Eliminating racial and ethnic disparities in health in the U.S. isn’t just the job of the health care sector—it’s the job of society as a whole, argues David R. Williams, Florence Sprague Norman and Laura Smart Norman Professor of Public Health.
In a viewpoint article published August 11, 2015 in JAMA (Journal of the American Medical Association), you discussed how unconscious racial bias on the part of health care professionals contributes to deficits in the quality of care given to nonwhites. Can you offer examples of how this bias impacts care?
Negative beliefs about race are deeply ingrained in U.S. culture, and popular culture continues to devalue blacks and other nonwhites. For instance, research has shown that greater exposure to TV shows that portray black people negatively is linked with higher levels of racial prejudice. Other research has shown that, in many widely read books and newspapers, the word “black” is most frequently paired with words like “poor,” “violent,” and “dangerous.” The word “white,” on the other hand, is most often linked with words such as “wealthy,” “progressive,” “conventional,” and “educated.” People absorb these sorts of messages and develop unconscious biases that favor whites over blacks. Clinicians are no exception. Previous studies have shown, for instance, that higher levels of implicit bias among clinicians is linked with biased treatment recommendations for black patients, as well as poorer quality patient-doctor communication and lower ratings by patients from racial or ethnic minority groups about the quality of their encounters with doctors.