Physician implicit attitudes and stereotypes about race and quality of medical care.

Full Abstract

BACKGROUND:
Recent reports speculate that provider implicit attitudes about race may contribute to racial/ethnic health care disparities.

OBJECTIVES:
We hypothesized that implicit racial bias exists among pediatricians, implicit and explicit measures would differ and implicit measures may be related to quality of care.

RESEARCH DESIGN:
A single-session, Web survey of academic pediatricians in an urban university measured implicit racial attitudes and stereotypes using a measure of implicit social cognition, the Implicit Association Test (IAT). Explicit (overt) attitudes were measured by self-report. Case vignettes were used to assess quality of care.

RESULTS:
We found an implicit preference for European Americans relative to African Americans, which was weaker than implicit measures for others in society (mean IAT score = 0.18; P = 0.01; Cohen's d = 0.41). Physicians held an implicit association between European Americans relative to African Americans and the concept of "compliant patient" (mean IAT score = 0.25; P = 0.001; Cohen's d = 0.60) and for African Americans relative to European Americans and the concept of "preferred medical care" (mean IAT score =-0.21; P = 0.001; Cohen's d = 0.64). Medical care differed by patient race in 1 of 4 case vignettes. No significant relationship was found between implicit and explicit measures, or implicit measures and treatment recommendations.

CONCLUSIONS:
Pediatricians held less implicit race bias compared with other MDs and others in society. Among pediatricians we found evidence of a moderate implicit "perceived patient compliance and race" stereotype. Further research is needed to explore whether physician implicit attitudes and stereotypes about race predict quality of care.

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Author information

Author/s: Sabin, Janice A (JA); Rivara, Frederick P (FP); Greenwald, Anthony G (AG);

Affiliation: University of Washington, School of Social Work, Seattle, Washington 98105-6299, USA. sabinja(-atsign-)u-washington.edu

Grants: 1-R36HS1576-01 (Agency:United States AHRQ) ; T32MH20010 (Agency:United States NIMH)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

Journal: Medical care (Med Care), published in United States. (Language: eng)

Reference: 2008-Jul; vol 46 (issue 7) : pp 678-85

Dates: Created 2008/06/26; Completed 2008/08/14;

PMID: 18580386, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Attitude of Health Personnel
Female
Health Care Surveys - methods
Healthcare Disparities
Humans

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