Implicit Bias: Implicit Bias in Health and Medicine
Provides resources on implicit bias, also called unconscious bias.
Created by Health Science Librarians
Implicit Bias in Medicine
"To achieve health equity, health care organizations have a responsibility to mitigate the effect of implicit bias in all interactions and at all points of contact with patients. This is important because implicit bias has the potential to impact not only outcomes of care, but also whether patients will return for services or even seek care at the organization in the first place."
Listen
- The Social Determinants of Health and Implicit BiasDr. Denise Rodgers, Rutgers University, on Your Health Radio
22:09 minutes - Implicit Bias : A Factor in Health CommunicationWith Dr. Winston Wong, Kaiser Permanente
19:58 minutes - Implicit Bias in Health Care: Consequences and RemediesWith Dr. Brenda J. Allen, University of Colorado, Denver
41:17 minutes - Bias, Black Lives and Academic MedicineDr. David Ansell on Your Health Radio (August 1, 2015)
21:42 minutes
Videos
- Weight Bias in Health CareFrom Yale University
16:56 minutes - Exploring Unconscious Bias in Academic MedicineWith Howard Ross, from the American Association of Medical Colleges
29:23 minutes - Is the "obesity crisis" just a disguise for a deeper problem?TedMed talk with Dr. Peter Attia
16:15 minutes - Implicit Bias and Social Categorization in MedicineMountain West Aids Education and Training Center webinar with Dr. Naomi Shike
18:53 minutes - Implicit Racial Bias in HealthcareChildren's National Hospital Grand Rounds recording with Dr. Tiffani Johnson (February 24, 2016)
1:02:11 minutes
Articles
These articles were selected, in part, to reflect a range of different biases and health professions. This list is in no way meant to be comprehensive. See "Researching Implicit Bias" tab for suggested search terms and places to search for additional articles.
- A Systematic Review of the Impact of Physician Implicit Racial Bias on Clinical Decision MakingDehon E. A systematic review of the impact of physician implicit racial bias on clinical decision making. Academic emergency medicine. 08/2017;24(8):895-904. doi: 10.1111/acem.13214.
- Implicit bias in healthcare professionals: A systematic reviewFitzGerald C. Implicit bias in healthcare professionals: A systematic review. BMC medical ethics. 12/2017;18(1). doi: 10.1186/s12910-017-0179-8.
- Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic ReviewHall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., … Coyne-Beasley, T. (2015). Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review. American journal of public health, 105(12), e60-76.
- Non-conscious bias in medical decision making: what can be done to reduce it?Stone J, Moskowitz GB. Non-conscious bias in medical decision making: what can be done to reduce it? Med Educ. 2011 Aug;45(8):768-76.
- Reducing racial bias among health care providers: lessons from social-cognitive psychologyBurgess D, van Ryn M, Dovidio J, Saha S. Reducing racial bias among health care providers: lessons from social-cognitive psychology. J Gen Intern Med. 2007 Jun;22(6):882-7.
- Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patientsGreen AR, Carney DR, Pallin DJ, Ngo LH, Raymond KL, Iezzoni LI, Banaji MR. Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. J Gen Intern Med. 2007 Sep;22(9):1231-8.
- Racism as a determinant of health: a protocol for conducting a systematic review and meta-analysisParadies Y, Priest N, Ben J, Truong M, Gupta A, Pieterse A, Kelaher M, Gee G. Racism as a determinant of health: a protocol for conducting a systematic review and meta-analysis. Syst Rev. 2013 Sep 23;2:85.
- The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: pain, urinary tract infection, attention deficit hyperactivity disorder, and asthmaSabin JA, Greenwald AG. The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma. Am J Public Health. 2012 May;102(5):988-95.
Readings
- The Scarlet F: Why Fat Shaming Harms Health and How We Can Change the ConversationHarvard Public Health
- Science of Equality Report: Addressing Implicit Bias, Racial Anxiety, and Stereotype Threat in Education and Health CareBerkeley Haas Institute and the Perception Institute
- Education to Identify and Combat Racial Bias in Pain Treatment by Brian B. DrweckiAMA J Ethics. 2015;17(3):221-228. doi: 10.1001/journalofethics.2015.17.3.medu1-1503.
- Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic ReviewHall WJ, Chapman MV, Lee KM, et al. Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review. Am J Public Health. 2015;105(12):e60-76.
- The Science of Equality, Volume 1: Addressing Implicit Bias, Racial Anxiety, and Stereotype Threat in Education and Health CareBy Rachel D. Godsil, Linda R. Tropp, Phillip Atiba Goff, john a. powell (November, 2014)
- Reflections on bias in health careBlog post from Health and Wellness by Dr. David Hilden (February 25, 2016)
- How does implicit bias by physicians affect patients' health care? by Tori DeAngelisFrom the American Psychological Association
- Sneaky bias: what you don't know may hurt you (and your patients)American Physical Therapy Association
Books
The books below are available in the UNC Chapel Hill Libraries. If you aren't affiliated with UNC, contact your local library for these and other books on implicit bias.
Seeing patients : unconscious bias in health care by
Growing up in Jim Crow-era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. And while race relations have changed dramatically, old ways of thinking die hard. In Seeing Patients White draws upon his experience in startlingly different worlds to make sense of the unconscious bias that riddles medical treatment, and to explore what it means for health care in a diverse twenty-first-century America.
White and coauthor David Chanoff use extensive research and interviews with leading physicians to show how subconscious stereotyping influences doctor-patient interactions, diagnosis, and treatment. Their book brings together insights from the worlds of social psychology, neuroscience, and clinical practice to define the issues clearly and, most importantly, to outline a concrete approach to fixing this fundamental inequity in the delivery of health care.
Call Number: RD27.35.W53 A3 2011ISBN: 9780674049055Publication Date: 2011-01-15
Doing harm : the truth about how bad medicine and lazy science leave women dismissed, misdiagnosed, and sick by
An eye-opening read for patients and health care providers alike, Doing Harm shows how women suffer because the medical community knows relatively less about their diseases and bodies and too often doesn't trust their reports of their symptoms. The research community has neglected conditions that disproportionately affect women and paid little attention to biological differences between the sexes in everything from drug metabolism to the disease factors--even the symptoms of a heart attack. Meanwhile, a long history of viewing women as especially prone to "hysteria" reverberates to the present day, leaving women battling against a stereotype that they're hypochondriacs whose ailments are likely to be "all in their heads."
Call Number: RA564.85 .D88 2017ISBN: 9780062470805Publication Date: 2018-03-06
The death gap : how inequality kills by
Inequality is all around us, and often the distance between high and low life expectancy can be a matter of just a few blocks. But geography need not be destiny, urges Ansell. In The Death Gap he shows us how we can face this national health crisis head-on and take action against the circumstances that rob people of their dignity and their lives.
Call Number: RA418.3.U6 A57 2017ISBN: 9780226428154Publication Date: 2017-04-21
Homosexuality and the mental health professions : the impact of bias by
This monograph acutely identifies problems of bias, overt and covert, as they affect the treatment of lesbian and gay patients and as they influence the training of mental health professionals. Incorporating clinical vignettes that detail actual incidents from a wide range of clinical and professional encounters, the report enables the clinician not only to review his or her own experience, but also to envision alternative possibilities of constructive and caring intervention.
Call Number: RC558 .H655 2000ISBN: 0881633186Publication Date: 2000-03-01
Unequal treatment : confronting racial and ethnic disparities in health care by
In Unequal Treatment , a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed.
Call Number: RA563.M56 U53 2003ISBN: 030908265XPublication Date: 2002-11-27
The handbook of attitudes. Volume 2, ApplicationsCall Number: ONLINEISBN: 9781351712323Publication Date: 2019CHAPTER 6: Doing Harm to Some: Patient and Provider Attitudes and Healthcare Disparities
Just medicine : a cure for racial inequality in American health care by
Just Medicine offers us a new, effective, and innovative plan to regulate implicit biases and eliminate the inequalities they cause, and to save the lives they endanger. Over 84,000 black and brown lives are needlessly lost each year due to health disparities, the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system--and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law.
Call Number: ONLINEISBN: 9781479896738Publication Date: 2015-12-11
Teeth : the story of beauty, inequality, and the struggle for oral health in America by
'Show me your teeth', the great naturalist George Cuvier is credited with saying, 'and I will tell you who you are'. In this shattering new work, veteran health journalist Mary Otto looks inside America's mouth, revealing unsettling truths about our unequal society. Teeth takes readers on a disturbing journey into the role teeth play in our health and our social mobility. Muckraking and paradigm-shifting, Teeth exposes for the first time the extent and meaning of our oral health crisis.
Call Number: RK58.5 .O88 2016 and ONLINEISBN: 9781620971444Publication Date: 2017-03-14
Online Course
- Conscious & Unconscious Biases in Health CareFrom the National Center for Cultural Competence at Georgetown University
How Does Implicit Bias Affect Health Care?
Test Yourself for Bias
- Implicit Association TestFrom Project Implicit. Includes the following IAT tests: Weight, Skin-tone, Gender-Career, Presidents, Race, Age, Asian, Sexuality, Transgender, Gender-Science, Arab-Muslim, Religion, Disability, Weapons.
- Test Yourself for Hidden BiasFrom Learning for Justice, formerly Teaching Tolerance