Centering racial health equity in systematic reviews paper 3: a systematic review of definitions for "racial health equity" and related terms within health-related articles

Elizabeth A Terhune; Mahederemariam Bayleyegn Dagne; Christi Piper; Ana B Pizarro; Miriam Barsoum; Anita Rizvi; Damian K Francis; Meera Viswanathan; Nila A Sathe; Vivian Welch; Tiffany Duque; Dru Riddle; Robert W Turner 2nd; Tamara A Baker; Patricia C Heyn

doi:10.1016/j.jclinepi.2024.111580

Centering racial health equity in systematic reviews paper 3: a systematic review of definitions for "racial health equity" and related terms within health-related articles

J Clin Epidemiol. 2024 Oct 28:176:111580. doi: 10.1016/j.jclinepi.2024.111580. Online ahead of print.

Authors

Affiliations

¹ Center for Optimal Aging, Marymount University, Arlington, VA, USA.
² Strauss Health Sciences Library, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
³ Clinical Research Center, Fundación Valle del Lili, Cali, Colombia.
⁴ School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
⁵ School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA.
⁶ RTI International, Research Triangle Park, NC, USA; RTI International-University of North Carolina Evidence-Based Practice Center US Cochrane Affiliate, Research Triangle Park, NC, USA.
⁷ Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
⁸ Cochrane, Central Executive Team, London, UK.
⁹ Center for Translational Research, Texas Christian University, Fort Worth, TX, USA.
¹⁰ Department of Population Health Sciences, Duke Aging Center, Duke University School of Medicine, Durham, NC, USA.
¹¹ Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
¹² Center for Optimal Aging, Marymount University, Arlington, VA, USA. Electronic address: Patricia.Heyn@Marymount.edu.

PMID: 39490593
DOI: 10.1016/j.jclinepi.2024.111580

Abstract

Objectives: To systematically evaluate definitions of "racial health equity" (RHE) and related terms within health-related academic literature.

Study design and setting: We systematically evaluated definitions of RHE and related terms within health-related academic articles. Articles published in English were included, and no date restrictions were imposed.

Results: We found 20 original articles containing relevant definitions out of 1816 retrieved articles, thirteen of which were published from 2020 to 2023. Themes used in the definitions varied; racism (n = 12) and quality of healthcare (n = 10) were the most common. Additional themes, including social hierarchy or marginalization, discrimination, justice, unmet social needs, and historical events were described within some definitions. Eleven of the included manuscripts defined race as a social construct.

Conclusion: This study depicts RHE as an emerging concept with limited consensus on racism, quality of health, and social determinants of health as important underlying frameworks. To center equity efforts and actions under a workable and shared vision, we recommend continued discussions regarding underlying meanings of RHE concepts and propose establishing a definition that promotes unity across health fields and prevents ambiguity.

Keywords: Definitions; Disparities; Health equality; Health inequity; Mapping; Racial health equity; Terminology.