Live Presentation
Speak with Emily Cranston about her practicum on January 31st from 3:30-4:00pm via this zoom link.
Video Presentation
View Emily Cranston's poster presentation in this video recording:
Abstract
Structural racism refers to the ubiquity, history, and ongoing reinforcement of racism within society due to discriminatory systems and inequitable distribution of key resources at every level of government and within every sector of society. There is a limited understanding of effective interventions or policy initiatives to increase racial health equities. We conducted a systematic review of structural interventions implemented in OECD countries that report on racial inequities in population health outcomes.
A broad search of EBSCO Medline, the Campbell Library of Systematic Reviews, Google Scholar, and grey literature using search terms related to race and racism was completed before the start of this practicum. After removing 100 duplicates, 25,875 references were eligible for evaluation. After screening titles and abstracts, 740 full texts were reviewed and a total of 29 articles were selected for inclusion. Two independent reviewers appraised each article for quality and extracted data on policy sector, population, intervention, and outcomes. Findings were synthesized descriptively due to the heterogenous nature of included studies.
Most studies were quasi-experimental or natural experiments. Nineteen of the included studies explicitly stated their objectives were to evaluate differential effects of interventions by race, the remaining 10 only conducted sub-group analyses by race as part of an evaluation of the general population. Evaluated interventions included supplemental income programs, minimum wage policies, nutrition safeguard programs, immigration-related policies, and reproductive and family-based policies.
Study findings were mixed within each intervention policy domain. Financial and nutrition safeguard interventions saw statistically significant improvements for some behavioural, gestational, and long-term health outcomes for some populations of interest. Studies of restrictive immigration policies found statistically significant associations with poor mental health and food insecurity for affected populations.
Overall, we found limited focus on structural interventions as they differentially affect health outcomes by race. The studies included in this systematic review had methodological limitations. The effects of the interventions studied were challenging to determine as racism affects outcomes for included populations beyond the scope of the intervention. Further research is needed to guide policy development to build racial health equity.