Resource Library

Authors Hassen, Lofters, Michael, Mall, Pinto and Rackal conducted a scoping review of the academic and grey literature to identify anti-racism interventions implemented in outpatient healthcare settings. The study recognizes the widespread racism, and resulting harms experienced by Black, Indigenous and other racialized people when seeking care or working in these contexts.  

Defining anti-racism interventions 

The authors acknowledge the ongoing legacy and impact of slavery and colonialism on today’s healthcare system. They delineate the existence of racism at three levels:  

• institutional racism 

• interpersonal racism 

• internalized racism  

The authors defined an anti-racism intervention as “an action-oriented, educational and/or political strategy for systemic and political change that addresses issues of racism and interlocking systems of social oppression” (p. 3).  

While much of the healthcare literature has focused on understanding and depicting existing disparities, this review can be used to initiate, implement, and evaluate actions to address racism in healthcare.  

Findings and recommendations 

The authors identified a total of 37 peer-reviewed and 6 grey literature articles. Using individual study findings, the authors created a set of recommendations and a conceptual framework to implement anti-racism actions at multiple levels.  

The framework is organized by the following domains of actions:  

• Establish the groundwork for anti-racism interventions which includes understanding the problem and identifying goals and objectives 

• Address institutional racism which includes a focus on policy, organizations and communities 

• Address personally mediated racism with a focus on interpersonal and individual levels 

• Incorporate monitoring and evaluation mechanisms 

• Ensure transparency, accountability and sustainability 

The authors noted the need for organizations to not use resources to assess whether racism is a problem within their organization as “racism is pervasive and present everywhere” (p. 11).  

Studies frequently used euphemistic wording or other poorly defined terms when describing anti-racism interventions. The authors cautioned against use of unclear language as this can weaken the focus on anti-racism actions.  

As many of the anti-racism interventions identified had not been evaluated for effectiveness in reducing racism the authors recommend that “healthcare institutions embarking on this work … evaluate their interventions for both processes and outcomes to contribute to the evidence base. The challenges encountered, not just the successes, will critically inform this work” (p. 12-13).  

Use this resource to:  

• identify where to start when initiating anti-racism interventions in a healthcare setting; 

• design anti-racism interventions at individual, interpersonal, organizational, community and policy levels using the conceptual framework presented; and 

• identify options for anti-racism strategies at different levels (e.g., cultural competency training; guidelines on ways to respond to racist comments; create meaningful partnerships with communities experiencing racism; establish supports for racialized and Indigenous staff; recruit, retain and promote Indigenous and racialized staff at all organizational levels).  

Related resources: