considering the perspectives of people who are different from them.…”

Section: Resultsmentioning

confidence: 99%

“…33 On an interpersonal level, one must consider implicit bias as a contributing factor to the differences seen in the decision to pursue surgery or not. 36 It is imperative to understand that just because a procedure is recommended, it does not mean that a patient has enough medical literacy to process what a provider is recommending. Further, if said provider's implicit biases are at play, they may not go the extra mile to help the patient truly understand.…”

Section: Resultsmentioning

confidence: 99%

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Racial disparities in surgical treatment of oropharyngeal cancer: A Surveillance, Epidemiology, and End Results review

et al. 2023

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ObjectivesOropharyngeal squamous cell carcinoma (OPSCC) has been rising. This manuscript looks to explore racial disparities in the surgical management of OPSCC.MethodsA cancer database was queried for patients with OPSCC diagnosed from 2004 to 2017. Univariate and multivariable logistic regressions were used to evaluate associations between patient race/ethnicity, surgical treatment, and reasons for lack of surgery.Results37 306 (74.3%) patients did not undergo surgery, while 12 901 (25.7%) patients did. Non‐Hispanic black (NHB) patients were less likely to undergo surgery than other races (17.9% vs. 26.5%; p < 0.0001). In clinical discussions, the Asian, Native American, Hawaiian, Pacific Islander (ANAHPI), and unknown race group was more likely to directly refuse surgery when recommended (2.5% vs. 1.5%; p = 0.015).ConclusionRacial differences exist in treatment for OPSCC. NHB patients are less likely to actually undergo surgical management for OPSCC, while other patients are more likely to directly “refuse” surgery outright when offered.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Racial disparities in surgical treatment of oropharyngeal cancer: A Surveillance, Epidemiology, and End Results review

et al. 2023

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“…Both health and the ability to live a life of dignity are human rights that cannot be attained in a context with racism, sexism, or other forms of discrimination. Racism, or “the hierarchical categorization of social groups into races for the purpose of differential allocation of status, resources, and power to White individuals” was shown to affect the quality of health care services in both structural and interpersonal ways (Volpe et al 2021:338); until structural racism and implicit bias are addressed in USA systems, such as health care, advancing health equity will be difficult (Bailey et al 2017). Participants affirmed racism as a barrier, adding gender, income, weight, and marital status as characteristics affecting care.…”

Section: Discussionmentioning

confidence: 99%

Diverse Perspectives to Support a Human Rights Approach to Reduce Indiana’s Maternal Mortality Rate

et al. 2022

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Maternal mortality in the United States of America is a human rights issue. This study gathered perspectives from Black women community members and from duty bearers in four fields (academic, special interest, government, and media) on barriers to maternal health in Indiana. Semi-structured interviews and an editing (data-based) analytic strategy revealed six themes regarding barriers to maternal health: lack of continuous, quality health care coverage; racism and implicit bias; trauma and lack of mental health services; lack of instrumental and emotional support systems; insufficient knowledge for self-advocacy; and lack of data transparency and reliability. Participants raised several strategies to address barriers, including continuous high-quality health care coverage, implicit bias training, mental health services, doulas, and grassroots-university partnerships. We discuss these barriers and solutions using a human rights-based approach to health (HRBA). These findings present a blueprint for duty bearers in Indiana to increase women’s ability to claim their right to health.

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“…The programme theory developed through this research could be used to develop interventions to reduce HIV-related stigmatisation by other HCP (eg, physicians) or in other contexts (eg, PLHIV workplaces). Further research should also assess the relevance of the programme theory to reduce the impact of other forms of stigmatisation, such as that related to racism, 89 mental illness 90 or obesity. 91 …”

Section: Ethics and Disseminationmentioning

confidence: 99%

Nurses’ clinical practices reducing the impact of HIV-related stigmatisation in non-HIV-specialised healthcare settings: a protocol for a realist synthesis

et al. 2022

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IntroductionDespite tremendous progress in care, people living with HIV (PLHIV) continue to experience HIV-related stigmatisation by nurses in non-HIV-specialised healthcare settings. This has consequences for the health of PLHIV and the spread of the virus. In the province of Quebec (Canada), only four interventions aimed at reducing the impact of HIV-related stigmatisation by nurses have been implemented since the beginning of the HIV pandemic. While mentoring and persuasion could be promising strategies, expression of fears of HIV could have deleterious effects on nurses’ attitudes towards PLHIV. In literature reviews on stigma reduction interventions, the contextual elements in which these interventions have been implemented is not considered. In order to develop new interventions, we need to understand how the mechanisms (M) by which interventions (I) interact with contexts (C) produce their outcomes (O).Methods and analysisRealist synthesis (RS) was selected to formulate a programme theory that will rely on CIMO configuration to describe (1) nursing practices that may influence stigmatisation experiences by PLHIV in non-HIV-specialised healthcare settings, and (2) interventions that may promote the adoption of such practices by nurses. The RS will draw on the steps recommended by Pawson: clarify the scope of the review; search for evidence; appraise primary studies and extract data; synthesise evidence and draw conclusions. To allow an acute interpretation of the disparities between HIV-related stigmatisation experiences depending on people’s serological status, an initial version of the programme theory will be formulated from data gathered from scientific and grey literature, and then consolidated through realist interviews with various stakeholders (PLHIV, nurses, community workers and researchers).Ethics and disseminationEthical approval for realist interviews will be sought following the initial programme theory design. We intend to share the final programme theory with intervention developers via scientific publications and recommendations to community organisations that counter HIV-related stigmatisation.

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State- and Provider-Level Racism and Health Care in the U.S.

Cited by 11 publications

References 38 publications

Racial disparities in surgical treatment of oropharyngeal cancer: A Surveillance, Epidemiology, and End Results review

Racial disparities in surgical treatment of oropharyngeal cancer: A Surveillance, Epidemiology, and End Results review

Diverse Perspectives to Support a Human Rights Approach to Reduce Indiana’s Maternal Mortality Rate

Nurses’ clinical practices reducing the impact of HIV-related stigmatisation in non-HIV-specialised healthcare settings: a protocol for a realist synthesis

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