*5.6. The Perspectives of Health Professionals and Patients on Racism in Healthcare: A Qualitative Systematic Review*

A qualitative systematic review of 23 articles, with a total of 1006 participants across the articles, looked at the perspectives of professionals and patients on racism. The authors found that healthcare providers perpetuated racism due to their unconscious (and sometimes conscious) biases toward patients. For example, providers professed less empathy toward racialized minority patients because they were less able to connect with patients of a different race than themselves, yet they often shifted blame for health disparities on minority patients behaviours as opposed to racism. The authors also found two major themes, generated through interviews with racialized minorities. These were: (1) alienation of minorities due to racial supremacism and lack of empathy, resulting in inadequate medical treatment; and (2) labelling of minority patients who were stereotyped as belonging to a lower socio-economic class and having negative behaviors. The findings of this study support the notion that experiences of racism in healthcare interactions contributes to inadequate medical service and treatment for racialized minorities, which can then lead to poor health outcomes [31].

#### *5.7. Perceived Racism and Mental Health among Black American Adults: A Meta-Analytic Review*

A meta-analytic review of perceived racism and mental health among Black Americans found that perceived racism is associated with poor physical and mental health outcomes [32]. The authors focused on this group because they report more incidents of racism than other racialized minorities. Pieterse et al. (2012) systematically reviewed 66 studies with total sample size of 18,140 across studies. Using a random effects model, the authors found a positive association between perceived racism and psychological distress (r = 0.20). As exposure to and appraised stressfulness of racist events increased, so did the likelihood of reporting mental distress. Moreover, effects for psychiatric symptoms and general distress were stronger than effects for life satisfaction and self-esteem. Thus, these

findings support the notion that racism ought to be viewed within the context of trauma in the field of mental health [32].
