Capsule Commentary on Paradies et al., ‘A Systematic Review of the Extent and Measurement of Healthcare Provider Racism’

Excerpt

Racial and ethnic disparities in health care are well documented, although the reasons underlying them are complex and multidimensional.1 The 2002 IOM report, Unequal Treatment, has become the de facto recent reference point for compiling the reasons, mechanisms, and possible approaches to solving this vexing healthcare problem. It defines disparities as differences in the treatment that are not directly attributable to access-related factors, clinical needs, patient preferences, or appropriateness of intervention. Bias leading to discrimination is one of the root causes for disparities that is very difficult to confront as healthcare providers. Not all bias is intentional, conscious or directed at the individual.2 Discrimination research has emphasized that bias has a broader context that is not limited to interpersonal factors or encounters but also includes institutional, historic, and socially determined components with complex interplay in how individuals experience, internalize and react to bias.3,4 …