Unconscious (Implicit) Healthcare Bias: Causes, Solutions (Research, Video 4:33)

Quality of healthcare always depends on the context in which it is given. Context includes all resources available, including attitudes (overt or implicit) of healthcare providers. Healthcare bias toward people of color is experienced widely in America. Sometimes the bias is overt, even intentional. Other times, it is done implicitly, unconsciously, but still doing harm. 

People of color face disparities in access to healthcare, the quality of care received, and health outcomes. Bias in attitudes and behavior of healthcare providers has been identified as a factor that contributes to health disparities. These disparities have been confirmed by considerable research, the Centers for Disease Control, the American Medical Association, and other reputable sources. 

An investigation of the extent to which implicit racial/ethnic bias exists among healthcare professionals was done. Including reviews of 15 studies using mostly American participants, this research examined the relationships between healthcare professionals' implicit attitudes about racial/ethnic groups and healthcare outcomes. These were the results:

1)   Low to moderate levels of implicit racial/ethnic bias were found among healthcare professionals in all but 1 study.

2)   Levels of implicit bias against Black, Hispanic/Latino/Latina, and dark-skinned people were relatively similar across these groups.

3)   Although some associations between implicit bias and healthcare outcomes were not significant, results also showed that implicit bias was significantly related to patient-provider interactions, treatment decisions, treatment adherence, and patient health outcomes.

4)   Implicit attitudes were more often significantly related to patient-provider interactions and health outcomes than treatment processes.

Conclusion of Research:

“Most healthcare providers appear to have implicit bias in terms of positive attitudes toward Whites and negative attitudes toward people of color.” 

Clearly, more interventions targeting implicit attitudes among healthcare professionals are needed. This video titled “How Can Providers Reduce Unconscious Bias?” addresses this issue. David R. Williams, Professor of Public Health at the Harvard T. H. Chan School of Public Health, has been researching health inequities in the United States for two decades. In this video, he sits down with Don Berwick, MD, President Emeritus and Senior Fellow at IHI, to describe three promising strategies to reduce implicit bias.

You can view my post on bias in pain treatment of African American children and adults here.

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.
Hospice and Nursing Homes Blog