TY - JOUR
T1 - "They created a team of almost entirely the people who work and are like them"
T2 - A qualitative study of organisational culture and racialised inequalities among healthcare staff
AU - Woodhead, Charlotte
AU - Stoll, Nkasi
AU - Harwood, Hannah
AU - Alexis, Obrey
AU - Hatch, Stephani
N1 - © 2021 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL (SHIL).
PY - 2022/2/19
Y1 - 2022/2/19
N2 - Racially and ethnically minoritised healthcare staff groups disproportionately experience and witness workplace discrimination from patients, colleagues and managers. This is visible in their under-representation at senior levels and over-representation in disciplinary proceedings and is associated with adversities such as greater depression, anxiety, somatic symptoms, low job satisfaction and sickness absence. In the UK, little progress has been made despite the implementation of measures to tackle racialised inequities in the health services. So, what is it about the health service organisational context which shapes and maintains such inequities, and what role does discrimination, bullying and harassment play? Drawing on qualitative interviews with 48 healthcare staff in London (UK), we identify how micro-level bullying, prejudice, discrimination and harassment behaviours, independently and in combination, exploit and maintain meso-level racialised hierarchies. Within teams, the high diversity-low inclusion dynamic shaped and was perpetuated by in- and outgroup inclusion and exclusion processes (including "insidious dismissal") often employing bullying or microaggressions. These were linked to intersecting factors, such as race, ethnicity, migration, language and religion, and could increase segregation. For racially and ethnically minoritised groups, ingroup maintenance, moving teams or leaving were also ways of coping with organisational inequities. We discuss implications for tackling racialised workplace inequities.
AB - Racially and ethnically minoritised healthcare staff groups disproportionately experience and witness workplace discrimination from patients, colleagues and managers. This is visible in their under-representation at senior levels and over-representation in disciplinary proceedings and is associated with adversities such as greater depression, anxiety, somatic symptoms, low job satisfaction and sickness absence. In the UK, little progress has been made despite the implementation of measures to tackle racialised inequities in the health services. So, what is it about the health service organisational context which shapes and maintains such inequities, and what role does discrimination, bullying and harassment play? Drawing on qualitative interviews with 48 healthcare staff in London (UK), we identify how micro-level bullying, prejudice, discrimination and harassment behaviours, independently and in combination, exploit and maintain meso-level racialised hierarchies. Within teams, the high diversity-low inclusion dynamic shaped and was perpetuated by in- and outgroup inclusion and exclusion processes (including "insidious dismissal") often employing bullying or microaggressions. These were linked to intersecting factors, such as race, ethnicity, migration, language and religion, and could increase segregation. For racially and ethnically minoritised groups, ingroup maintenance, moving teams or leaving were also ways of coping with organisational inequities. We discuss implications for tackling racialised workplace inequities.
KW - Bullying
KW - Delivery of Health Care
KW - Humans
KW - Organizational Culture
KW - Qualitative Research
KW - Workplace
U2 - 10.1111/1467-9566.13414
DO - 10.1111/1467-9566.13414
M3 - Article
C2 - 34866199
SN - 0141-9889
VL - 44
SP - 267
EP - 289
JO - Sociology of Health and Illness
JF - Sociology of Health and Illness
IS - 2
ER -