Exploring Race in Nursing

Teaching Nursing Students About Racial Inequality Using the Historical Lens

Carole Bennett, PhD, PMHCS-BC; Ellen K Hamilton, DNP, RN; Haresh Rochani, DrPH, MPH, MBBS


Online J Issues Nurs. 2019;24(2) 

In This Article

Abstract and Introduction


Discussing racial inequalities is challenging for nursing faculty and students of all races. Faculty report feeling inadequately prepared to systematically address this topic within clinical and classroom learning environments. This article reports student attitudes of race and health following a case study discussion of racial inequalities present in nursing and healthcare in Charleston, South Carolina between the years of 1883 to 2016. Forty-two students completed a 10-item visual analog scale (VAS) measuring their level of agreement regarding the issues of race and health before and after a classroom lecture. Most students reported an increase in racial tolerance following the lecture. A few students, however, indicated a decrease in racial tolerance following the lecture. Strategies for integrating the curriculum with learning experiences regarding issues of race are discussed.


Scholars define racism as the economic, political, social, and cultural structures, actions and beliefs that systematize and perpetuate an unequal distribution of privileges, resources, and power between white people and black people (Hilliard, 1992). The direction of this power and how it flows is historic, traditional, normalized, and deeply embedded in the fabric of the United States (Feagin, 2001). Discrimination, bias, and prejudice on the part of healthcare providers influence caregiving and treatment decisions and contribute to disparities in health status (Plough, 2010).

Financial resources impact access to healthcare. Poverty rates for white Americans are 11.6 percent and 25.8 percent for black Americans (Macartney, S., Bishaw, A., & Fontenot, K., 2013). Oppressive structures of higher unemployment, incarceration rates, and disenfranchisement, both intentional and unintentional, interact to maintain this level of disadvantage and poverty in the black community (Cole, 2016).