Abstract
This paper describes the difficulties of researching racism in healthcare contexts as part of the wider issue of neoliberal reforms in welfare states in the age of global migration. In trying to understand the contradiction of a phenomenon that is historical and strongly felt by individuals and yet widely denied by both institutions and individuals, we consider the current political and socioeconomic context of healthcare provision. Despite decades of legislation against racism, its presence persists in healthcare settings, but data on these experiences is rarely gathered in Europe. National systems of healthcare provision have been subject to neoliberal reforms, where among others, cheaper forms of labor are sought to reduce the cost of producing healthcare, while the availability of services is rationed to contain demand. The restriction both on provision of and access to welfare, including healthcare, is unpopular among national populations. However, the explanations for restricted access to healthcare are assumed to be located outside the national context with immigrants being blamed. Even as migrants are used as a source of cheap labor in healthcare and other welfare sectors, the arrival of immigrants has been held responsible for restricted access to healthcare and welfare in general. One implication of (im)migration being blamed for healthcare restrictions, while racism is held to be a problem of the past, is the silencing of experiences of racism, which has dire consequences for ethnic minority populations. The implications of racism as a form of inequality within healthcare and the circumstances of researching racism in healthcare and its implication for the sociology of health in Sweden are described.
Highlights
Racism and HealthRacism is a complex social phenomenon to study, given the variations in historical and geographical contexts as well as non-availability of data especially in the European context which is the main focus in this review
As stressed by Priest and Williams and conceptualized by Paradies et al (2015) is a critical determinant and fundamental cause of inequalities in health, as underlined by Mulinari and Neergaard (2017) in the case of Sweden. In spite of such disparities, racism, as is becoming clear from a newly initiated research in Sweden by the authors of this review, is difficult to discuss in healthcare encounters (Bradby et al, 2019), largely because it manifests in very subtle ways
Contextualizing racism in healthcare within this broad global neoliberalism will, we argue, enable us to understand, not just how racism is rendered invisible but more significantly, the marginalization, vulnerabilities and suffering created in the process
Summary
Racism is a complex social phenomenon to study, given the variations in historical and geographical contexts as well as non-availability of data especially in the European context which is the main focus in this review. Be internalized, through incorporating racist attitudes, beliefs, and ideologies in one’s worldview; this can be interpersonal through interaction between individuals or systemic for example, through lack of control of and access to labor, material, and symbolic resources within a society This implies that racial inequalities in healthcare can be understood as lack of access to socioeconomic opportunities and resources, within contexts of negative images, stereotypes, prejudice, and discrimination against certain minority groups. Contextualizing racism in healthcare within this broad global neoliberalism will, we argue, enable us to understand, not just how racism is rendered invisible but more significantly, the marginalization, vulnerabilities and suffering created in the process This is important because the inability to identify the historical, social, economic, and ideological structuring of racism within social institutions such as healthcare today, seem to result in attributing responsibility for the effects of racism to those individuals and groups who may be its casualties (Mueller, 2017; Waldman, 2018). We conclude the paper by briefly reflecting on the role of academia and advocating for the application of participatory or collaborative research methodologies in order to help create spaces for promoting open discussion of racism in healthcare settings
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