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Diversity and Inclusion Office hosts discussion on implicit bias in health care disparities

Khiara M. Bridges, JD, PhD, professor of law at UC Berkeley School of Law, presented the talk “Explaining Racial Disparities in Health: The Limitations of Implicit Bias,” on Wednesday, March 16, as the guest speaker for the Diversity and Inclusion Office Centering the Margins series.

Khiara M. Bridges, JD, PhD

Dr. Bridges outlined what researchers have long documented: that Black people have higher rates of major illness such as hypertension, diabetes, heart disease, asthma, and maternal and infant mortality and morbidity and explained the role that implicit bias plays in health disparities.

Bridges cited two studies to explain the limitations of implicit bias. When given implicit association tests that measure associations between concepts and stereotypes, test results often show that anti-Black or pro-white implicit biases are as prevalent among providers as they are with the general public.

“There is nothing about medical school and residency that cleanses people of the implicit biases that they had before entering and there is nothing about medical school residency that would make physicians and health care providers less biased than the general population,” she said.

The 2005 Institute of Medicine report on implicit bias described the “uncomfortable reality of implicit bias,” she said.

“The idea is that providers have negative views about racial minorities of which they are not consciously aware, and these views lead them to make unintentional and ultimately harmful judgments about the care that they give people of color,” she said.

While both studies show that implicit bias leads to racial disparities in health, and while medical institutions might go as far as requiring students to take implicit association tests to make them aware of their implicit bias, Bridges said the field of implicit bias is limited. “On its own terms, the field is focused on the individual and the prejudices and aversions that they may or may not possess. This individual-centered framework causes us to think of racism as a private concern.”

Bridges called for a paradigm shift in which institutions work toward the deconstruction of a society where the social well-being of people of color is not compromised.

“In a society where people of color are unemployed more frequently, get sicker and die violent deaths more frequently than white people, it is doubtful that implicit bias alone can explain these disturbing qualities. More likely, the reverse is true—these qualities explain implicit biases,” she said.

Marlina Duncan, EdD, vice chancellor for diversity and inclusion, encouraged participants to weigh in on the discussion. 

“How can people tackle a system they have been brought up in, are comfortable with and have a bias toward?” Dr. Duncan asked.

A robust conversation between the event attendees and speaker ensued, culminating in a collective sense that an approach in which implicit bias and its limitations are threaded through a medical school curriculum would allow future providers and scientists to work toward the goal of dismantling racism.

The Centering the Margins series, which chronicles the ways diversity, equity and inclusion can be infused into the practice of medicine, invites community leaders and scholars to lead conversations that give insight and guidance to the implementation of diversity, equity and inclusion at UMass Chan.