How is Racial Discrimination Assessed in Quantitative Health Research? A Systematic Review from a European Perspective

Racial discrimination is a global issue that affects both physical and mental health. However, a comparative study looking at how racial discrimination is assessed in studies focusing on the effect of racial discrimination on overall health is lacking. This systematic review aimed to compare and describe the most commonly used racial discrimination assessment tools and the connection between racial discrimination and overall health. The review was conducted in accordance with the PRISMA-P guidelines and checklist. A total of 70 studies were identified as eligible for inclusion. The methodological quality of the reviewed studies was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies and varied considerably across studies. Most studies were conducted in the USA with only five studies examining European samples. Within these European studies, ethnicity or race was not examined in relation to racial discrimination, but rather in the context of migration and minority status. Longitudinal designs, the use of standardized and validated instruments, and data from national or health-related surveys were rare. Nearly all studies reported positive associations between racial discrimination and adverse health outcomes. Overall, the review suggests that racial discrimination as a health risk has received little attention in European research and is predominantly discussed in the context of migration and integration. The findings further underscore the necessity of including quantitative assessments of racism, using validated questionnaires as an integral part of national and health-related surveys to better understand the significance of racial discrimination for health and obtain representative results that allow meaningful comparisons.