Identification of Conceptual Domains Associated with Normalized Structural Racism at the Healthcare Delivery that Contribute to Quality of Care Disparities Between Patients Racialized as Non-Hispanic Black/African American and Non-Hispanic White

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Publication Date

1-2-2024

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Presentation: 47:12

Abstract

Structural racism is a mechanism of intersecting components that reinforce inequity among racialized populations within various institutions, including health care. When entrenched at the system level, structural racism is believed to contribute to low quality of care for patients racialized as non-Hispanic Black/African American (NHB/AA) when compared to their counterparts who are racialized as non-Hispanic White (NHW). This study mapped the conceptual space of racism in healthcare delivery and explored how it is operationalized within related structures and processes that adversely impact quality of care. We employed group concept mapping (GCM) as a 3-step mixed method approach for collecting qualitative data and conducting quantitative analyses. Healthcare clinicians, researchers, and employee participants who self-identified as NHB/AA were recruited from Thomas Jefferson University Hospital and Vanderbilt University networks between May 2022 and March 2023. Recruited persons (n=15) participated in the first GCM step of brainstorming, n=16 completed the second step of sorting, and n=8 participated in the third step of rating. We identified eight conceptual domains of structural racism in healthcare delivery. All conceptual domains were identifiable and interpretable, suggesting that structural racism impacts quality of care. Results also revealed four new concepts not previously addressed in academic literature; one was determined as under-investigated. To our knowledge, this study is the first to employ GCM informed by critical race theory to create a conceptual map of structural racism at the system level of healthcare delivery. This data may be useful for expanding conceptual and theoretical research, policy assessment, interventions, and measurement tool development.

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English

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