Racial/Ethnic Inequities in Healthcare-associated Infections Under the Shadow of Structural Racism: Narrative Review and Call to Action

Jiabi Chen, Rohan Khazanchi, Gonzalo Bearman, Jasmine R. Marcelin

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


Purpose of Review: The purpose of this study is to review racial and ethnic inequities in the incidence and prevention of healthcare-associated infections (HAIs) in the USA, identify gaps in the literature, and recommend future directions to mitigate these inequities. Recent Findings: While some existing literature has identified the presence of racial/ethnic inequities in HAI incidence and outcomes, few studies to date have evaluated whether HAI prevention efforts have mitigated these inequities. Factors contributing to inequities in HAI prevention may include unconscious bias of healthcare professionals towards minoritized patients; socioeconomic and structural inequities disparately affecting minoritized communities; the racial segregation of quality healthcare through hospital price discrimination; divergent reimbursement rates between public and private insurers; policies or performance metrics which underfund and financially penalize safety-net hospitals; and insufficient research evaluating and addressing HAI inequities. Summary: Expansion of the literature is needed to further interrogate root causes and evaluate the impact of interventions on racial/ethnic inequities in HAI incidence. Measures to mitigate inequities might include teaching healthcare workers how to recognize and mitigate unconscious biases, expanding community resources which address the social and structural determinants of health, increasing access to preventive health services, reforming federal and institutional policies to better support safety-net hospitals and disincentivize price discrimination, and improving diversity and inclusion within the health workforce.

Original languageEnglish (US)
Article number17
JournalCurrent Infectious Disease Reports
Issue number10
StatePublished - Oct 2021


  • Health policy
  • Healthcare-associated infections (HAIs)
  • Racial/ethnic disparities
  • Social determinants of health
  • Structural racism

ASJC Scopus subject areas

  • Infectious Diseases


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