Pain, mistrust, misdiagnosis: How racism jeopardizes healthcare

• The analysis of 800 online reports shows that racism in the health care system is not an isolated case.
• Health complaints are sometimes not taken seriously or misjudged.
• As a result, mistrust of healthcare is growing.

Racist experiences in the health care system are not an isolated case - this is what researchers from the Chair of Health Care Research at Witten/Herdecke University (UW/H) have discovered. They analysed around 800 posts on various review platforms such as jameda.de and klinikbewertungen.de as well as on YouTube and TikTok. The posts were analysed both quantitatively according to frequently mentioned topics and qualitatively according to their content and emotional experiences.

Discrimination based on language and origin

Patients reported discrimination based on language and origin particularly frequently. In some cases, communication problems led to complaints not being taken seriously or being misjudged - with consequences for diagnosis and treatment.

Other recurring themes were

• racist stereotypes that influenced treatment decisions
• lack of cultural sensitivity in dealing with patients

• mistrust in the entire healthcare system as a result of experiences of discrimination

   

Emotional reports make the extent visible

The intensity of many posts was striking for the researchers. Although the number of posts and comments on racism in the health care system was lower overall than for other health topics, such as cancer prevention or the COVID-19 pandemic, the published reports of experiences were often particularly detailed and emotional.

"People describe their experiences in great detail - apparently also because they are otherwise rarely heard," says Dr Tuğba Aksakal, academic staff member at the Chair of Health Care Research. "These reports also show the extent to which discrimination can shake trust in the healthcare system."

More diversity and clear anti-discrimination structures needed

The study also shows that discrimination does not only occur on a personal level. Institutional and structural factors also play a role - for example, when patients do not understand important information due to a lack of interpreting services, when forms and information sheets are only available in German or when cultural differences are not taken into account in everyday medical practice. Such structures can lead to people being less well informed and therefore disadvantaged.

The researchers derive several recommendations from their findings:

• mandatory training on intercultural competence for healthcare professionals
• transparent anti-discrimination guidelines and complaints procedures
• more diversity in management positions in the health care system

These measures could help to reduce prejudice and improve care for all patients.

Further information: The study was conducted in the context of the project "Racism in the Health Care System" (RiGeV), funded by the Federal Ministry of Research, Technology and Space (BMFTR). RiGeV is a joint project that aims to analyse racism in the German healthcare system from various perspectives. Recommendations for action to reduce racism in healthcare were developed. They are based on the results of all sub-projects and are aimed in particular at managers and those responsible in inpatient healthcare facilities. The recommendations are available to download online: https://zenodo.org/records/18957444

You can also find more information about the project here: www.uni-wh.de/rigev