Addressing racial health inequity: systematic review of systematic reviews
3Bruyere Research Institute, Canada
4University of Ottawa, Canada
5Marymount University, USA
7Georgia College and State University, USA
8Texas Christian University, USA
Background: Racialized populations are affected by the sociopolitical and historical context in which they live. For example, African American and Black people face persistent discrimination and exclusion in the United States. Reducing racism and its negative consequences is a key global priority .
Objectives: Our primary aim is to assess methods to center racial health equity in systematic reviews. Our secondary aim is to describe the evidence base on types of interventions for addressing racial health inequities.
Methods: We developed a theory-based overview of systematic reviews to evaluate methods and map the evidence base from systematic reviews of effectiveness on reducing racial inequities. We use the Dahlgren-Whitehead rainbow model to describe policy entry points to tackle health inequities, and employ a framework for reducing racial inequities to classify types of policies. We used a comprehensive search strategy in MEDLINE, Psychinfo, the Cochrane library and Campbell systematic reviews, designed with a librarian scientist. We included systematic reviews focused on reducing racial health inequity in a high income country setting published in 2020-2022. Two independent reviewers screened studies at the title and abstract and full-text levels. We will collect data and appraise quality in duplicate using a pre-tested form
Results: We screened more than 7,500 titles and abstracts. We identified 433 articles for full-text review. The analysis will summarize methods used to address racial inequity in health, and generate an evidence and gap map of systematic reviews focused on effectiveness of interventions to address systemic and structural racial inequities.
Conclusions: This systematic review and evidence map is part of a larger project, funded by the Robert Wood Johnson Foundation, on centering racial inequity in systematic reviews and will be used to inform a priority-setting exercise to establish the future phases of research to advance knowledge on reducing racial inequity.
Patient, public and/or healthcare consumer involvement: This project has an advisory board which includes people with lived experience of racial inequity. One of the parallel projects is conducting a listening exercise with people with lived experience of inequities which will inform the priority setting phase.