Barriers to healthcare for racialised populations in Europe: a scoping review of reviews

欧洲少数族裔群体获得医疗保健的障碍:一项综述的范围界定

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Abstract

BACKGROUND: Racism is a significant barrier to equitable healthcare, yet it remains under-researched in Europe. Barriers across various stages of the healthcare process limit the equitable realisation of the right to health for racialised populations. This review synthesises existing literature on the barriers to healthcare faced by racialised populations in Europe. METHODS: We conducted a scoping review of reviews to identify barriers to healthcare for racialised populations in Europe. We systematically searched across four databases (PubMed, Scopus, Web of Science, and PsycINFO) for review articles published from January 2010 to September 2024. We obtained data from 30 eligible reviews and classified them according to the dimensions of healthcare access. RESULTS: Our review identified multiple, interrelated barriers across the dimensions of availability, accessibility, acceptability, and quality. Key barriers include insufficient interpretation and intercultural mediation services, complex and restrictive administrative procedures, economic costs, and cultural insensitivity in clinical practices. Racialised individuals also reported experiencing interpersonal racism and stereotypes, which affected their healthcare experiences and outcomes. The review highlights a significant lack of cultural competence among healthcare professionals, as well as inadequate adaptation of services to meet the needs of diverse populations. Additionally, we identified legal and administrative barriers, particularly for undocumented migrants, as crucial obstacles. CONCLUSIONS: Our findings underscore the need for systemic changes to address the structural racism that limits equitable access to European healthcare systems. There is a critical need for racism-reflexive healthcare, with culturally competent healthcare services, improved training for healthcare professionals, and resources adapted to the needs of a diverse population. Additionally, research should focus on the experiences of racialised populations in under-researched settings, such as primary care, as well as on racialised populations beyond the most vulnerable. This review calls for health policies that ensure the effective exercise of the right to health for all individuals, regardless of their racial or ethnic background. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12939-025-02577-1.

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