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Evidence-Based Implicit Bias Implications for Physicians and Healthcare Professionals Summary
Early Childhood Research One of the important areas of implicit bias research focuses on the question, how early in one's development does implicit bias begin to show up? Recent research suggests that the foundation for what later shows up as implicit bias occurs in infancy. For example, if we track the eyes of infants, at about four weeks of age they will stare longer and more frequently at female faces if a woman has been the primary caregiver. This is clearly not implicit bias, but it appears to reflect a differential association or a preference. As toddlers and older children begin to spend time online, watch television, and read books, they sense the race or gender of the people who tend to be in leadership roles, those who appear dangerous, those who are police and fire people, those who are doctors, etc. Inequities and biases in the broader society get incorporated into media, which get consumed by children, whether intentionally or not. These portrayals then influence and shape unconscious associations in children of all ages. Children are also influenced by the behavior of parents, caregivers, and other significant adults in their life, noticing the complexion and gender of their close friends, as well as comments and jokes. Adult Research Within the racial history of America, the complexion of Black people has always been a
complex dynamic. The One Drop Rule, in practice and then in law, has existed since Africans were forcibly brought to this country. Interracial relationships, both forced and voluntary, resulted in bi-racial children and adults. Essentially, any African ancestry (“one drop of African American blood”) classified an individual as African American. Although the deliberate disparate treatment of light-skinned and darker-skinned Black individuals has significantly diminished, unconscious bias related to the complexion of people still exists in many sectors of American society. Hiring and promotions of Blacks can sometimes be significantly influenced by implicit racial bias related to complexion. Excessive and biased focus on Black youth’s behavior in schools contributes to the disparate suspension rate for Black and White students in primary and secondary schools. This does not appear to be the result of conscious discrimination. It appears that similar behavior is judged differently when occurring by a Black versus a White student. Blake and colleagues went a step further and examined race, complexion, and suspension rates. They found that Black teenage girls with darker complexions are suspended at a higher rate than those with lighter complexions. Again, unconscious bias seems to be a major factor.
CASE STUDY - EXERCISE 1 You’ve just come from a meeting with a group of Black and Latinx community residents. They presented the committee, which you are a part of, with a list of demands related to what they perceive as a racist hospital environment. Your first patient is a 24-year-old Black male, dressed in a t-shirt and jeans. You greet him and before you can ask any questions, he asks you a few questions. ”Where did you grow up?” “Did you have any Black friends?” “Why are you looking at your watch?” “Is this going to be more than a 10-minute visit?” Question 1: Why might the community members perceive a hospital or healthcare system as being racist? Commentary on question 1 : In addition to the history and present state of a particular hospital or healthcare system, the history of racism in America in general, as well as continuing racial health disparities, may contribute to some Black and Latinx community residents perceiving a hospital as being racist.
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