By UHN Research Communications
Researchers at UHN's KITE Research Institute have found that racial biases in traumatic brain injury rehabilitation research could be harming Black patients, who are disproportionately affected by this condition.
Traumatic brain injury (TBI) is one of the most severe forms of injury, affecting about 70 million people globally every year. It can often cause long-lasting or permanent damage to the brain, impacting memory, movement and behaviour.
Recent research has revealed that Black individuals with TBI often face greater challenges in recovery, including limited access to quality care and higher rates of complications.
While current research looks at how TBI recovery varies by race, it often overlooks how racism within the health care system impacts rehabilitation care.
To address this, Dr. Samira Omar — who works in the Acquired Brain Injury Lab led by KITE Senior Scientist Dr. Angela Colantonio, Dr. Charmaine Williams, professor and Dean of the Factor-Inwentash Faculty of Social Work at the University of Toronto (U of T), and Dr. Laura Beth Bugg, professor and Director of the University of California, Santa Cruz Global and Community Health Program — reviewed over 43 studies on race, the TBI clinical care journey, and Black populations to identify common practices that could ultimately lead to unequal care for Black patients.
Using the critical race theory — a framework that explores how racism is embedded in systems and policies — the team analyzed the methods, findings and interpretations of these studies.
"Critical race theory allows us to uncover how racism influences every aspect of TBI research, from methods and analyses to interpretations and conclusions," says Dr. Omar, PhD graduate and first author of the study, whose doctoral thesis is one of several studies published from this writing.
"This approach helps us rethink and improve rehabilitation practices to ensure they better serve Black individuals with TBI," she says.
The research team found that racial biases are often present in TBI rehabilitation research. These studies often ignore the impact of race, assume everyone has equal access to resources and reinforce perspectives that overlook the unique challenges that Black patients experience.
"This shift is about ensuring that rehabilitation is equitable for everyone, especially those who have been historically underserved," concludes Dr. Colantonio, who serves as the Director of the Rehabilitation Sciences Institute at U of T.
Dr. Colantonio is also a professor in the Department of Occupational Science and Occupational Therapy and the Dalla Lana School of Public Health and holds a Canada Research Chair in Traumatic Brain Injury in Underserved Populations.
The study calls for a shift in how rehabilitation research and practice addresses race and racism. By developing anti-racist research, improving training for health care workers, and engaging more with Black communities, rehabilitation programs can be more inclusive and effective.
This work was supported by UHN Foundation, the Ontario Ministry of Health, the University of Toronto, Canada Research Chairs Program, Toronto Rehabilitation Institute, the Heart & Stroke Foundation, Brain Canada, and the Canadian Institutes of Health Research Institute of Circulatory and Respiratory Health.
