Singh Jennifer S, Brasher Susan, Sarrett Jennifer, Barger Brian, Guerra Karen, Dilly Laura J, Rubin I Leslie, Stapel-Wax Jennifer L, Benevides Teal, Fernandez-Carriba Samuel
School of History and Sociology, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA.
J Racial Ethn Health Disparities. 2025 Jan 16. doi: 10.1007/s40615-024-02280-x.
Disparities in autism research and practices based on race and ethnicity are evident across many outcomes and life course stages. However, most of the research has focused on outlining differences and not the underlying systemic inequities driving these disparities. In this conceptual paper, we aim to shift the focus by outlining mechanisms of structural racism within the institutions of science, healthcare, and residential segregation and educational systems in the United States (U.S.). We argue that these and other forms of institutional racism constitute structural racism that are influencing the racial and ethnic disparities we see in autism services and care. For each of these institutions, we identify institutional racism related to autism and offer an example of how it shapes interpersonal racism and adverse outcomes, including misdiagnosis, delayed diagnosis, unequal access to educational services, and differential treatment in clinical encounters. We then provide anti-racism approaches in autism research and practice for each of these institutions that addresses institutional and interpersonal racism shaping autism inequities among racial and ethnic minorities. We conclude with a call to action to clinicians, researchers, and others to prioritize and disrupt the impacts of structural, institutional, and interpersonal racism through targeted anti-racism approaches.
基于种族和族裔的自闭症研究与实践差异在许多结果和生命历程阶段都很明显。然而，大多数研究都集中在概述差异上，而不是导致这些差异的潜在系统性不平等。在这篇概念性论文中，我们旨在通过概述美国科学、医疗保健、居住隔离和教育系统机构内的结构性种族主义机制来转移焦点。我们认为，这些以及其他形式的制度性种族主义构成了结构性种族主义，正在影响我们在自闭症服务和护理中看到的种族和族裔差异。对于这些机构中的每一个，我们确定与自闭症相关的制度性种族主义，并举例说明它如何塑造人际种族主义和不良后果，包括误诊、诊断延迟、获得教育服务的机会不平等以及临床诊疗中的差别对待。然后，我们为这些机构中的每一个提供自闭症研究和实践中的反种族主义方法，以解决塑造种族和族裔少数群体中自闭症不平等现象的制度性和人际种族主义问题。我们最后呼吁临床医生、研究人员和其他人员采取行动，通过有针对性的反种族主义方法，优先处理并消除结构性、制度性和人际种族主义的影响。
