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Healthcare staff's racialized talk: The perpetuation of racism in healthcare
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Department of Ethnology, History of Religion and Gender Studies, Stockholm University, Stockholm, Sweden.ORCID iD: 0000-0001-8547-8772
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.ORCID iD: 0000-0002-0664-1170
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.ORCID iD: 0000-0002-1962-410x
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Skaraborg Institute for Research and Development, Skövde, Sweden.ORCID iD: 0000-0003-1670-2843
2024 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 355, article id 117085Article in journal (Refereed) Published
Abstract [en]

Research points to the existence of racial bias and beliefs among healthcare staff but does not explicate accounts of racialization in healthcare and the day-to-day utterances that have racializing effects excluding minoritized users' right to care. This study understands racism as structural and embedded in societies and institutions, including healthcare, as well as in interactions and talk. Through excavating accounts of healthcare staff's talk that devalues minoritized users, this study posits talk as reflective and constitutive of the dominant structure of racism within which it is situated. Drawing on qualitative interviews with 58 staff in Sweden, the study delineates three categories through which racialized talk differentiates between minoritized and majoritized users. These are: Characterizing minoritized users as ‘bad’ users, Characterizing minoritized users' health complaints as unworthy and finally, Devaluing minoritized users as justification for suboptimal and differential care. Healthcare staff accounts show that continuous racialization of minoritized users maintains existing power-relations representing Western users as civilized and non-Western users as uncivilized and problematic. Through reiteration, these practices of exclusion become invisible, normalized, and assume the status quo. It is imperative to address racialization as it has implications for the core ethics of healthcare.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 355, article id 117085
Keywords [en]
racialization, racism, healthcare, healthcare staff, Sweden
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-488467DOI: 10.1016/j.socscimed.2024.117085ISI: 001275410400001PubMedID: 39032198Scopus ID: 2-s2.0-85198968581OAI: oai:DiVA.org:uu-488467DiVA, id: diva2:1711218
Part of project
Understanding racism in healthcare: Developing and implementing anti-racist strategies through shared knowledge production and evaluation, Swedish Research Council
Funder
Swedish Research Council, 2016-04078Available from: 2022-11-16 Created: 2022-11-16 Last updated: 2025-09-02Bibliographically approved
In thesis
1. Healthcare Staff's Racialised talk: Examining Accounts of Racialisation in Healthcare
Open this publication in new window or tab >>Healthcare Staff's Racialised talk: Examining Accounts of Racialisation in Healthcare
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis contributes to the literature on racism in healthcare and the scholarship on racism and racialisation by moving the current focus of healthcare literature from demonstrating the existence of racism to examining accounts of racialisation through analysing healthcare staff’s racialised talk. Drawing from critical ‘race’ and postcolonial theories, the thesis departs from the premise that racism is a structural phenomenon embedded in nation states and institutions, including healthcare across the globe. Through a scoping review ofstudies on racism in healthcare, this thesis maintains that the current literature does not conceptualise racism as structural, and does not attempt to uncover accounts of racialisation. The review argues that the trends uncovered are part of why racism continues to reproduce itself in healthcare, despite equality regulations and policy makers’ efforts to eradicate racism. The thesis posits racialisationas a process situated within the sociohistorical playing out of colonial domination, where in groups of people are stratified somatically and culturally within groups of subordination and supraordination. Societies, institutions, and interactions are viewed as racialised such that an analysis ofracialised talk captures the seemingly subtle racialisation intrinsic tohealthcare. Analytically, the excavation of racialised talk regards talk as reflective and constitutive of the dominant structures within which talk is situated. Drawing on qualitative interviews with 58 healthcare staff in Sweden, the thesis examines how healthcare staff’s racialised talk is used to devalue minority healthcare users and obfuscate racism. The findings of this thesis contradict previous characterisations of racism in today’s society as covert. Racialised talk against minority healthcare users is found to be overt and used to categorise minority users as ‘bad’ users and their health complaints as ‘unworthy’ by labeling symptoms as ‘ethnic’, ‘cultural’ or ‘functional’. The devaluingof minority healthcare users through talk further justifies differential and suboptimal care. Besides demonstrating that racialised talk in healthcare is overt, this thesis proposes that by emphasising healthcare neutrality and equality regulations, blaming minorities for racism, viewing racism as an individual aberration, locating racism outside both national and institutional contexts, healthcare staff manage (albeit inadvertently) to obfuscate racism. It is suggested that obfuscation of racism may serve to allow racism to be perpetuated, resulting in a culture of resignation, where resistance to racism isnegligible.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2022. p. 111
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 204
Keywords
Racism, racialisation, racialised talk, healthcare, healthcare staff, critical ’race’ theory, postcolonial theory, Sweden
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:uu:diva-488470 (URN)978-91-513-1659-8 (ISBN)
Public defence
2023-01-23, Humanistiska teatern, Thunbergsvägen 3C, Uppsala, 10:15 (English)
Opponent
Supervisors
Available from: 2022-12-16 Created: 2022-11-17 Last updated: 2022-12-16

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Hamed, SarahBradby, HannahThapar-Björkert, SuruchiAhlberg, Beth Maina

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