The pervasiveness of racism in healthcare facilities in Latin America: a scoping review.

Abstract

Racism in healthcare facilities across Latin America systematically affects Indigenous, Afrodescendant, and migrant populations. Yet, no comprehensive synthesis has mapped its scope across different populations, healthcare settings, and countries in the region. This scoping review followed PRISMA guidelines and searched PubMed, EBSCOhost, and EMBASE for peer-reviewed studies published between January 2015 and June 2025. We included studies addressing racism in healthcare facilities where clinical encounters between populations and healthcare workers occur. Data were charted using AI-assisted tools and analyzed thematically. We retained 70 studies from 15 countries, predominantly Brazil (n = 30) and Mexico (n = 14). Racism manifested through three interconnected forms: institutional racism (policies restricting access, absence of data reflecting ethnic identification and racialization processes, resource inequities), personally mediated racism (verbal abuse, physical mistreatment, denial of culturally appropriate care), and internalized racism (self-devaluation, acceptance of mistreatment). These forms of discrimination pervade multiple medical fields, including maternal and reproductive health, mental health services, dental care, chronic disease management, infectious disease treatment, and emergency care. Racialized populations experience delayed diagnoses, inadequate treatment protocols, and systematic exclusion from preventive care. Language barriers, cultural dismissal, and discriminatory triage decisions compound these inequities. Intersectional marginalization based on gender, class, migration status, and sexuality amplifies these effects, producing multiplicative rather than additive health impacts. Achieving health equity requires dismantling institutional racism through meaningful community participation in healthcare governance, mandatory collection of ethno-local data-population descriptors reflecting local ethnic identification and racialization processes-integration of anti-racist and decolonial frameworks in medical education, legal accountability mechanisms, and recognition of racism as a fundamental determinant of health. Interventions targeting only individual bias will fail without addressing structural transformation.