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Racism: a fundamental driver of racial disparities in health-care quality

Racial disparities in health-care access, quality and outcomes are pervasive and persistent. Racism is a fundamental driver of racial disparities. Individuals and institutions in the health-care system must prioritize addressing racism as their professional responsibility through training, support and inclusion.

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  1. 2018 National Healthcare Quality and Disparities Report. AHRQ. (2019).

  2. Smith, K. A., Gehricke, J.-G., Iadarola, S., Wolfe, A. & Kuhlthau, K. A. Disparities in service use among children with autism: a systematic review. Pediatrics 145, S35–S46 (2020).

    Article  Google Scholar 

  3. Singh, J. A., Lu, X., Rosenthal, G. E., Ibrahim, S. & Cram, P. Racial disparities in knee and hip total joint arthroplasty: an 18-year analysis of national Medicare data. Ann. Rheum. Dis. 73, 2107–2115 (2014).

    Article  Google Scholar 

  4. Lam, M. B. et al. Changes in racial disparities in mortality after cancer surgery in the US, 2007-2016. JAMA Netw. Open 3, e2027415 (2020).

    Article  Google Scholar 

  5. Mateo, C. M. & Williams, D. R. Addressing bias & reducing discrimination: the professional responsibility of healthcare providers. Acad. Med. 95, S5–S10 (2020).

    Article  Google Scholar 

  6. Williams, D. R., Mohammed, S. A., Leavell, J. & Collins, C. Race, socioeconomic status and health: complexities, ongoing challenges and research opportunities. Ann. N. Y. Acad. Sci. 1186, 69–101 (2010).

    Article  Google Scholar 

  7. Mateo, C. M. & Williams, D. R. More than words: a vision to address bias and reduce discrimination in the health professions learning environment. Acad. Med. 95, S169–S177.

  8. Williams, D. R., Lawrence, J. A. & Davis, B. A. Racism and health: evidence and needed research. Annu. Rev. Public Health. 40, 105–125 (2019).

    Article  Google Scholar 

  9. White, K., Haas, J. S. & Williams, D. R. Elucidating the role of place in health care disparities: the example of racial/ethnic residential segregation. Health Serv Res. 43, 1278–1299 (2012).

    Article  Google Scholar 

  10. Boyd, R. W., Lindo, E. G., Weeks, L. D. & McLemore, M. R. On racism: a new standard for publishing on racial health inequities. Health Affairs Blog. (2020).

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Correspondence to David R. Williams.

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Mateo, C.M., Williams, D.R. Racism: a fundamental driver of racial disparities in health-care quality. Nat Rev Dis Primers 7, 20 (2021).

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