Experiences Of Racism Research Articles

Racial Discrimination and Cognitive Function: An Instrumental Variable Analysis

Racial inequities in cognitive function persist with mixed evidence regarding the impacts of racial discrimination on cognitive outcomes. We examined the association between experiences of racial discrimination within institutional settings, such as getting a job or housing, and multiple measures of cognitive function among middle-aged adults using analytic methods to strengthen the existing evidence base and provide potential points for intervention. We used cross-sectional data from 2895 participants in Wave 8 (Mage=50.20, range: 43-55) and 2618 participants in Wave 9 (Mage=55.20, range: 48-60) of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Self-reported racial discrimination was operationalized using the Experiences of Discrimination Scale. Cognitive measures included were the Stroop Interference Test, Rey Auditory Verbal Learning Test, Digit Symbol Substitution Test, and the Montreal Cognitive Assessment. Analyses were conducted using ordinary least squares regression (OLS) and instrumental variable (IV) analysis using reflectance meter-measured skin color as the instrument. We find that increased experiences of racial discrimination are associated with poorer performance on cognitive assessments across OLS and IV analyses. For example, reporting one additional experience of racial discrimination was associated with approximately 0.50 SD lower auditory verbal learning scores using IV and 0.08 SD lower scores using OLS (Wave 8 IV 95% CI: -0.54, -0.41; OLS 95% CI: -0.10, -0.06). Such results in a relatively young sample yield insight into the potential implications of navigating a racialized society over one's life course in contributing to inequities in cognitive decline in older age.

Association of racism experience with gun purchase during COVID-19: Evidence from a national survey in the United States

ObjectiveConcurrent with a substantial surge in gun purchases among Americans during COVID-19, there was an escalation of racism and hate crimes in the United States. Despite this disturbing trend, little is known about whether and the extent to which racism experience is linked to gun purchase during the pandemic. This study aims to examine the association between experience of racial discrimination and gun purchase among Americans during COVID-19. MethodsBased on data from the Health, Ethnicity, and Pandemic Survey (n = 2,584), a national survey conducted in the U.S. in October 2020, chi-square tests and logistic regressions were estimated to examine the association between racism experience and gun purchase during COVID-19 with and without controlling for selected covariates. ResultsAbout 6.9 % of the sample reported gun purchases during COVID-19. Among respondents who reported experience of racism, 18.3 % purchased a gun as compared to 5.8 % among those who did not report experience of racism. Relative to respondents with no experience of racism, the odds of gun purchase for those who reported racism experience became 257 % as much (AOR = 2.57, 95 % CI: 1.63, 4.04) after controlling for other covariates in the analysis. Non-Hispanic Blacks were more likely to report gun purchases than non-Hispanic Whites (AOR = 1.80, 95 % CI: 1.04, 3.10). ConclusionsAmericans who reported experience of racism during COVID-19 were far more likely to purchase a gun than those otherwise. These findings elevate the need for addressing racism as an important risk factor of firearm violence.

Anti-Black racism in Canadian health care: a qualitative study of diverse perceptions of racism and racial discrimination among Black adults in Montreal, Quebec.

Racism has been shown to impact the health of Black persons through its influence on health care, including its expression through implicit biases in provider training, attitudes, and behaviours. Less is known about the experiences of racism in contexts outside of the USA, and how race and racism interact with other social locations and systems of discrimination to shape Black patients' experiences of racism in health care encounters. To help address this gap, this study examined diverse Black individuals' perceived experiences of, and attitudes towards, anti-Black racism and racial discrimination in Canadian health care, specifically in Montreal, Quebec. This descriptive qualitative study adopted a social constructionist approach. Employing purposive maximal variation and snowball sampling strategies, eligible study participants were: self-identified Black persons aged 18 years and older who lived in Montreal during the COVID-19 pandemic, who could speak English or French, and who were registered with the Quebec medical insurance program. In-depth interviews were conducted, and a Framework Analysis approach guided the systematic exploration and interpretation of data using an intersectionality lens. We interviewed 32 participants, the majority of whom were women (59%), university educated (69%), and modestly comfortable financially (41%), but diverse in terms of age (22 to 79 years), country of origin, and self-defined ethnicity. We identified five major themes demonstrating substantial variations in perceived racism in health care that are influenced by unique social locations such as gender identity, age, and immigration history: (1) no perceptions of racism in health care, (2) ambiguous perceptions of racism in health care, (3) perceptions of overt interpersonal racism in health care, (4) perceptions of covert interpersonal racism in health care (including the downplaying of health concerns, stereotyping, and racial microaggressions), and (5) perceptions of systemic racism in health care. Perceptions of anti-Black racism and racial discrimination in Canadian health care are complex and may include intra-racial group differences. This study begins to address the dearth of empirical research documenting experiences of anti-Black racism in health care in Quebec, highlighting a continued need for serious consideration of the ways in which racism may manifest in the province, as well as a need for anti-racist advocacy. Advancing racial health equity requires greater sensitivity from providers and decision makers to variations in Black patients' health care experiences, towards ensuring that they have access to high quality and equitable health care services.

“Close to my Heart”: Teacher Educators Building Racial Literacies

Although building preservice teachers’ racial literacy is a key goal to reducing racial inequity in K-12 settings, little attention has been paid to how literacy teacher educators are prepared to conduct this work. This is unsurprising given the neoliberal logic underpinning universities today. In this multiduo autoethnographic study, six literacy teacher educators utilized reflection on critical incidents to examine their own racial literacy development. By forming cross-racial pairs and utilizing a combination of writing and dialogue, these six participant/researchers interrogated their own views and experiences of race and racism. Findings suggest that the examination of critical incidents can support teacher educators’ racial literacy growth. Specifically, participants reflected on the vulnerability necessary to support preservice teachers’ racial literacy development and utilized ethnographic methods to build the practice of sharing about their own racial literacy learning. They also used critical incidents to come to a deeper understanding of the construct of racial literacy itself. These results imply that for professional organizations such as the Literacy Research Association to deliver on their espoused commitments to addressing ongoing institutional racism, they must intentionally create professional spaces for coreflection and dialog about racial literacy. Further, we consider the implications of this work for literacy doctoral programs and teacher educator preparation within contexts of college and university-based teacher education programs.

Real-time experiences of racism and stress in association with postpartum weight retention: A longitudinal ecological momentary assessment study.

Racial inequities in postpartum weight have been documented with limited studies on the influences of racism and other forms of discrimination. In a prospective longitudinal study applying ecological momentary assessment (EMA) and ambulatory assessment of weight, we measured the association between discrimination, stress and postpartum weight change. The Postpartum Mothers Mobile Study (PMOMS) is a cohort of 313 pregnant and birthing individuals who were followed during their second and third trimester through 1 year postpartum. They were recruited in clinical settings between 2017-2020 in a major city center in Pennsylvania. Measures of racism and gender-based discrimination were collected via random EMA surveys throughout pregnancy and postpartum; and weight was collected via blue-tooth enabled scales at least weekly. Among Black participants, a 10% increase in the number of days a participant experienced racial discrimination in the past month was associated with retaining 0.3 more pounds; 10% increase in EMA gender discrimination was associated with retaining 0.4 more pounds; and EMA stress reported in the past month was associated with decreased weight retention. Chronic experiences of racial and gender discrimination may contribute to weight retention immediately after pregnancy and beyond.

SENSORY EXPERIMENTS, SENSORY ORDERS, AND AESTHETIC EDUCATION

ABSTRACTErica Fretwell's Sensory Experiments: Psychophysics, Race, and the Aesthetics of Feeling (2020) raises crucial questions about the making of a concept of difference through marshaling the senses to the ends of a sensory order in postbellum United States. In this essay, I argue that Fretwell's book has opened a crucial horizon for rethinking how race and ideas of difference marking gender and disability were remade through the short‐lived but deeply consequential science of psychophysics. While the study focuses on how psychophysics and its aftermaths recast questions of difference in the US, Fretwell indirectly poses a major challenge for the critique of the twentieth‐century experience of race elsewhere—for example, of apartheid in South Africa. In this review essay, I argue that, beyond the US, Fretwell's meticulously elaborated argument renews approaches to the problem and problematization of race and difference. Read in relation to the making of race in South Africa, the book inadvertently brings into view a deceptive plot of petty apartheid, a banal everyday constitution of a sensory order that shares its origins in the discourse of psychophysics. When placed alongside the more pronounced forms of grand apartheid, the resultant psychophysical aesthesis conscripts the human sensorium to a cybernetic mode of power that shifts between a racialization of labor and a racialization of desire. Fretwell effectively invites us to consider the endpoints of psychophysics in a hierarchy of the senses, for which an aesthetic education may yet be required to short‐circuit and reroute the senses through intervals of synesthesia.

Racial discrimination and Aboriginal and Torres Strait Islander suicide mortality rates in Queensland.

The study aimed to examine the associations between experiences of racial discrimination within communities with suicide mortality rates for Aboriginal and Torres Strait Islander people. Age-standardised suicide rates (ASRs) were calculated using suicides recorded by the Queensland Suicide Register (QSR) of Aboriginal and Torres Strait Islander people in Queensland from 2009 to 2015. Rate Ratios (RRs) were used to compare ASRs in areas with high and low levels of reported discrimination, and other comparative community-level risk and protective factors (remoteness, socio-economic resources, and Indigenous language use). The age-standardised suicide rate was 31.74 deaths per 100 000 persons/year for Aboriginal and Torres Strait Islander people for the years 2009-2015. ASRs were significantly higher in areas where more of the First Nations residents experienced recent discrimination (RR = 1.33; 95%CI = 1.05-1.70, p = 0.02), and the age-specific suicide rate was significantly higher for those aged 25-34 in areas with more discrimination (RR = 1.67; 95%CI = 1.04-2.74, p = 0.03). By comparison, the ASRs were not significantly higher in areas with regional and remote communities (RR = 1.10, CI 95%=0.75-1.61, p = 0.60), or areas with lower socioeconomic resources (RR = 0.86, 95%CI = 0.66-1.13, p = 0.28). Areas in which more First Nations residents spoke Indigenous languages had significantly lower ASRs (RR = 0.71; CI95%=0.53-0.95, p = 0.02). Suicide mortality rates for Aboriginal and Torres Strait Islander people in Queensland were influenced by experiences of racial discrimination within communities and Indigenous language use, with greater associations reported than with socio-economic resources or remoteness. The findings reflect the public health risk of discrimination and provide evidence for enacting strategies to reduce institutional and personal discrimination to reduce suicide.

The Intersectionality of Chronic Pain Stigma and Racial Discrimination in Black and White Adults with Chronic Low Back Pain.

We examined the intersection between chronic pain stigma and racial discrimination, separately among Black and White U.S. adults with chronic low back pain. Participants completed measures of chronic pain stigma, lifetime experiences of racial discrimination, pain severity and interference. A composite variable representing the intersectionality of stigma and discrimination was created, and Black and White participants were separately categorized into 4 groups. Black participants were categorized as: 1) high discrimination/high stigma, 2) high discrimination/low stigma, 3) low discrimination/high stigma, and 4) low discrimination/low stigma. White participants were categorized as: 1) any discrimination/high stigma, 2) any discrimination/low stigma, 3) no discrimination/high stigma, and 4) no discrimination/low stigma. Black participants reported more frequent experiences of racial discrimination than White participants (p<.05), but there was not a racial difference in chronic pain stigma (p>.05). Among Black participants, those in the high discrimination/high stigma and low discrimination/high stigma groups reported greater pain severity and interference than those in the high discrimination/low stigma and low discrimination/low stigma groups (p<.05). Among White participants, those in the any discrimination/high stigma group reported greater pain severity and interference than those in the no discrimination/low stigma group (p<.05), but there were no differences in pain severity or interference between the any discrimination/no stigma and no discrimination/high stigma groups (p>.05). Our findings suggest that the relationship of intersectional chronic pain stigma and racial discrimination with pain is nuanced and differs across racial groups.

Culprits or Victims? Social Media Use, Mediated Ethnic Blame, and Asian American Mental Health During COVID-19

ABSTRACT The present study aims to understand whether and how social media use negatively affected Asian Americans’ mental health during the COVID-19 pandemic. We build on previous research on media framing, stigma, and stereotyping to understand whether social media messages about Asians as culprits to blame for the pandemic, direct experiences of racism, or media coverage of victims of anti-Asian hate crimes led to mental health outcomes for this racial group. We use an online survey of Asian American participants (N = 527) conducted in 2020 to test the role of (a) mediated ethnic blame (MEB), (b) direct stigma, and (c) indirect stigma in explaining the relationship between social media use and mental health among Asian Americans during the COVID-19 pandemic. Our results demonstrate that mediated ethnic blame, but not direct or indirect stigma experiences, is associated with Asian Americans’ mental health. Implications for media framing, health communication, and journalism are discussed.

A Composite Counternarrative of Discrimination as a Social Determinant of Health: Black College Women's Experiences of Gendered Racism.

Discrimination is a social determinant of health (SDOH) that negatively affects racially minoritized students and patients. Nurses and nurse educators must understand discrimination, including nuanced and intersecting ways that it negatively affects academic and health outcomes. In-depth interviews were conducted with 12 Black women at a primarily White institution in the Southeast United States. The interview guide, informed by critical race and intersectionality theories, explored experiences of gendered racism, particularly in the students' social environments. Narrative analysis was conducted, then a composite counternarrative was composed to portray experiences of gendered racism across multiple levels, including intrapersonal, interpersonal, and institutional. The composite narrative revealed experiences of multi-leveled gendered racial microaggressions that shape the daily lived experiences of Black college women students. Three main themes emerged: Limited Autonomy, Differential Treatment and Differential Assumptions, and Differential Access to Power and Resources. Gendered racism differs from White women's experiences of sexism and Black men's experiences of racism. Institutional efforts to support Black college women must be intentional in addressing the unique ways they experience discrimination in various settings on campus. Nurses' and nurse educators' understanding of gendered racism as a SDOH may ease the hesitancy in addressing health inequities. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Challenging patriarchal motherhood: A critical analysis of fictional mothers in Caryl Phillips’ The Final Passage and The Lost Child

This study explores the literary mother figures in Caryl Phillips’ novels The Final Passage (1985) and The Lost Child (2015) through the critical lens of matricentric feminism, focusing on patriarchal notions of motherhood including normalisation, idealisation, depoliticalisation and naturalisation. Extensive research has been conducted on these novels, but their representations of mother characters have remained relatively under-explored. With the aim of addressing that gap in the literature, we argue that Caryl Phillips problematises idealised, universal and traditional conceptions of motherhood by offering multiple and, particularly, otherised mother figures in these novels. Deconstructing such conceptions of motherhood, he exposes the socio-political and economic inequalities arising from racial discrimination, class inequalities, patriarchal oppression and colonial experiences that affect his characters’ mothering adversely. Through an intersectional reading of the mother characters in these two novels, this study aims to highlight the characters’ complexities and significance, thereby contributing to a more comprehensive understanding of the novels and enriching the discourse surrounding the representation of motherhood in literature and culture. A comparative study of these novels further reveals that they encompass various settings for multiple depictions of motherhood and different stages of imperialism, presenting haunting continuities and discontinuities in different centuries.

"Where are you really from?": a qualitative study of Asian American medical provider experiences.

The COVID-19 pandemic highlighted how racially minoritized patients and clinicians have suffered racial discrimination. It also made visible the ways in which Asians across the globe experience racial hate and illuminated that the experiences of Asians in medicine are not often spotlighted. In the United States specifically, Asian Americans are not viewed as minoritized in medicine, yet their professional experiences are rarely highlighted. Informed by the discourses of the model minority, the forever foreigner, and ethnic lumping, we used Asian critical theory to explore how Asian American medical providers in Utah understand racial and ethnic identity and how these identities and experiences of racialization inform their professional identities. Using a case study approach, we identified and interviewed 23 physicians, physician assistants, and nurse practitioners (during spring 2022) who live in and practice medicine in Utah. Transcribed interviews were coded using reflective thematic analysis. Findings were organized into three themes: (1) feeling different, (2) experiences with discrimination, and (3) wrestling with the model minority myth. While Asian American medical providers experience not belonging, they also have the agency to disrupt discrimination and stereotypes. Asian American medical providers' racial and ethnic identities influence their professional interactions. Understanding the intersections of their social and professional identities are important to providing support for Asian medical providers, within the United States and beyond.

“They talk about it like it's an overdose crisis when in fact it's basically genocide”: The experiences of Indigenous peoples who use illicit drugs in Vancouver's Downtown Eastside neighbourhood

Indigenous Peoples who use illicit drugs (IPWUID) are disproportionately represented among toxic drug poisoning deaths in Canada. These drug-related harms are framed by the historical and ongoing trauma related to settler colonialism and are acutely visible in Vancouver, Canada's Downtown Eastside - a low-income neighbourhood that is an epicenter of the drug poisoning crisis and characterized by entrenched poverty, substance use, violence, and homelessness. This study was undertaken to examine the experiences and perspectives of IPWUID in the Downtown Eastside regarding the drug poisoning crisis and the responsiveness of harm reduction programs within the context of settler colonialism. Indigenous-led qualitative interviews were conducted with 16 IPWUID recruited by Indigenous peer researchers. Indigenous ways of knowing were embedded throughout the entire research design to ensure research was culturally congruent. Interview transcripts were analyzed thematically and interpreted by drawing on concepts of social violence and racial capitalism. Our analysis reviewed three key themes that centered the experiences of IPWUID in Vancouver's Downtown Eastside in relation to the drug poisoning crisis: (1) that the drug poisoning crisis is understood as a form of genocide toward Indigenous Peoples; (2) that the crisis is experienced within the context of pervasive distrust and adversarial relationships with police rooted in structurally racist experiences of place-based policing practices; and (3) that there is a desire for culturally-safe harm reduction care with Indigenous representation, cultural integration, and that addresses inequities and injustice stemming from colonialism and structural racism. Findings demonstrate how responses to the drug poisoning crisis among IPWUID need to respond to social and materials conditions perpetuated by colonialism and racial capitalism, while also centering IPWUID through the development and implementation of Indigenous-led and culturally safe harm reduction approaches.

Heightened vulnerabilities to anti-Asian racism during the COVID-19 pandemic: an intersectional analysis

ABSTRACT This study examines how anti-Asian racism intersects with sexism and ageism, impacting Asian Americans’ fear of racial victimization. Using nationally representative data from the “Dynamics of Social Life during COVID-19” survey, we show that these intersections affect subjective experiences of racism among young and older Asian Americans across various ethnic groups in the U.S. Younger Asian women report the highest levels of worry about racism, with this concern decreasing with age. In contrast, older Asian men worry more than younger men. Asian women also reported more instances of unfair treatment and discrimination, while Asian men reported higher instances of racial violence. Our findings reveal that anti-Asian racism is a multifaceted phenomenon shaped by intersections of gender, age, and ethnicity. We discuss existing obstacles and potential pathways to building panethnic solidarity among Asians across cultures.

Secondhand racism: What we know and where to go regarding the relationship between vicarious racism and mental and physical health

AbstractRacism has long been established to be a significant determinant of racial inequalities in health among racially minoritized individuals. Most of this research, however, has been focused on individuals' direct perceived experiences of racism, and far less has been conducted on the relationship between indirect, vicarious experiences of racism and mental and physical health outcomes and behaviors. In this review, racism and vicarious racism are defined, and what is known about the relationship between vicarious experiences of racism and psychological and physical well‐being and health behaviors is documented. Like direct experiences of racism, research on vicarious experiences of racism suggests it is also adversely related to anxiety, depression, general psychological distress, and physiological health (e.g., allostatic load, cardiometabolic risk). Lastly, future directions for research and clinical practice are discussed. Understanding the intricate interplay between vicarious racism and overall mental and physical wellbeing is crucial for informing interventions aimed at mitigating the adverse mental health outcomes associated with experiences with racism.

Attitudes and Beliefs Regarding Pain and Discrimination Among Black Adults with Sickle Cell Disease: A Mixed Methods Evaluation of an Adapted Chronic Pain Intervention.

This study sought to adapt a chronic pain group curriculum for adults with sickle cell disease (SCD). Given the association of experiences of racism and discrimination with health outcomes, this study also explored how such experiences for patients with SCD impact their interactions with clinicians and health-care systems. This mixed methods study recruited patients (aged ≥18 years) in a sickle cell treatment program; all self-identified as Black or African American. Key informant interviews evaluated a chronic pain program curriculum and rated the curriculum sessions' importance for SCD pain management. A survey containing six validated instruments then measured experiences of pain and discrimination, level of emotional expressivity, and trust in physicians and health insurers. Of the 19 adult patients approached, 12 (63%) completed the interview and survey. Interview data analysis resulted in five themes comprising pain, treatment, mental/emotional, health-care clinicians, and differences in SCD versus other chronic conditions. Each curriculum session was rated as "very important" or "important" by participants. Most described at least one experience of racism or discrimination in the medical setting and identified clinicians' lack of knowledge as a barrier to appropriate SCD care. Participants identified the importance of non-pharmacological treatments for SCD pain and appropriately managing pain caused by comorbid chronic conditions. Conversely, survey responses reported moderate levels of pain, infrequent discriminatory experiences in the medical setting, and moderate trust in medical professionals, whereas most reported experiences of discrimination in general settings. Many participants reported they either accepted it or did nothing in response to discriminatory experiences. Study findings emphasize the need to address experiences of racism and stigma in addition to experiences of emotional and physical pain among patients with SCD in the context of pain management. Findings from this study will inform the development of a SCD pain group curriculum for adult patients.

“Drug Use with Racism…The Reason I Wanted to Do This Study”: Perceptions of Race and Racism’s Impact on Drug Use among Black Americans Using Opioids

Background: Several studies link racism with drug use disparities among systemically marginalized populations. However, few invite Black Americans to discuss how they perceive racism’s impact on their drug use. Objectives: To examine qualitative accounts from N=40 Black adults reporting non-medical prescription opioid use on their experiences of racism and drug use. Results: A deductive structural tabular thematic analysis informed by Jones’s (2000) levels of racism resulted in two themes: (a) Experiences of Racism (subthemes: Denying Experiences of Racism and Endorsing Experiences of Racism) and (b) Race, Racism, and Drug Use (subthemes: Rejecting Race and Racism’s Impact on Drugs and Rejecting Race and Racism’s Impact on Drugs). Conclusions: Participants provided examples of internalized, personally mediated, and institutionalized racism associated with their drug use. Implications for policy, practice, and research are discussed. Specifically, implications detail how to center Black Americans and demonstrate anti-racism when developing treatment strategies and drug policies.

Patients’ experiences of racism in German inpatient healthcare

Abstract Background Racism is recognised as a social determinant of health. An evolving concern in research and policymaking has been the impact of racism in the healthcare system, particularly regarding the quality of healthcare and barriers for healthcare. Little is known about patients’ experiences of racism in hospitals and rehabilitation facilities in Germany and their coping strategies in dealing with racism. Methods As part of a joint project on racism in healthcare (RiGeV) funded by the Federal Ministry of Education and Research, twenty qualitative interviews and two group discussions with patients and their next of kin about their experiences in hospitals and rehabilitation facilities were conducted and analysed using the documentary method. Ethical approval for this study was obtained from the Ethics Committee of Fulda University of Applied Sciences. Results Interviews with patients and their next of kin revealed that the most significant experiences of racism in hospitals are attributions of dramatisation and exaggeration of pain, embedded in a general perception of not being taken seriously and/or being ignored. Patients try to avoid such experiences that compromise their trust and sense of security, as well as the quality of treatment they receive. Healthcare for refugees is impacted by structural barriers (AsylBLg) which jeopardise the healing process and represent a considerable psychosocial burden. Conclusions Recommendations for policies and practice include a mission statement for non-discriminatory treatment and the sanctioning of racism within healthcare institutions. A complaints office should manage implementation and offer support for affected patients. The topic of racism must be addressed in the training and further education of doctors and healthcare professionals. Patient trust in a safe and high-quality form of healthcare should be strengthened by addressing their complaints. Health care for refugees has to be improved. Key messages • Racism in German inpatient healthcare represents a considerable psychosocial burden for patients and impairs the quality of treatment they receive. • Policies for reducing racism inpatient healthcare have to be implemented.

Reflecting (on) power?Critical reflections by healthworkers in Germany on racial power and privilege

Abstract Background Healthcare users have increasingly reported on experiences of racial discrimination in healthcare encounters in Germany (Aikins et al. 2020). While research on the experiences of racialised users predominates, examining the perspectives of white professionals, especially those holding positions of authority, regarding their internalised stereotypes and discriminatory practices is also crucial. This study therefore investigated the prevalence of conscious or unconscious biases related to critical whiteness and anti-racism among healthcare workers (doctors, nurses and therapists) and how these attitudes shaped their professional practice. Methods Problem-centred expert interviews (Döringer 2021) with 20 healthcare professionals from medicine, nursing, and therapeutic professions working in hospitals or rehabilitation facilities across three German federal states. Data were analysed using documentary method (Bohnsack 2002). Results Respondents exhibited varying degrees of reflective abilities, and there are limited opportunities for structured self-reflection focused on recognizing and addressing racism. The research interview constituted a much-needed space for such reflection. Those who are sensitised about their own positions of privilege often are so due to external influences and personal trajectories (teenaged children, trade union activism) rather than through the values or structures of their institutions. Unconscious racism nonetheless still manifests, demonstrating the need to create more inclusive environments where critical self-reflection on racism is encouraged. Conclusions To effectively combat racism, German healthcare institutions must systematically implement anti-racist and intersectional interventions. This also entails creating spaces for reflection where staff can openly examine and acknowledge their own biases, fostering an environment conducive to collective action for promoting anti-racist workplace practices. Key messages • Opportunities for self-reflection critical of racism should also be offered across institutions in order to ensure trusting, non-hierarchical spaces. • Reflections on one’s own social positioning and privileges are not common in all circles, so the necessity of this attitude should be communicated in an error-friendly manner.

Racism in inpatient settings in Germany: professionals’ perspectives

Abstract Background Experiences of racial discrimination during healthcare encounters have increasingly been recognised as a source of health inequity. Narrative accounts by racialised healthcare users have dominated research in the field but it is equally important to capture the perceptions and practices of professionals to understand how racism operates in healthcare provisioning. This presentation asks: how does racism manifest in the German inpatient healthcare system (hospitals, rehabilitation facilities), and are there areas or phases of healthcare provisioning where racism is observed more frequently? Methods Problem-centred expert interviews (Döringer 2021) with 20 healthcare professionals from medicine, nursing, and therapeutic professions working in hospitals or rehabilitation facilities across three German federal states. Data were analysed using documentary method (Bohnsack 2002). Results Racism occurs widely in German inpatient settings. It manifests both structurally, e.g. in the absence of professional translators for healthcare users with limited German skills, and interpersonally, e.g. in the form of microaggressions and stereotyping but also the witholding of treatment and verbal abuse. Targets of racism are both patients and staff, especially internationally recruited healthcare workers. Respondents thereby identify night shifts, psychiatric settings and the emergency ward as contexts where racism is more likely to occur. The hierarchical nature of and pervasive power asymmetries in hospitals thereby prevent effective interventions against racial discrimination. Conclusions Racism in German healthcare institutions requires multiscalar public health interventions, particularly at the level of the institutions themselves. These include the establishment of a robust and low-threshold complaints structure, spaces for self-reflection for professionals, and mandatory anti-racism training rather than a focus on diversity-sensitive competence. Key messages • In future research approaches, structurally determined reproductions of racism should be investigated using a multi-method approach. • Experiences of powerlessness are reported by both those affected by racism and those professionals who observe racism and should be addressed by the institutions.