Racial Discrimination and Race-Based Biases on Orthopedic-Related Outcomes: An Integrative Review

Area of Science:

• Orthopaedics
• Health Disparities Research
• Sociology of Health

Background:

• Musculoskeletal diseases cause significant functional limitations and debility.
• Health disparities in musculoskeletal disease burden exist across racial and ethnic groups.
• Racial discrimination is a key driver of these health disparities, as identified by the National Academy of Medicine.

Purpose of the Study:

• To review and synthesize evidence on the impact of racial discrimination and biases on orthopaedic outcomes.
• To explore the relationship between implicit and explicit biases (racial, gender, appearance) and musculoskeletal health.

Main Methods:

• An integrative review methodology was employed.
• Nine studies meeting specific inclusion criteria were analyzed.
• The review synthesized findings across diverse orthopaedic outcomes.

Main Results:

• Experiences of racial discrimination are linked to poorer orthopaedic outcomes in minority populations.
• Race-based implicit biases and other biases (e.g., gender, appearance) contribute to these negative outcomes.
• Specific outcomes studied include osteoarthritis, rheumatoid arthritis, low back pain, pain tolerance, disability, and total knee arthroplasty recommendations.

Conclusions:

• Racial discrimination and biases significantly worsen orthopaedic-related health outcomes for minority groups.
• Orthopaedic nurses have a critical role in mitigating these disparities.
• Targeted interventions are needed to address bias in orthopaedic care delivery.