1. Implicit Bias: What Every Pediatrician Should Know About the Effect of Bias on Health and Future Directions
- Author
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Margee Louisias, Jeanette Schnierle, and Nicole Christian-Brathwaite
- Subjects
Attitude of Health Personnel ,Societal attitudes ,Child Health Services ,Emigrants and Immigrants ,Debiasing ,Article ,03 medical and health sciences ,Nonverbal communication ,Racism ,0302 clinical medicine ,030225 pediatrics ,Health care ,Humans ,Pediatricians ,Healthcare Disparities ,Child ,Association (psychology) ,Physician-Patient Relations ,Unconscious, Psychology ,business.industry ,Implicit-association test ,General Medicine ,Health equity ,Systematic review ,Pediatrics, Perinatology and Child Health ,Psychology ,business ,Social psychology ,030217 neurology & neurosurgery - Abstract
Implicit bias has entered modern discourse as a result of our current sociopolitical climate. It is an area that has been largely explored in the social sciences, and was highlighted in the landmark 2003 IOM report, Unequal Treatment, as a contributor to racial/ethnic health disparities. Implicit bias is the process of unconscious societal attitudes affecting our individual understanding, actions and decisions, thus leading to assumptions about groups. Immigrant populations are particularly at risk in our present-day environment, and as a result experience limited healthcare access and higher levels of psychological distress. There are many measures of implicit bias, but the most highly regarded tool is the Implicit Association Test (IAT), as it is valid and reliable. Some level of pro-White/anti-Black bias has been found in most systematic reviews and studies, although there are less studies on bias towards Latinx populations. Limited evidence exists about the association between implicit bias and health outcomes. However, existing publications have demonstrated clear associations between bias and treatment recommendations, nonverbal communication, adverse birth outcomes and provider communication styles. Implicit biases can be unlearned via debiasing strategies, but these have not been examined extensively amongst health care providers. Future research must rely on more than pre- and post-IAT measurements to examine the effect of these strategies on improving patient outcomes. Additionally, healthcare system leadership must prioritize implicit bias trainings for students and medical staff and make greater tangible efforts to improve workforce diversity as a debiasing strategy.
- Published
- 2019
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