Blog Post

Using an Anti-Racist Approach To Address Patient Social Needs

LDI Researchers Develop A New Framework To Guide Health Systems

March 27, 2024

By:

Kaday Kamara, MPH

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In response to growing health inequities driven by social determinants of health, such as food insecurity and housing instability, many pediatric and adult health systems have implemented interventions aimed at addressing patients’ and families’ social risks and needs.

For these interventions to be equitable and beneficial to patients, they must be grounded in an antiracist approach. An antiracist approach recognizes how policies and practices can promote or combat racism, and then deliberately designs and implements policies to create and sustain racial equity.

LDI Senior Fellows Aditi Vasan and George Dalembert, and colleague Arvin Garg, developed a useful framework to aid health systems in considering structural, institutional, interpersonal, and internalized racism in their social care programs and policies.

Structural racism includes societal factors that systematically disadvantage individuals from minoritized groups and can pose challenges when addressing social needs. For example, government benefit programs are often particularly difficult to navigate for individuals who are from minoritized backgrounds or speak languages other than English, and this may exacerbate inequities in access to benefits even when referrals to these programs are made equitably.
Institutional racism occurs within health systems, particularly through patient-facing policies. These policies can lead to inequitable access to health care services and social care programs, perpetuating disparities in healthcare access and quality.
Interpersonal racism occurs between individuals and often stems from implicit and explicit biases. Clinicians and staff members hold conscious and unconscious biases that can impact who they screen for social needs, how they conduct that screening, and how they respond to positive screens, including which patients they ultimately refer to resources.
Internalized Racism relates to an individual’s acceptance of racist narratives regarding their own worth and abilities. Social care interventions should use a strengths-based focus that normalizes needs and focuses on providing care and support aligned with families’ priorities, rather than solely highlighting the challenges these families face.

Racism at all levels must be identified as a root cause of social risk and a key factor in determining access to support; otherwise, social care interventions will fall short. Improving health outcomes for marginalized patients, families, and communities requires health systems to target the racist structures and policies driving inequities in health.

The study, “An Antiracist Approach to Social Care Integration,” was published in Pediatrics on December 7, 2023. Authors include Aditi Vasan, George Dalembert, and Arvin Garg.