Racism and Indigenous Adolescent Development: A Scoping Review.
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SUBMITTER: Uink B
PROVIDER: S-EPMC9320946 | biostudies-literature | 2022 Jun
REPOSITORIES: biostudies-literature
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Racism and Indigenous Adolescent Development: A Scoping Review.
Uink Bep B Bennett Rebecca R Bullen Jonathan J Lin Ashleigh A Martin Gregory G Woods Jenna J Paradies Yin Y
Journal of research on adolescence : the official journal of the Society for Research on Adolescence 20220403 2
Previous studies on the impacts of racism on adolescent development have largely overlooked Indigenous youth. We conducted a scoping review of the empirical literature on racism against Indigenous adolescents to determine the nature and scope of this research and to establish associations with developmental outcomes. Our literature search resulted in 32 studies with samples from the United States, Canada, Australia and New Zealand. Studies were limited to self-reported experiences of racism and ...[more]
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Project description:Health inequity between Indigenous (First Nations, Inuit, and Métis) peoples and other citizens is an important policy concern in Canada, as in other colonial countries. Racism in healthcare has been identified as contributing to poorer care and to worse outcomes. Despite a large literature regarding racism in other healthcare contexts, the dimensions of the existing literature on anti-Indigenous racism in Canadian healthcare are unclear. A scoping review examined the evidence of anti-Indigenous racist experiences in healthcare in the research literature, including the types of racist behaviours identified, settings studied, and Indigenous populations and geographic regions included. We identified English and French language journal articles on anti-Indigenous racism in Canadian healthcare settings in Scopus, PubMed, CINAHL, and the Bibliography of Indigenous Peoples in North America, and grey literature reports. A total of 2250 journal articles and 9 grey literature reports published since 2000 were included in screening, and 66 studies were included in the final review. Most used qualitative interviews with patients, but a large proportion included healthcare providers. Most were conducted in urban settings, a majority in Ontario or British Columbia, with mixed Indigenous populations. The largest proportion focussed on patient experiences with healthcare in general, rather than specific clinical contexts. Most racist experiences identified were 'covert' racism, including patients feeling treated differently from non-Indigenous patients, being ignored, treated more slowly, or not believed. Stereotyping of Indigenous peoples as substance users, poor patients, or poor parents was also commonly reported. 'Overt racism', including the use of racist slurs, was not widely found. Some quantitative studies did use standardized or validated instruments to capture racist experiences, but most did not result in generalizable estimates of their prevalence. The few studies linking racism to health outcomes found that experiencing racism was related to reluctance to seek healthcare, potentially leading to higher unmet healthcare needs. Gender was the intersecting dimension most identified as shaping healthcare experiences, with Indigenous women and girls at risk to specific stereotypes. Some papers suggested that socio-economically disadvantaged Indigenous people were at the highest risk to experiencing racism. Types of anti-Indigenous racism identified in Canadian healthcare appear similar to those reported in other jurisdictions. Indigenous peoples facing multiple dimensions of disadvantage, especially gender and social class, may be the most likely to experience racism. It is likely that the experience of racism in healthcare has implications for Indigenous peoples' health, mainly by reducing healthcare access.
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Project description:BackgroundRacism constitutes a barrier towards achieving equitable healthcare as documented in research showing unequal processes of delivering, accessing, and receiving healthcare across countries and healthcare indicators. This review summarizes studies examining how racism is discussed and produced in the process of delivering, accessing and receiving healthcare across various national contexts.MethodThe PRISMA guidelines for scoping reviews were followed and databases were searched for peer reviewed empirical articles in English across national contexts. No starting date limitation was applied for this review. The end date was December 1, 2020. The review scoped 213 articles. The results were summarized, coded and thematically categorized in regards to the aim.ResultsThe review yielded the following categories: healthcare users' experiences of racism in healthcare; healthcare staff's experiences of racism; healthcare staff's racial attitudes and beliefs; effects of racism in healthcare on various treatment choices; healthcare staff's reflections on racism in healthcare and; antiracist training in healthcare. Racialized minorities experience inadequate healthcare and being dismissed in healthcare interactions. Experiences of racism are associated with lack of trust and delay in seeking healthcare. Racialized minority healthcare staff experience racism in their workplace from healthcare users and colleagues and lack of organizational support in managing racism. Research on healthcare staff's racial attitudes and beliefs demonstrate a range of negative stereotypes regarding racialized minority healthcare users who are viewed as difficult. Research on implicit racial bias illustrates that healthcare staff exhibit racial bias in favor of majority group. Healthcare staff's racial bias may influence medical decisions negatively. Studies examining healthcare staff's reflections on racism and antiracist training show that healthcare staff tend to construct healthcare as impartial and that healthcare staff do not readily discuss racism in their workplace.ConclusionsThe USA dominates the research. It is imperative that research covers other geo-political contexts. Research on racism in healthcare is mainly descriptive, atheoretical, uses racial categories uncritically and tends to ignore racialization processes making it difficult to conceptualize racism. Sociological research on racism could inform research on racism as it theoretically explains racism's structural embeddedness, which could aid in tackling racism to provide good quality care.
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Project description:BackgroundIn recent decades there has been increasing evidence of a relationship between self-reported racism and health. Although a plethora of instruments to measure racism have been developed, very few have been described conceptually or psychometrically Furthermore, this research field has been limited by a dearth of instruments that examine reactions/responses to racism and by a restricted focus on African American populations.MethodsIn response to these limitations, the 31-item Measure of Indigenous Racism Experiences (MIRE) was developed to assess self-reported racism for Indigenous Australians. This paper describes the development of the MIRE together with an opportunistic examination of its content, construct and convergent validity in a population health study involving 312 Indigenous Australians.ResultsFocus group research supported the content validity of the MIRE, and inter-item/scale correlations suggested good construct validity. A good fit with a priori conceptual dimensions was demonstrated in factor analysis, and convergence with a separate item on discrimination was satisfactory.ConclusionThe MIRE has considerable utility as an instrument that can assess multiple facets of racism together with responses/reactions to racism among indigenous populations and, potentially, among other ethnic/racial groups.
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Project description:Addressing racism within health systems and services is critical to addressing health vulnerabilities and promoting health equity for racialized populations. Currently, there is limited knowledge about the ways in which racism affects health services for adolescents. A scoping review was undertaken following the Joanna Briggs Institute Manual for Evidence Synthesis methodology and guided by the research questions: (1) What are the characteristics of the literature examining racism in health service use for adolescents? (2) What are the foci of the literature on systemic racism and health services for adolescents? A systematic literature search was conducted in April 2021 to identify all relevant published studies. The search identified 3049 unique articles, with a total of 13 articles included in this review. Multiple levels of racism were examined in the included articles across various health care settings. Five foci were identified: racism prevention, missed care, quality of care, racial bias, and experiences of racism. Our review indicates a current emphasis on interpersonal racism within this field of study, with emergent discussion of the impact of systemic racism. However, greater attention is needed that would investigate multiple forms of racism (institutional, interpersonal, internalized) in relation to specific contexts and adolescent populations.
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Project description:Racism towards Black, Indigenous and people of colour continues to exist in the healthcare system. This leads to profound harm for people who use and work within these settings. This is a scoping review to identify anti-racism interventions in outpatient healthcare settings. Searching the peer-reviewed and grey literature, articles were screened for inclusion by at least two independent reviewers. Synthesizing the socio-ecological levels of interventions with inductively identifying themes, a conceptual model for implementing anti-racism interventions in healthcare settings is presented. In total, 37 peer-reviewed articles were included in the review, with 12 empirical studies and 25 theoretical or conceptual papers. Six grey literature documents were also included. Healthcare institutions need to incorporate an explicit, shared language of anti-racism. Anti-racism action should incorporate leadership buy-in and commitment with dedicated resources, support and funding; a multi-level approach beginning with policy and organizational interventions; transparent accountability mechanisms for sustainable change; long-term meaningful partnerships with Black, Indigenous, and people of colour (i.e., racialized communities); and ongoing, mandatory, tailored staff education and training. Decision-makers and staff in healthcare settings have a responsibility to take anti-racism action and may improve the success and sustainability of their efforts by incorporating the foundational principles and strategies identified in this paper.
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Project description:IntroductionRacism in healthcare leads to significant harm to healthcare professionals and the clients, families and communities they serve. Increasingly, health practitioner regulators-responsible for protecting the public and ensuring practitioner competence-are recognising the importance of reforming policies and practices to contribute to antiracist regulatory approaches. Examples of this work include developing specific standards of practice related to antiracism and antidiscrimination, supporting education and training, re-evaluating discriminatory licensure policies for internationally educated professionals and reforming internal governance structures to address unconscious bias. An understanding of the current state of literature can help identify knowledge gaps and inform the development of research agendas that can build the evidence base required to improve health practitioner regulators' approaches to addressing racism.The objective of this scoping review is to explore the nature, extent and range of literature focused on racism and health practitioner regulation and identify gaps in the literature.Methods and analysisThe review will be conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Database searches will include OVID MEDLINE, EMBASE, CINAHL, Scopus and Web of Science Core Collection. The review will include papers that discuss how health practitioner regulation can contribute to and perpetuate interpersonal and institutional racism, and how regulatory policies and practices can help address racism. We will also search for grey literature using the websites of leading regulatory organisations. Data will be analysed using descriptive statistics and conventional content analysis. Findings will be presented using evidence tables and a narrative summary. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.Ethics and disseminationEthics approval is not applicable to this review protocol. Findings will be disseminated through presentations, meetings with health practitioner regulators and a publication in a peer-reviewed journal.
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