Purpose: Racial minoritized children and youth with acquired brain injury (ABI) often experience multiple forms of discrimination. The purpose of this systematic review was to understand the racial disparities in health care among children and youth with ABI and their caregivers.
Method: Six international databases (Ovid Medline, Embase, Healthstar, Psychinfo, Scopus, and Web of Science) were systematically searched for peer-reviewed articles. Studies were screened by two researchers who also conducted the data extraction and quality appraisal. A narrative synthesis approach was used to analyze the data.
Results: Of the 8081 studies identified in the search, 34 met the inclusion criteria, which involved 838,052 children and youth with brain injuries (or caregivers representing them) across two countries. The following themes were noted in the studies in our review: (1) racial disparities in accessing care (i.e., diagnosis, hospital admission, length of stay, rehabilitation treatment); (2) racial disparities in ABI-related health outcomes (i.e., functional outcomes and mortality rates); and (3) factors affecting racial disparities (i.e., sources in injury, insurance and expenditures, and intersectionality).
Conclusions: Our findings reveal the concerning racial disparities among children and youth with ABI. Further research should explore solutions for addressing such racial disparities and solutions to address them.
Keywords: Access to care; brain injury; discrimination; inequities; racism; youth.
Racial minoritized youth with acquired brain injury experience many barriers and inequalities in accessing care and health care leaders should help to address such gaps and disparities in the health system.Clinicians should familiarize themselves with the common factors affecting racial disparities in acquired brain injury outcomes including sources of injury, types of insurance and cultural factors.Additional training in working with patients from racially diverse backgrounds and in providing culturally appropriate care among healthcare providers is needed.More efforts are needed to address racial disparities at the individual and structural levels that continue to exist in rehabilitation services for children and youth with acquired brain injury.