Physician Implicit Attitudes and Stereotypes About Race and Quality of Medical Care
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 soci…
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One study found that paediatricians held less implicit race bias compared with other MDs.
“One study found that paediatricians held less implicit race bias compared with other MDs [47].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [47]
Four studies examining the correlation between IAT scores and responses to clinical vignettes found a significant correlation between high levels of pro-white implicit bias and treatment responses that favoured patients specified as white.
“Four studies examining the correlation between IAT scores and responses to clinical vignettes found a significant correlation between high levels of pro-white implicit bias and treatment responses that favoured patients specified as white [42, 45–47].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [47]
Eight articles appeared to refer to the same data collected in a single cross-country comparison study, and a further two articles analysed the same data.
“eight articles appeared to refer to the same data collected in a single cross-country comparison study [27–32, 34, 35] and a further two articles analysed the same data [45, 47].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [47]
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- Authors
- Sabin, J. A., Rivara, F. P., & Greenwald, A. G.
- Affiliations
- University of Washington (US)
- Corresponding author
- Sabin, Janice A.
- Venue
- Medical Care
- Published
- 2008-07
- Volume
- 46
- Issue
- 7
- Pages
- 678-685
- ISSN
- 0025-7079 (ISSN-L)
- OpenAlex
- W2068518169
- Cited by
- 325
- References
- 5
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 20 · 2023: 15 · 2022: 38 · 2021: 29 · 2020: 25 · 2019: 16 · 2018: 19 · 2017: 16 · 2016: 22 · 2015: 31 · 2014: 19 · 2013: 13 · 2012: 13
- FWCI
- 33.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- Agency for Healthcare Research and Quality (1-R36HS1576-01)
- National Institute of Mental Health (T32MH20010, T32MH020010)
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Keywords
- implicit racial bias, physician attitudes, racial stereotypes, pediatricians, quality of care, Implicit Association Test, medication adherence, African Americans, European Americans
- MeSH terms
- Adult, Attitude of Health Personnel, Female, Humans, Male, Physician-Patient Relations, Prejudice, Quality of Health Care, Stereotyped Behavior, United States, Health Care Surveys, Healthcare Disparities
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