The danger of implicit bias: Discrimination in people of color’s experiences in healthcare

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In early 2018, tennis star Serena Williams faced a near-death experience after having an emergency cesarean section done to deliver her daughter.

According to an American Medical Association study from The Journal of Perinatal Education, black women are “2 to 6 times more likely to die from complications of pregnancy than white women, depending on where they live.”

This can largely be attributed to implicit bias perpetuated throughout the U.S. healthcare system.

In October 2019, UW professor Dr. Molly Altman authored a study that investigated the experiences of women of color in their interactions with healthcare providers during pregnancy and childbirth.

“Basically, the underlying experience that I’ve observed through research and literature is that there’s a level of racism and discrimination that factors into how they treat people of color when pregnant,” Altman said. 

She added that this discrimination is something that “white people would not be experiencing due to their race because they’re not exposed to racism in the same way.”

According to Altman, racism in healthcare isn’t something that’s always overt and explicit. 

Especially in a place like Seattle, these biases are very harmful, Altman said, due to the idea of Seattle being very progressive. This perception allows for implicit biases to be perpetuated, which is “just as much, if not more,” of a harm than healthcare in areas where people would generally consider racism and discrimination to be more of an issue.

This implicit bias is reflected in the treatment of pregnant people of color by providers, such as when patients of color are trusted less and aren’t always provided the full, necessary information.

“As a healthcare provider, I’ve also seen it personally, like when people of color are told they need cervical exams without actually asking permission,” Altman said. “That’s essentially assault.”

Though this is a relatively new issue being talked about in a mainstream sense, the issue of disparities in treatment of people of color versus white people is not a new issue. In medical history, you can look back at past hospital segregation and experimentation on slaves, Altman said.

“A lot of this is known by the communities that are affected, but has only recently come to the forefront of those privileged enough not to think about it.”

The interactions that Altman looked at in her study were those between the healthcare provider and patient. She found that the most profound part of the research was the fact that healthcare providers are largely responsible for perpetuating these disparities in experience between white people and people of color.

Altman stated that there was “definitely a lot of pushback to the study [she] published.” Many people are still unaware of the issue, with much unconscious and implicit biases being involved.

Definitively figuring out how much of a role racism and discrimination really plays in healthcare is still in the early stages, according to Altman. 

Bias and racism in the healthcare system is a multifaceted issue and can’t be measured with any numbers or a percentage, Altman said. However, it “impacts care more than we’ve ever given it credit [for].”

Reach contributing writer Deborah Kwon at Twitter: @debskwo

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