Lee Jun Hyuk, Lee Hyeri, Son Yejun, Kim Hyeon Jin, Park Jaeyu, Lee Hayeon, Fond Guillaume, Boyer Laurent, Smith Lee, Rahmati Masoud, Pizzol Damiano, Kang Jiseung, Yon Dong Keon, Oh Hans
Health and Human Science, University of Southern California, Los Angeles, California, USA.
Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Med Princ Pract. 2025;34(2):138-151. doi: 10.1159/000542988. Epub 2024 Dec 5.
We aimed to systematically investigate the associations between racial discrimination and various health outcomes and to evaluate the certainty of evidence from existing meta-analyses of observational studies.
We systemically searched the associations between racial discrimination and health outcomes for PubMed/MEDLINE, Embase, WoS, and Google Scholar up until January 31, 2024. Notably, the included studies were predominantly conducted in the USA and Europe, limiting the generalizability of our findings to a global context.
Eight meta-analyses of observational studies involving over 1 million individuals were included, describing 15 potential health outcomes related to racial discrimination. The quality assessment revealed that most included meta-analyses were of low quality. For oncological health outcomes, significant associations were found with the mortality of hepatocellular carcinoma (HCC); black patients had a higher risk, while Asian patients had a lower risk when compared to white patients. In addition, black patients with disparities on the cancer care continuum are a protective factor for early-stage HCC diagnosis. For gastroenterological health outcomes, Hispanic patients with nonalcoholic fatty liver disease and black patients with socioeconomic status/differential access to health care, compared to white patients (reference), showed significant associations. For mental health outcomes, racial discriminations were significantly associated with increased odds of psychotic experiences, suicidal ideation, and suicidal attempts. Numerous significant associations were from weak to suggestive evidence levels, indicating variability in the evidence.
Despite the complexity of measuring its impact, racial discrimination shows a profound influence across clinical areas, including an unexpected protective association in early-stage HCC diagnosis among black patients.
We aimed to systematically investigate the associations between racial discrimination and various health outcomes and to evaluate the certainty of evidence from existing meta-analyses of observational studies.
We systemically searched the associations between racial discrimination and health outcomes for PubMed/MEDLINE, Embase, WoS, and Google Scholar up until January 31, 2024. Notably, the included studies were predominantly conducted in the USA and Europe, limiting the generalizability of our findings to a global context.
Eight meta-analyses of observational studies involving over 1 million individuals were included, describing 15 potential health outcomes related to racial discrimination. The quality assessment revealed that most included meta-analyses were of low quality. For oncological health outcomes, significant associations were found with the mortality of hepatocellular carcinoma (HCC); black patients had a higher risk, while Asian patients had a lower risk when compared to white patients. In addition, black patients with disparities on the cancer care continuum are a protective factor for early-stage HCC diagnosis. For gastroenterological health outcomes, Hispanic patients with nonalcoholic fatty liver disease and black patients with socioeconomic status/differential access to health care, compared to white patients (reference), showed significant associations. For mental health outcomes, racial discriminations were significantly associated with increased odds of psychotic experiences, suicidal ideation, and suicidal attempts. Numerous significant associations were from weak to suggestive evidence levels, indicating variability in the evidence.
Despite the complexity of measuring its impact, racial discrimination shows a profound influence across clinical areas, including an unexpected protective association in early-stage HCC diagnosis among black patients.
我们旨在系统地研究种族歧视与各种健康结果之间的关联，并评估现有观察性研究的荟萃分析证据的确定性。
我们系统地检索了截至2024年1月31日PubMed/MEDLINE、Embase、WoS和谷歌学术中种族歧视与健康结果之间的关联。值得注意的是，纳入的研究主要在美国和欧洲进行，这限制了我们研究结果在全球范围内的普遍性。
纳入了八项涉及超过100万人的观察性研究的荟萃分析，描述了15种与种族歧视相关的潜在健康结果。质量评估显示，大多数纳入的荟萃分析质量较低。对于肿瘤健康结果，发现与肝细胞癌（HCC）死亡率存在显著关联；与白人患者相比，黑人患者风险更高，而亚洲患者风险更低。此外，在癌症治疗连续过程中存在差异的黑人患者是早期HCC诊断的一个保护因素。对于胃肠健康结果，与白人患者（对照）相比，患有非酒精性脂肪性肝病的西班牙裔患者以及具有社会经济地位/获得医疗保健机会差异的黑人患者显示出显著关联。对于心理健康结果，种族歧视与精神病体验、自杀意念和自杀企图的几率增加显著相关。许多显著关联的证据水平从弱到提示性不等，表明证据存在变异性。
尽管衡量其影响存在复杂性，但种族歧视在各个临床领域都显示出深远影响，包括黑人患者在早期HCC诊断中存在意外的保护关联。
我们旨在系统地研究种族歧视与各种健康结果之间的关联，并评估现有观察性研究的荟萃分析证据的确定性。
我们系统地检索了截至2024年1月31日PubMed/MEDLINE、Embase、WoS和谷歌学术中种族歧视与健康结果之间的关联。值得注意的是，纳入的研究主要在美国和欧洲进行，这限制了我们研究结果在全球范围内的普遍性。
纳入了八项涉及超过100万人的观察性研究的荟萃分析，描述了15种与种族歧视相关的潜在健康结果。质量评估显示，大多数纳入的荟萃分析质量较低。对于肿瘤健康结果，发现与肝细胞癌（HCC）死亡率存在显著关联；与白人患者相比，黑人患者风险更高，而亚洲患者风险更低。此外，在癌症治疗连续过程中存在差异的黑人患者是早期HCC诊断的一个保护因素。对于胃肠健康结果，与白人患者（对照）相比，患有非酒精性脂肪性肝病的西班牙裔患者以及具有社会经济地位/获得医疗保健机会差异的黑人患者显示出显著关联。对于心理健康结果，种族歧视与精神病体验、自杀意念和自杀企图的几率增加显著相关。许多显著关联的证据水平从弱到提示性不等，表明证据存在变异性。
尽管衡量其影响存在复杂性，但种族歧视在各个临床领域都显示出深远影响，包括黑人患者在早期HCC诊断中存在意外的保护关联。
