Hidden Biases Contribute to Inequities in Health Care, Experts Say

Experts believe hidden bias against patients who are socially and economically disadvantaged are contributing to disparities in health care and outcomes for people of racial and ethnic minorities.

The poor and those who are socially disadvantaged or from racial and ethnic minorities continue to experience lower quality of health services, are less likely to receive routine medical procedures and have higher rates of disease and death than non-minorities, according to the American Medical Association (AMA).

While educational attainment and income are two major determinants associated with better health and health outcomes, studies show that disparities persist even when controlling for gender, condition, age and socioeconomic status according to the AMA.

Dr. Irene Dankwa-Mullan is acting deputy director of the Division of Extramural Scientific Programs for the National Institute on Minority Health and Health Disparities in Bethesda, Maryland. The organization is on the cutting edge of research on various aspects of health disparity.

“In the medical community, research shows that unconscious or implicit bias play a role in the medical decision-making and quality of care provided to patients,” Dr. Dankwa-Mullan said. “Research findings from neurology, social and cognitive psychology show that hidden biases operating in several institutions, including the medical community, and largely under the scope of human consciousness, influence the way we see and treat individuals, even when we are determined to be fair and objective.”

Organizations such as the Institute of Medicine, a nonprofit, non-governmental organization that provides advice on medicine and health, have researched disparities and issued guidelines for health care providers and key stakeholders to eliminate differences in the quality of care that minority populations receive, compared to non-minorities, but the gap remains.
“How to reach the goal of eliminating health disparities or completely closing the health disparities gap remains largely undefined in the research community,” Dr. Dankwa-Mullan said.

“However, it is possible to close the health disparities gap with persistent local, institutional and national efforts. The concept of achieving health equity entails special efforts to improve the health of health disparity populations and especially those who experience social and economic disadvantage.”