Exploring Biases in Research

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 around 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, in a recent study, Dr. Samira Omar, in the Acquired Brain Injury Lab led by KITE Senior Scientist Dr. Angela Colantonio, Dr. Charmaine Williams, Professor and Dean of the University of Toronto’s Factor-Inwentash Faculty of Social Work, 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 Samira Omar, PhD graduate and first author of the study. “This approach helps us rethink and improve rehabilitation practices to ensure they better serve Black individuals with TBI.” 

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. 

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 shift is about ensuring that rehabilitation is equitable for everyone, especially those who have been historically underserved,” concludes Dr. Colantonio.  

This work is part of Dr. Omar’s doctoral thesis titled “Confronting and Addressing Institutionalized Racism in Rehabilitation Research and Practice for Black People with Traumatic Brain Injury: A Critical Race Perspective” and is one of several studies published from this writing. 

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.  

 Dr. Angela Colantonio is the Director of the Rehabilitation Sciences Institute at the University of Toronto and a Professor in the Department of Occupational Science and Occupational Therapy and the Dalla Lana School of Public Health. Dr. Colantonio holds a Canada Research Chair in Traumatic Brain Injury in Underserved Populations. Dr. Charmaine Williams is Dean and Professor of the Factor-Inwentash Faculty of Social Work at the University of Toronto. Dr. Laura Beth Bugg is an Associate Professor and Associate Director of the Global and Community Health Program at the University of California, Santa Cruz.  

Omar S, Williams CC, Bugg LB, Colantonio A. Mapping the institutionalization of racism in the research about race and traumatic brain injury rehabilitation: implications for Black populations. Disabil Rehabil. 2024 Jul 1. doi: 10.1080/09638288.2024.2361803.