Structural Racism and Its Health Consequences for Minority Ethnic Groups Accessing Primary Healthcare in Nigeria: A Critical Sociological Analysis

Background: Structural racism as a determinant of health inequities is a well-theorised concept in global health literature but has received limited empirical and analytical attention in the Nigerian context, where intra-national ethnic hierarchies shape access to resources including healthcare. This study critically analyses the health consequences of structural racism for minority ethnic groups accessing primary healthcare in Nigeria. Methodology: A critical sociological study employed a multi-layer methodology including secondary analysis of national health survey data disaggregated by ethnicity, critical discourse analysis of health policy documents, and 48 in-depth interviews with minority ethnic community members and primary healthcare practitioners across five geopolitical zones. Critical race theory framed the analytical approach. Results: Significant disparities in primary healthcare access, quality, and health outcomes were documented across ethnic minority groups. Structural mechanisms including marginalisation in health resource allocation, language barriers in health information dissemination, and racialised practitioner attitudes were identified as contributors. Policy discourse consistently failed to name ethnicity as a determinant of healthcare inequity. Conclusion: Structural racism is an underacknowledged but empirically demonstrable driver of primary healthcare inequities in Nigeria. Family medicine departments must lead advocacy for anti-racist health policy development and culturally competent clinical education frameworks. Keywords: structural racism, ethnic minority, primary healthcare, health inequity, critical race theory