An Experimental Study of Implicit Racial Bias in Recognition of Child Abuse

Abstract

We demonstrated an experimental approach to study the influence of implicit racial bias on recognition of child abuse. Though we failed to find an effect, it is too early to conclude that none exists. The relationship among human cognition, behavior, and healthcare disparities is complex. Studies are needed that incorporate diverse approaches, clinical contexts and scenarios, patient and physician characteristics, and validated measures if we are to understand how it might be used to reduce healthcare disparities.

A systematic review of implicit bias in health care: A call for intersectionality

“…This study found an association between implicit racial bias and markers of poor visit communication and poor ratings of care, especially in Black patients [36]. Three studies found evidence of implicit bias but found no evidence that it affects clinician's provision of care or that it predicts treatment recommendations to minority patients [27,32,34]. Similarly, two studies that measured race and social class implicit bias found that their participants had an implicit preference for White persons and for those in the upper social class [30,31].…”

“…Majority of the studies reported the presence of moderate to strong implicit bias among the participants. Twelve studies found strong evidence of implicit bias favoring White Americans [25][26][27][28][29][30][31][32][33], while two studies found weak to moderate evidence of race bias [34,35]. Green et al (2007) found implicit stereotypes of African Americans as less cooperative with medical procedures [10].…”

“…Greater physician bias was associated with disability among individuals with SCI. [34] Racial implicit bias 342 pediatricians. To evaluate whether implicit racial bias influences pediatricians' suspicion of child abuse as measured by 9 injury vignettes.…”

“…About 64% of the studies measured implicit bias among medical doctors [10,[26][27][28][29][30][31][32][34][35][36][37]41,42,44,46,[55][56][57], the rest included registered nurses (11%), medical students (20%), genetic counselors (0.2%), research and health professionals (0.8%) [42,43], and pre-kinesiology students (0.2%). Forty-two percent of the studies included specific medical specialties: internal medicine, primary care physicians, and emergency residents [10,27,36,39,46].…”

“…Types of patients were: patients with hypertension or spinal cord injury, and patients of different races [29,32,36,37,55]. More than a quarter (26%) of the study included participants who were students, the category of students being medical students, nursing students, psychology students, and masters level dietetic students [30,34,45,48,49,51,52,54].…”