Evidence map›Paper›PMID 42656014›Full record

ArticleNursing open2026

Structural Racism in Healthcare: Nurses' Ethical and Professional Responsibility to Lead Structural Reform.

Chanchal Kurup, Deepa Rijal

Abstract read
In one paragraph

Article in Nursing open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Chanchal KurupSchool of Nursing, Midwifery and Social Sciences, Norman Gardens, Queensland, Australia.ORCID https://orcid.org/0000-0003-0526-2539
Deepa RijalSchool of Nursing, Midwifery and Social Sciences, Norman Gardens, Queensland, Australia.ORCID https://orcid.org/0000-0002-0618-9305

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStructural racism remains a pervasive and deeply embedded determinant of healthcare inequity globally. Despite strengthened professional standards and policy commitments to equity, racialised populations continue to experience substantial disparities in healthcare access, quality, safety and outcomes. These inequities are sustained not only through interpersonal encounters but also through structural conditions embedded within healthcare systems, workforce arrangements, governance processes and organisational cultures. Structural racism additionally affects nurses' wellbeing, workforce sustainability, psychological safety and professional progression, creating implications for both patient outcomes and healthcare system functioning.

aimTo articulate an evidence-informed position that addressing structural racism in healthcare is a moral, ethical and professional responsibility of nurses, and to propose a conceptual framework positioning nurses as leaders of structural reform, governance accountability and equity-driven healthcare transformation.

designPosition paper drawing on interdisciplinary empirical evidence, ethical frameworks, workforce literature and contemporary nursing scholarship. DISCUSSION: This paper introduces the NSERF, which conceptualises structural racism as a multidimensional patient safety, workforce sustainability and governance accountability issue requiring coordinated nurse-led structural advocacy and institutional reform. Structural racism is shown to operate through interconnected systems including healthcare policy, workforce structures, organisational governance, clinical practice and professional hierarchies, contributing to inequitable access to care, workforce exclusion, reduced psychological safety, burnout and poorer health outcomes. While nursing advocacy has historically focused on individual patient protection, this paper argues that structural advocacy is necessary to address systemic inequities embedded within institutional systems. Strategic reform directions include governance accountability, equity-integrated clinical governance, workforce equity, structural competency education and policy engagement.

conclusionStructural racism compromises healthcare equity, patient safety, workforce sustainability and organisational trust. Nurses possess an ethical mandate, professional authority and practice-informed insight to lead structural reform. Moving beyond interpersonal advocacy towards sustained structural advocacy is essential for developing equitable, culturally safe, accountable and sustainable healthcare systems.

Indexed as

Ethics, NursingNurse's RoleRacismSystemic RacismAntiracismHealthcare DisparitiesHumansculturally safe caregovernance accountabilityhealthcare inequitynursing leadershiporganisational reformpatient safetystructural advocacystructural racismworkforce equity

Identifiers

PMID42656014
PMCPMC13519522

What Socratic holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.