Anti-Racist Practices in Health Care Organizations-A Qualitative Analysis

A considerable body of evidence shows significant racial inequities in health and health care, affecting access, care and treatment for patients, as well as the wellbeing of employees. Many hospitals and health care organizations have committed to anti-racist change within their systems. Still, there is limited systematic knowledge regarding organizational anti-racist practices, the conditions under which they can be implemented successfully and their effectiveness. This research aims to identify anti-racist practices within health care organizations with a special focus on three areas: (1) increasing workforce diversity, (2) reducing racial health disparities and (3) responding to discriminatory behavior. Moreover, the role of different stakeholders in implementing anti-racist change will be analyzed, as well as the challenges organizations have encountered and strategies they have utilized to implement change.

Primary (n = 11) and secondary qualitative data (n = 26) were used to gain insights from anti-racism diversity experts and health equity officers within organizations across the US in the beginning of 2024. A qualitative content analysis was used to identify anti-racist practices in organizations.

Findings reveal a broad range of anti-racist practices in use across these organizations. These practices include (1) collecting patient and staff data, (2) actively normalizing and implementing anti-racist work standards and guidelines, (3) developing organizational policies and tools to address racism, (4) creating accountability procedures for addressing racist behavior and (5) building safe and culturally appropriate spaces for racialized communities. By embedding a structural anti-racist lens across these organizations, stakeholders acknowledge their role in (past) harms and commit to addressing disparities in health care and creating a vision for health equity.

The identification of anti-racist practices makes solutions visible to a broader audience and identifies the potential influence and responsibility each stakeholder in health care has to address racism. In order to apply these practices to other health care organizations, there is a need to rigorously evaluate the interventions and analyze their effectiveness.