In recent years, the challenge of ensuring equitable access to healthcare among racialised populations in Europe has captured the attention of policymakers, healthcare providers, and social scientists alike. A groundbreaking scoping review of reviews, authored by González-Rábago, Lanborena, and Rodríguez-Álvarez and published in the International Journal for Equity in Health in 2025, delves into the multifaceted barriers that racialised communities face when attempting to navigate European healthcare systems. This comprehensive synthesis highlights systemic, socio-economic, and cultural obstacles that impede medical access and delivery for these communities, ultimately exacerbating health disparities across the continent.
The study emerges against a backdrop of growing diversity in Europe, where increased migration and demographic shifts have intensified the need for inclusive healthcare frameworks. Despite policy commitments made by European Union member states and other national governments aimed at reducing health inequities, racialised groups—which include migrants, ethnic minorities, and individuals discriminated against based on skin color or cultural identity—continue to experience disproportionate challenges when seeking medical care. The scoping review meticulously examines these persistent issues by analyzing a wide range of literature, offering a panoramic view of the structural and individual-level barriers that undermine healthcare equity.
Central to the authors’ analysis is the recognition that barriers to healthcare are not merely a consequence of isolated factors but are intricately intertwined within broader social determinants of health. Economic insecurity, precarious employment, housing instability, and educational disparities create a web of disadvantage that compounds the difficulties racialised individuals face in accessing timely and appropriate healthcare. Moreover, these social determinants intersect with institutional challenges such as inadequate translation services, cultural insensitivity, and implicit biases within healthcare institutions, systematically marginalising racialised patients.
An especially salient finding of the review is the role of healthcare providers’ attitudes and cultural competencies in shaping access outcomes. Implicit racial biases, whether conscious or unconscious, among medical professionals can significantly affect the quality of care delivered. Studies included in the review demonstrate that racialised patients frequently report experiences of discrimination, stereotyping, and diminished trust in healthcare settings, which deter engagement and adherence to medical advice. This highlights an urgent need for targeted training programs aimed at raising awareness and fostering culturally sensitive communication within the healthcare workforce.
The review also sheds light on the structural impede of legal and administrative barriers. Many racialised individuals, particularly undocumented migrants or those with uncertain residency status, face formidable bureaucratic hurdles when attempting to register with health services or secure insurance coverage. These administrative obstacles not only delay access to essential medical interventions but also contribute to a climate of fear and invisibility, disincentivizing individuals from seeking necessary care. The complexities of national policies across Europe, which vary widely in inclusivity, further compound these challenges.
Beyond institutional factors, linguistic barriers emerge as a recurrent theme in the review. Limited proficiency in official languages poses a critical challenge for racialised populations, hindering effective communication between patients and providers. While some countries have implemented interpreter services, the coverage and quality of these resources remain inconsistent. This linguistic disconnect often results in misdiagnoses, inappropriate treatments, or incomplete patient histories, underscoring the critical role of language access in healthcare equity initiatives.
The review further explores the impact of health literacy disparities on healthcare utilization. Racialised populations often contend with lower levels of health literacy due to a combination of educational disadvantages and insufficient culturally tailored health information. This gap impairs their ability to understand medical instructions, navigate health systems, and participate in preventive health measures. Accordingly, the authors advocate for the development of health education campaigns that are linguistically and culturally adapted to the unique needs of diverse communities.
Importantly, the authors highlight the intersectionality of race with other axes of inequality such as gender, age, disability, and socioeconomic status. Intersectional analysis reveals that certain subgroups within racialised populations, including women, older adults, and disabled individuals, face compounded barriers. These overlapping identities create complex challenges that single-axis approaches to healthcare equity often overlook, emphasizing the necessity for multifaceted strategies that address the heterogeneous experiences of marginalized groups.
In terms of policy implications, the review calls for comprehensive reforms aimed at dismantling systemic barriers to healthcare access. This includes adopting inclusive health policies that guarantee universal coverage regardless of immigration status, enhancing the cultural competence of healthcare professionals, and strengthening community-based interventions that build trust and facilitate healthcare navigation for racialised populations. The authors also emphasize the need for robust data collection and monitoring systems that capture disaggregated health information to inform and evaluate equity interventions effectively.
From a technological standpoint, the review discusses the potential of digital health innovations to bridge some access gaps. Telemedicine, mobile health applications, and online patient portals could provide alternative pathways to healthcare for marginalized groups, especially during crises such as the COVID-19 pandemic which exposed and intensified existing inequities. However, the digital divide—characterized by limited internet access, low digital literacy, and affordability issues—remains a significant obstacle that must be addressed to harness technology’s full potential for health equity.
The comprehensive nature of this scoping review sets a new benchmark in public health research, synthesizing knowledge from a spectrum of disciplines including sociology, medicine, public policy, and human rights. By aggregating evidence from numerous systematic reviews, the authors effectively map the terrain of healthcare barriers for racialised populations across the varied sociopolitical contexts of Europe. This meta-perspective is critical for understanding both shared and country-specific challenges, enabling cross-national learning and fostering collaboration among policymakers and practitioners.
Ultimately, the review asserts that achieving healthcare equity for racialised populations requires transformational change rooted in social justice principles. This transcends mere adaptation of existing services to include genuine empowerment of marginalized communities through participatory approaches, capacity building, and advocacy. The authors stress that without addressing the underlying systemic inequalities—ranging from racism and xenophobia to socio-economic deprivation—healthcare interventions risk falling short of their intended equity goals.
As Europe continues to grapple with demographic changes and growing health disparities, the insights provided by this scoping review provide a scientific and ethical roadmap for policymakers, healthcare systems, and civil society actors. It demands urgent action to implement evidence-based, culturally informed strategies that are both sustainable and scalable. Only through such concerted efforts can the vision of equitable healthcare—one in which race or ethnicity no longer predicts health outcomes—become a reality.
In conclusion, González-Rábago and colleagues offer an indispensable resource that synthesizes complex, intersecting challenges facing racialised populations in European healthcare. Their work delineates the contours of an urgent public health issue and emphasizes the need for integrated, multilevel approaches to combat inequity. This comprehensive analysis propels the discourse on health equity beyond rhetoric into actionable pathways, charting a course for more just and inclusive health systems across Europe.
Subject of Research: Barriers to healthcare access for racialised populations in Europe, focusing on systemic, socio-economic, cultural, linguistic, and policy challenges.
Article Title: Barriers to healthcare for racialised populations in Europe: a scoping review of reviews
Article References:
González-Rábago, Y., Lanborena, N. & Rodríguez-Álvarez, E. Barriers to healthcare for racialised populations in Europe: a scoping review of reviews. Int J Equity Health 24, 212 (2025). https://doi.org/10.1186/s12939-025-02577-1
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