Ableism within health care professions: a systematic review of the experiences and impact of discrimination against health care providers with disabilities

Abstract

Purpose

People with disabilities experience concerning rates of ableism and are significantly under-represented within healthcare education and professions. Focusing on healthcare professions is important for enhancing the diversity and inclusion of equity-deserving groups within the workforce. The objective of this review was to explore the experiences and impact of workplace discrimination and ableism among healthcare providers and trainees with disabilities.

Methods

Systematic searches of seven databases from 2000 to January 2022 were conducted. Five reviewers independently applied the inclusion criteria, extracted the data and rated the study quality.

Results

48 studies met our inclusion criteria, representing 13,815 participants across six countries over a 21-year period. The findings highlighted rates and types of workplace ableism, which occurred at the institutional (i.e., inaccessible environments, physical barriers and unsupportive work environments) and individual level (i.e., negative attitudes, bullying, harassment). The impact of ableism on healthcare providers included difficulty disclosing due to fear of stigma, and effects on well-being and career development.

Conclusions

Our findings revealed a critical need for more research on the experiences of ableism amongst healthcare providers and the impact it has on their well-being. Further efforts should explore mechanisms for including and welcoming people with disabilities in healthcare professions.

Implications for rehabilitation

• Workplace ableism is prevalent in health care professions and could be discouraging people with disabilities from entering or completing health care education and training, leading to an under-representation of this equity-deserving group within health care.

• More efforts are needed to recruit, retain and support people with disabilities in the health care workforce.

• Health care providers who have a disability often experience workplace discrimination and inaccessible physical environments which can impact their health and well-being.

• Managers, senior leadership and health care organizations should advocate for improved social inclusion of employees with disabilities.

Keywords:

• Ableism
• disclosure
• discrimination
• health care personnel
• stigma

Acknowledgements

We wish to acknowledge this land on which the University of Toronto operates. For thousands of years, it has been the traditional land of the Huron-Wendat, the Seneca, and the Mississaugas of the Credit. Today, this place is still the home to many Indigenous people from across Turtle Island and we are grateful to have the opportunity to work on this land. The authors thank the TRAIL lab staff for their support in this project.

Ethics approval

No animal or human studies were carried out by the authors of this article.

Author contributions

SL conceived and designed the study, conducted the article search, data extraction and drafted the manuscript. All authors contributed to article screening and checking the data extraction and analysis. All authors read and approved the final manuscript.

Disclosure statement

The authors have no conflicts of interest

Additional information

Funding

Funding for this study was provided, in part, by the Canadian Institutes of Health Research and Social Sciences and Humanities Research Council (CIHR-SSHRC) Partnership grant and the Kimel Family Fund through the Holland Bloorview Kids Rehabilitation Hospital.