patients explicitly and implicitly, with male physicians having a more substantial implicit bias (Sleek, 2018). Charlesworth and Banaji (2019) found that from 2007 to 2016, biases toward body weight were the only attitudes that had Gender In 2018, researchers published a literature review on gender bias in healthcare and gendered norms toward patients with chronic pain (Samulowitz et al.). Women were portrayed as being more sensitive to pain and more willing to report pain. It was even suggested that pain without a real reason was a natural characteristic of a woman's body. The researchers also found that women were viewed as hysterical, emotional, complaining, and fabricating the pain in their heads. They were given more psychological diagnoses than actual somatic causes for their pain. Men experiencing pain Veterans Veterans face significant challenges related to implicit biases when seeking healthcare. Healthcare providers may hold assumptions about their mental health needs based on their military service, potentially leading to the oversight of nuanced conditions or trauma-related issues. Moreover, stereotypes about veterans' resilience or susceptibility to certain disorders can result in misdiagnoses or inadequate Race The overall theme of health disparities is differences in health among different groups, most commonly racial groups. In 2020, Healthy People indicated disparities are caused or affected by social, economic, and/or environmental disadvantages. With COVID-19 bringing the issue back to the forefront, it has been identified that there are increased disparities between White people and people of color, including morbidity, mortality, and overall health status (Hall et al., 2015; Yang & Qi, 2022). For example, a researchers reviewed records from 800,000 Sexual Identity The lesbian, gay, bisexual, transgender, and questioning (LGBTQ) community is known to experience significant health disparities, including cancer, cardiovascular disease, obesity, and suicide. The significant disparities are thought to mainly be caused by the LGBTQ community's lack of seeking healthcare. Implicit and explicit biases are identified as the contributing factor due to perceived discrimination, from microaggressions to providers' refusal to provide treatment. A large study (n = 4,441) with heterosexual first- year medical students from across the U.S. found that 46% expressed explicit bias, and 82% indicated some implicit bias against the LGBTQ community (Burke et al., 2015; Morris et al., 2019). Regardless of the specific bias, we see inequitable decision making from providers, a failure to communicate effectively, barriers, and disparities in access to and delivery of
increased. Stereotype characteristics used to describe people who are obese are lazy, unmotivated, uneducated, and lacking willpower.
were described as stoic, tolerating, autonomous, in control, and even brave if they waited to seek or chose not to seek provider assistance. This bias affected treatment options, with fewer treatments offered to women, thus proving that the healthcare providers' beliefs about pain affected treatment decisions. Unfavorable outcomes were seen more often with women. Other stereotypical characteristics identified specifically related to gender are that men are considered cold and strong, while women are considered weak and warm (Greenwald & Lai, 2020). treatment plans. These biases can discourage veterans from seeking care altogether due to the fear of being misunderstood or stigmatized. Recognizing and rectifying these biases is crucial in order to provide veterans with the tailored and unbiased healthcare support they require for their physical and mental well-being (Schreger & Kimble, 2017). hospitals nationwide and found an identifiable pattern in treatment differences between Black and White patients with peripheral artery disease, with Black patients being 77% more likely to receive an amputation (Dovidio et al., 2016). Racial disparities are also seen within U.S. maternal and infant mortality rates. Significant differences are seen by race, with Black women having a maternal mortality rate 3.55 times higher than White women, and American Indian/ Alaskan Natives having a rate 2.3 times higher than White women (Dagher & Linares, 2022). healthcare services. However, inequitable decision making can also come from the patient through their preferences. Video: Healthcare Professionals
DISPARITIES IN PERINATAL CARE
In the U.S., approximately 50,000 women experience severe pregnancy-related complications. Of that number, approximately 700 women die each year, with two-thirds of the deaths considered preventable (Centers for Disease Control and Prevention [CDC], 2022). Between 2016 and 2018, non-Hispanic pregnancy-related deaths were 41.1 per 100,000 live births, and non-Hispanic American Indian or Alaska Natives were second highest, with 26.5 deaths per 100,000 live births. Non-Hispanic White women were at 13.7 per 100,000 live births, and Hispanics were at 11.2 per 100,000 live births.
The National Vital Statistics Reports shows a continual increase in the percentage of cesareans for all women regardless of race and ethnicity; however, since the data has been collected, non-Hispanic Black women have continued to have the highest cesarean rates. The 2021 data found non-Hispanic Black women to have a cesarean rate of 36.8%, Hispanic women at 31.6%, and non-Hispanic White women at 31%. For participating in prenatal care within the first trimester, non-Hispanic Blacks were at 69.7%, Hispanic at 72.5%, and non-Hispanic White at 83.2% (Osterman et al., 2023).
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Book Code: PCUS1525
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