Defining Racial Health Equity (RHE): A Landscape Review of Definitions, Terminology and Related Concepts
2Center for Translational Research, Texas Christian University, USA
3Clinical Research Center, Fundación Valle del Lili, Colombia
4Georgia College and State University, USA
5RTI International, RTI-UNC US Cochrane Affiliate, USA
6School of Epidemiology and Public Health, University of Ottawa,, Canada
7School of Epidemiology and Public Health, University of Ottawa, Canada
8School of Psychology, University of Ottawa, Canada
9Cochrane, USA, USA
Background: Vast gaps in healthcare access exist within the United States, particularly across racial and ethnic groups. Promoting health equity has become a priority of the US government and major health organizations; however, a national consensus on shared definitions of these terms does not yet exist. In this study, we will compile, evaluate, and synthesize “racial health equity” (RHE) definitions via a landscape review. Inclusion criteria will encompass systematic reviews, primary literature, narrative reviews, and healthcare guides that include RHE definitions. Defining RHE is a first step to centering and advancing racial health equity.
Objectives: To evaluate RHE terminology and definitions from key health organizations, primary articles, narrative reviews, and systematic reviews and to compile and synthesize findings to evaluate research gaps and make recommendations for future research.
Methods: We developed a three-part search strategy to encompass RHE definitions. First, definitions of RHE were compiled from major health organizations with relevance to high-income countries. Second, for systematic reviews, we used a comprehensive search strategy in MEDLINE, Psychinfo, the Cochrane Library, and Campbell systematic reviews since 2020. Third, for primary research articles and narrative reviews, we searched MEDLINE, CINAHL, Psychinfo, and the Campbell Collaboration library, with no date restriction. Both systematic search strategies were developed with a research librarian. Study title/abstracts and full texts will be screened by two reviewers and disputes will be resolved by consensus.
Results: Health equity definitions largely differed across healthcare organizations, although some definitions were shared and cited the same original source. Few major healthcare organizations reported explicit definitions of RHE, although it was commonly listed as a priority. Preliminary search results of RHE across primary research articles yielded ~2,500 articles. Search results of systematic reviews identified >7,500 citations.
Conclusions: Defining racial health equity is a first step toward establishing actionable interventions to further research and reduce health inequities. This landscape review is part of a larger research project, funded by the Robert Wood Johnson Foundation, investigating racial health equity in systematic reviews.
Patient, public and/or healthcare consumer involvement: This study and the parent project were reviewed by multiple diverse stakeholders in healthcare.