Representation in Healthcare Institutions Promotes Intergroup Tolerance: Evidence from the COVID-19 Crises in Israel and the US

Abstract

How does minority representation in public institutions shape intergroup relations? To answer this question, I develop a theory of prejudice reduction through descriptive representation. I suggest that embedding minorities in public institutions can promote tolerance by providing majority group members with positive information regarding minorities. To test my theory, I implemented a survey experiment in Israel, further replicated in the U.S., during the first outburst of the COVID-19 pandemic. In the experiment, treated respondents were informed about the share of minority (Arab/Muslim) workers in healthcare institutions. Results from Israel suggest that information about minority representation reduces prejudice and promotes preferences for political inclusion in a similar magnitude to about a one-unit leftward-shift on a seven-point ideology scale. Similar, albeit more moderate patterns emerge from the U.S. These findings emphasize how institutions and the people embedded within them can shape intergroup relations.

Diversity in health care institutions reduces Israeli patients’ prejudice toward Arabs

“…One encouraging piece of evidence regarding the possible generalizability of effects identified in this paper comes from a series of recent experiments in Israel and the United States. These experiments demonstrate that mere information regarding the role of Arab and Muslim doctors in combatting COVID-19 reduces prejudice among Israeli as well as American majority group members (47). These findings provide an encouraging intuition regarding the generalizability of the results identified in this paper.…”

Ingroup Bias in Healthcare Contexts: Israeli-Jewish Perceptions of Arab and Jewish Doctors

“…For example, considering the positive effects found for physician-patient concordance within other medical settings, examining the impact of concordance within an emergency room using a natural experiment may help underscore the need for increasing physician diversity. Other studies may focus on how moderating factors such as spreading positive information in the media may help reduce bias within a framework such as that presented here ( Ortiz and Harwood, 2007 ; Weiss, 2020 ).…”

“…For example, Popper-Giveon et al (2014) found that while Israeli-Arab physicians supportive of integration did not necessarily display a preference for patient concordance, both Israeli-Arab and Jewish patients would often rather be treated by physicians from their own ethnic group (see also Popper-Giveon, 2019 ). Further studies conducted in medical clinics in Israel found that positive intergroup contact could help reduce intergroup prejudice and improve attitudes both in a natural setting and in those based on positive information ( Weiss, 2020 , 2021 ). In light of these studies, we must also consider the positive effects found of patient-physician concordance on general health outcomes, as well as the likelihood of survival and correct treatment ( Alsan et al, 2019 ; Greenwood et al, 2020 ).…”