11 2.4: Macroaggressions: Overt and Systemic Racism

While microaggressions are often subtle and indirect, macroaggressions refer to more overt, systemic forms of racism that occur at an institutional or societal level. These include discriminatory policies, practices, or structures within institutions that create barriers for Black individuals. In healthcare and dietetics, macroaggressions can manifest through unequal access to opportunities, biased hiring practices and student recruitment, or educational systems that fail to address the cultural needs of Black students and practitioners (Henry & Tator, 2009; Braveman et al., 2022).

Physical or verbal assaults, such as racially motivated violence or using a racial slur, are also examples of macroaggression.

These examples highlight how Black patients, students and professionals are subjected to both microaggressions and macroaggressions in healthcare, professional and academic environments. The failure to address these behaviours perpetuates a culture of silence and complicity, where racism is allowed to persist without consequence (NCCDH, 2018; ACLRC, n.d.). This creates an environment where Black individuals often feel the need to suppress their concerns to avoid further marginalization (Henry & Tator, 2009).