Creating the Healthcare Racial Justice Assessment Tool (HC-RJAT): A Novel Tool to Identify Modifiable Loci of Structural Racism in the Healthcare Setting to Guide Equity-Focused Improvements

Racial and ethnic health inequities are pervasive in the US healthcare system and affect individuals at all stages of life. These inequities are the result of racism and not due to biology. Racism is a multi-level system that embodies institutional, structural, interpersonal, and internalized racism. Racism in the healthcare setting creates hierarchies of power based on the social construct of race that impact opportunity, access, quality, and experiences of minoritized individuals. Most interventions to address health inequity in the healthcare setting target individual-level racism, but this has largely been ineffective in closing the equity gap. Few interventions have been developed to target structural and institutional racism. This may in part be due to a lack of healthcare-specific tools that can identify targets for intervention at the structural and institutional level. In this article, we report the development of the Healthcare Racial Justice Assessment Tool (HC-RJAT), a novel tool specifically designed to identify modifiable loci of structural and institutional racism within the healthcare setting to guide equity-focused interventions.