title: Race matters: perceptions of race and racism in a sickle cell center.
abstract: BACKGROUND
  Health care disparities based on race have been reported in the management of many diseases. Our goal was to identify perceptions of race and racism among both staff and patients/families with particular attention to provider attitudes as a potential contributor to racial healthcare disparities.
  
  
  METHODS
  A confidential survey addressing issues of race and health care was given to all patients with sickle cell disease and their families upon arrival to clinic. The survey was made available online to all staff in the hematology/oncology program. Free text comments were obtained.
  
  
  RESULTS
  We received completed surveys from 112 patients/families. Surveys were completed by 135 of 158 staff members (85% return rate). The majority (92.6%) of patients/families identified as black, while 94.1% of staff identified as white (P < 0.001). More patients/families felt that race affects the quality of health care for sickle cell patients (50% vs. 31.6%, P = 0.003). More staff perceived unequal treatment of patients, especially in the inpatient setting (20.9% vs. 10.9%, P = 0.03).
  
  
  CONCLUSIONS
  Provider attitudes contribute to continued racial health care disparities. We propose training health care providers on issues of race and racism. Training should provide critical thinking tools for improving medical providers' comfort and skills in caring for patients who are of a different race than their own.
authors.affiliation: Pediatric Hematology, Children's Hospitals and Clinics of Minnesota, Minneapolis and St. Paul, Minnesota 55405, USA. stephen.nelson@childrensmn.org
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Nelson
authors.forename: Heather W
authors.initials: HW
authors.lastname: Hackman
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000208:ethnology*; D002648:Child; D005190:Family; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010564:Personnel, Hospital; D063505:Racism; D055815:Young Adult