Have you ever become so
accustomed to an odor, even a bad one, that you stopped noticing it at all?
Sometimes race and class biases are like that. Unfortunately, men, women, and
children can be harmed, even killed, as a result. Many people don’t realize how
embedded racism and classism are in our society, particularly when they are not victimized regularly themselves. Overt acts are intended, meant to
be hurtful. Covert acts are implied, often done unconsciously, but still do damage
because the recipients of these actions are mistreated.
The healthcare industry, like many others, consists of workers who make decisions about people’s lives on a daily basis. Consistently high numbers of disparities related specifically to race and class have existed over many years. Still, most healthcare workers continue to say they treat all patients equally. Ongoing disparities impact, not only patients, but also their families, communities, and ultimately our nation. In addition to generational suffering and repercussions on many levels, illnesses create long-term economic burdens and major losses of productivity.
The healthcare industry, like many others, consists of workers who make decisions about people’s lives on a daily basis. Consistently high numbers of disparities related specifically to race and class have existed over many years. Still, most healthcare workers continue to say they treat all patients equally. Ongoing disparities impact, not only patients, but also their families, communities, and ultimately our nation. In addition to generational suffering and repercussions on many levels, illnesses create long-term economic burdens and major losses of productivity.
This post is based on race and class bias research in which implied preferences
for a specific social group are shown that can have adverse consequences for
patient care of other groups. Clinical stories were used and analyzed to determine
whether implicit race or class biases among
registered nurses influenced their decisions in managing patients. Performed at
the Johns Hopkins Hospital, the study involved nurses who were given 8
multi-stage clinical stories to read in which patients' race or social class
were randomly altered. In addition, nurses were given implicit association
tests about race and social class.
Results of this
study involving 245 mostly white and female registered nurses were the
following:
1) Most
nurses stated that they had no explicit race or class preferences.
2) Only 36 nurses demonstrated no implicit race preference as measured by implicit
association tests for race and social class.
3) Only
16 nurses displayed no implicit class preference on the implicit association
tests for social class and race.
This research, along with many other
examples, concluded that the majority of registered nurses displayed implicit (unconscious) preferences
toward white race and upper social class patients. However, unlike published
data on physicians, implicit biases among registered nurses did not correlate
with clinical decision-making.
In this video, Michelle van Ryn, Ph.D., a
researcher at the Mayo Clinic, describes implicit bias in health care and future
research underway to understand and further address this critical issue. Keep
in mind that this is not only a healthcare issue, but also a moral one.
Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer
in Urban Nursing Homes is available in paperback and e-book
editions in America and other countries at online and offline booksellers.
Implicit and Overt Racism,
Overt and Implicit Classism, Nurses and Doctors Racism-Classism, Dr.
Michelle van Ryn, Bias in Healthcare Research
