Aversive racism and medical interactions with Black patients: A field study

Abstract

Medical interactions between Black patients and nonBlack physicians are usually less positive and productive than same-race interactions. We investigated the role that physician explicit and implicit biases play in shaping physician and patient reactions in racially discordant medical interactions. We hypothesized that whereas physicians' explicit bias would predict their own reactions, physicians' implicit bias, in combination with physician explicit (self-reported) bias, would predict patients' reactions. Specifically, we predicted that patients would react most negatively when their physician fit the profile of an aversive racist (i.e., low explicit-high implicit bias). The hypothesis about the effects of explicit bias on physicians' reactions was partially supported. The aversive racism hypothesis received support. Black patients had less positive reactions to medical interactions with physicians relatively low in explicit but relatively high in implicit bias than to interactions with physicians who were either (a) low in both explicit and implicit bias, or (b) high in both explicit and implicit bias.Although there has been dramatic improvement in the health of all people living in the United States over the past 50 years, the level of disparities between Black and White Americans for

An Investigation of Associations Between Clinicians’ Ethnic or Racial Bias and Hypertension Treatment, Medication Adherence and Blood Pressure Control

“…Several studies [15][16][17] found that clinician implicit bias was associated with worse clinical interactions with black patients. In our own work with the same clinicians and patient population studied here, 15 black patients reported less patient-centered treatment from clinicians who had higher levels of implicit bias.…”

“…Greater implicit bias among clinicians, in turn, has been linked to less patient-centered interactions with black patients. [15][16][17] Evidence on the effects of clinician implicit bias on medical decisions in hypothetical scenarios has been mixed. 13,[18][19][20] The linkage between clinician implicit bias and more technical processes and outcomes of care has not been Electronic supplementary material The online version of this article (doi:10.1007/s11606-014-2795-z) contains supplementary material, which is available to authorized users.…”

Social Determinants of Risk and Outcomes for Cardiovascular Disease

“…Several studies [52][53][54] have found associations between clinicians' implicit bias and worse clinical interactions with black patients. Most relevant to CVD is a study by Blair and colleagues 44 in which primary care providers' levels of implicit race bias predicted differences between black and white patients' reports of their clinicians' patient centeredness, with black patients reporting less patient centeredness for clinicians previously categorized as having higher levels of implicit racial bias.…”

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

“…In addition, next iterations of this evaluation might include implicit measures of attitudinal shifts, given known biases of self-reported attitudes regarding sensitive social topics. 83 Finally, due to a dearth of scales assessing MHPs' (or any healthcare professionals') attitudes toward and beliefs about transgender individuals, we adapted scales originally designed to assess health professionals' attitudes and beliefs regarding lesbian, bisexual, and gay individuals. These original scales' focus was on sexual orientation rather than gender identity.…”