Migrants and Healthcare: A Complex Landscape
Racism is a recognized social factor impacting health outcomes and access to healthcare. However, research on its specific impact on racialized migrants in Europe is surprisingly scarce. This new scoping review aims to bridge this gap by mapping existing research, identifying areas requiring further investigation, and paving the way for future studies on racism in European healthcare settings for migrants.
Sifting Through the Evidence: A Methodological Approach
Following established guidelines (PRISMA), researchers searched four major databases for relevant studies published in English between 1992 and 2022. The focus was on empirical studies exploring experiences and impacts of racial and ethnic discrimination faced by racialized migrants within European healthcare systems. The review then summarized these studies based on factors like geographical scope, research design, specific research questions, and the methods used to measure outcomes.
A Startling Scarcity: Gaps in Existing Research
The review identified a significant gap in existing research. Despite an initial search yielding over 2,300 results, only 38 studies met the inclusion criteria. This highlights a critical lack of evidence on racism in healthcare for migrants across many European countries and healthcare settings.
Furthermore, the review found that most existing research uses an exploratory qualitative design, focusing on individual experiences. This limits the ability to compare findings across studies and generalize the results to broader populations.
Another key finding is the overwhelming focus on interpersonal racism, meaning instances of bias exhibited by individual healthcare providers. This leaves a significant blind spot regarding institutional and structural racism, which refers to discriminatory policies and practices within healthcare systems themselves.
The Hydra of Racism: Manifestations and Impacts
By synthesizing the existing research, the review identified three key ways racism manifests in European healthcare, impacting the quality of care received by migrants:
- General Anti-Migration Bias: This refers to negative attitudes towards migrants held by some healthcare personnel, potentially influencing their interactions with migrant patients.
- Health- and Healthcare-Related Prejudice: This encompasses stereotypes about migrants’ health status or behaviors, leading to assumptions or judgements that can negatively impact clinical decision-making.
- Differential Medical Treatment: This is the most concerning manifestation, where migrants experience unequal treatment compared to non-migrant patients, potentially leading to poorer health outcomes.
A Call to Action: Charting the Path Forward
This review underscores the critical role racism plays in perpetuating inequities in healthcare access and quality for racialized migrants in Europe. It highlights the urgent need for further research to:
- Expand the Geographical Scope: Studies are needed from a wider range of European countries to understand the nuances of racism within different healthcare systems.
- Diversify Healthcare Settings: Research should explore racism across various healthcare settings, from primary care to specialist services.
- Include Diverse Migrant Populations: Studies need to consider the experiences of different migrant groups, as experiences of racism can vary based on ethnicity, national origin, and legal status.
The review also emphasizes the importance of moving beyond individual-level racism and incorporating the influence of institutional and structural factors. Additionally, drawing insights from other disciplines like sociology and history can provide a richer understanding of racism within the context of broader social, political, and economic structures.
By addressing these research gaps and employing a more comprehensive approach, future studies can shed light on the complex interplay between racism and migrant health in Europe. This knowledge will be invaluable in developing strategies to dismantle discriminatory practices and ensure equitable access to quality healthcare for all.