Sorice Vittoria, Mortimore Gerri, Faghy Mark, Sorice Rossella, Tegally Davinder
College of Health, Psychology and Social Care, University of Derby, Derby, UK.
Emergency and Acute Medicine, Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK.
J Racial Ethn Health Disparities. 2025 Apr 16. doi: 10.1007/s40615-025-02417-6.
This systematic review aimed to identify and categorise racial bias in healthcare and education; evaluate their impact on healthcare practitioners, students, and patients; and explore strategies to reduce these biases and improve health equity.
A systematic review was conducted following PRISMA guidelines to investigate racial bias in healthcare and healthcare education. Databases searched included PubMed, Cochrane, EMBASE, and CINAHL. Identification of additional papers was completed by employing backward and forward snowballing techniques. Rigorous interprofessional multi-reviewer screening and data extraction processes were performed. Thematic analysis was conducted inductively and collaboratively refined, with disagreements resolved through discussion and a third reviewer confirming resolutions as an additional quality assurance measure.
From an initial pool of 1634 records, 45 studies were included in the final review. The studies employed various designs, primarily cross-sectional, with most conducted in the United States of America. Five themes emerged: disparities in healthcare access and/or provision, perceived discrimination and/or medical mistrust, provider bias and/or stereotyping, disparities in education and training, and healthcare literature disparities.
The findings suggest significant racial disparities across multiple medical specialties, including maternal and infant healthcare, chronic disease management, and emergency care. The review also highlights the underrepresentation of racial minorities in medical imagery and educational materials, contributing to implicit bias and inadequate training for healthcare providers. Overall, the five identified themes appear interconnected, forming a self-reinforcing cycle of racial bias in healthcare and education.
本系统评价旨在识别医疗保健和教育中的种族偏见并进行分类；评估其对医疗从业者、学生和患者的影响；探索减少这些偏见和改善健康公平性的策略。
按照PRISMA指南进行系统评价，以调查医疗保健和医学教育中的种族偏见。检索的数据库包括PubMed、Cochrane、EMBASE和CINAHL。通过采用向前和向后滚雪球技术来识别其他论文。进行了严格的跨专业多评审员筛选和数据提取过程。采用归纳法进行主题分析，并进行协作完善，通过讨论解决分歧，并由第三位评审员确认决议，作为额外的质量保证措施。
在最初的1634条记录中，最终纳入了45项研究。这些研究采用了各种设计，主要是横断面研究，大多数在美国进行。出现了五个主题：医疗保健获取和/或提供方面的差异、感知到的歧视和/或对医疗的不信任、提供者偏见和/或刻板印象、教育和培训方面的差异以及医疗保健文献差异。
研究结果表明，在多个医学专科中存在显著的种族差异，包括母婴保健、慢性病管理和急诊护理。该评价还强调了少数族裔在医学图像和教育材料中的代表性不足，这导致了隐性偏见以及医疗保健提供者培训不足。总体而言，确定的这五个主题似乎相互关联，在医疗保健和教育中形成了一个自我强化的种族偏见循环。
