欧洲种族化人群的医疗保健障碍：综述的范围综述
Barriers to healthcare for racialised populations in Europe: a scoping review of reviews.
作者信息
González-Rábago Yolanda, Lanborena Nerea, Rodríguez-Álvarez Elena
机构信息
Department of Sociology and Social Work, Faculty of Labour Relations and Social Work, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa (Biscay), 48940, Spain.
Research Group in Social Determinants of Health and Demographic Change-OPIK, Barrio Sarriena s/n, Leioa (Biscay), 48940, Spain.
出版信息
Int J Equity Health. 2025 Jul 28;24(1):212. doi: 10.1186/s12939-025-02577-1.
BACKGROUND
Racism is a significant barrier to equitable healthcare, yet it remains under-researched in Europe. Barriers across various stages of the healthcare process limit the equitable realisation of the right to health for racialised populations. This review synthesises existing literature on the barriers to healthcare faced by racialised populations in Europe.
METHODS
We conducted a scoping review of reviews to identify barriers to healthcare for racialised populations in Europe. We systematically searched across four databases (PubMed, Scopus, Web of Science, and PsycINFO) for review articles published from January 2010 to September 2024. We obtained data from 30 eligible reviews and classified them according to the dimensions of healthcare access.
RESULTS
Our review identified multiple, interrelated barriers across the dimensions of availability, accessibility, acceptability, and quality. Key barriers include insufficient interpretation and intercultural mediation services, complex and restrictive administrative procedures, economic costs, and cultural insensitivity in clinical practices. Racialised individuals also reported experiencing interpersonal racism and stereotypes, which affected their healthcare experiences and outcomes. The review highlights a significant lack of cultural competence among healthcare professionals, as well as inadequate adaptation of services to meet the needs of diverse populations. Additionally, we identified legal and administrative barriers, particularly for undocumented migrants, as crucial obstacles.
CONCLUSIONS
Our findings underscore the need for systemic changes to address the structural racism that limits equitable access to European healthcare systems. There is a critical need for racism-reflexive healthcare, with culturally competent healthcare services, improved training for healthcare professionals, and resources adapted to the needs of a diverse population. Additionally, research should focus on the experiences of racialised populations in under-researched settings, such as primary care, as well as on racialised populations beyond the most vulnerable. This review calls for health policies that ensure the effective exercise of the right to health for all individuals, regardless of their racial or ethnic background.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12939-025-02577-1.
背景
种族主义是实现公平医疗保健的重大障碍，但在欧洲仍未得到充分研究。医疗保健过程各个阶段的障碍限制了种族化群体公平实现健康权。本综述综合了欧洲种族化群体在医疗保健方面面临的障碍的现有文献。
方法
我们对综述进行了范围界定审查，以确定欧洲种族化群体在医疗保健方面的障碍。我们系统地在四个数据库（PubMed、Scopus、科学网和PsycINFO）中搜索了2010年1月至2024年9月发表的综述文章。我们从30篇符合条件的综述中获取数据，并根据医疗保健可及性的维度对其进行分类。
结果
我们的综述在可及性、可获得性、可接受性和质量维度中确定了多个相互关联的障碍。主要障碍包括口译和跨文化调解服务不足、复杂且严格的行政程序、经济成本以及临床实践中的文化不敏感。种族化个体还报告称经历了人际种族主义和刻板印象，这影响了他们的医疗保健体验和结果。该综述强调医疗保健专业人员严重缺乏文化能力，以及服务未能充分适应以满足不同人群的需求。此外，我们确定法律和行政障碍，特别是对无证移民而言，是关键障碍。
结论
我们的研究结果强调需要进行系统性变革，以解决限制公平获得欧洲医疗保健系统服务的结构性种族主义问题。迫切需要开展反种族主义的医疗保健工作，提供具备文化能力的医疗保健服务，加强对医疗保健专业人员的培训，并提供适应不同人群需求的资源。此外，研究应关注在研究不足的环境（如初级保健）中种族化群体的经历，以及最脆弱群体之外的种族化群体。本综述呼吁制定卫生政策，确保所有个人，无论其种族或族裔背景如何，都能有效行使健康权。
补充信息
在线版本包含可在10.1186/s12939-025-02577-1获取的补充材料。
Zotero 插件