Black and African American Young Adults’ Healthcare Perceptions: A Scoping Review Concerning US Healthcare Experiences

Background and Purpose: Extensive literature has examined Black and African American (BAA) parents’ perceptions of their children’s and adolescent’s healthcare experiences; however, far less is known about BAA young adults’ young adults’ (YA; ages 18-29) perceptions of their own healthcare experiences, particularly during pediatric-to-adult healthcare transitions in metropolitan US settings. This scoping review aimed to identify, chart, and synthesize relevant empirical literature depicting BAA YA perceptions regarding their healthcare experiences published between 2014 and 2024.

Methods: Following PRISMA-ScR guidelines, we conducted a scoping review of three electronic databases utilizing keywords: Black and African American; young adult and emerging adult; attitudes and perceptions and cognitions; and US healthcare experiences. Records were limited to those: conducted in urban facilities; 2014-2024; sample mean age 18-29; BAA subsample >50% of aggregated sample; and pediatric-to-adult healthcare transitions. Two independent researchers conducted the review 2025-2026.

Results: In total, 1,408 records were identified, of which 9 were relevant to our review (N= 326 aggregated participants). Most inclusive records employed qualitative (n= 4) or mixed methods (n= 4) designs, were conducted at HIV treatment clinics (n= 5) and primary care/community health clinics (n= 2) and were located in metropolitan Southern (n= 5) or Midwestern (n= 3) cities. Participants were predominantly BAA YA men who have sex with men (n= 5), while only 1 article portrayed BAA YA women. Across records, key perception themes included intersectional identities and stigma, discrimination, medical mistrust, and differential healthcare treatment. Negative healthcare perceptions were reported in all records, whereas positive healthcare perceptions were only described in only three records.

Conclusions and Implications: Our findings highlight a persistent gap in healthcare engagement research focused on BAA YA, despite ongoing health and wellbeing disparities. BAA YA healthcare perceptions were complex and shaped by formative healthcare experiences that informed expectations of inadequate or suboptimal future healthcare, particularly during pediatric-to-adult transitions. These findings suggest negative healthcare perceptions may be associated with unsuccessful pediatric-to-adult healthcare transitions. Our synthesized findings warrant the need for future BAAYA healthcare engagement research to advance evidence-based, anti-racist, trauma-informed, and inclusive healthcare and clinical social work practices that encourage BAA YA healthcare engagement and successful pediatric-to-adult healthcare transitions. Moreover, our findings also have implications for healthcare curriculum and training improvements, diverse workforces, and healthcare policy enhancements.