October 29, 2008

U.S. study says doctors subconsciously favor whites

Doctors subconsciously favor whites over blacks, U.S. researchers said on Tuesday in a finding that may explain widespread racial disparities in health care in the United States.

A long line of studies have found that U.S. blacks get inferior care for cancer and a variety of other ailments compared to whites but experts concerned about the disparities have struggled to understand why.

"This supports speculation that subtle race bias may affect health care, but does not imply that it will," said Janice Sabin of the University of Washington in Seattle, who presented the study at the American Public Health Association's annual meeting in San Diego.

Sabin said it was too early to know if there was a direct link between the findings and the quality of care delivered to blacks in the United States.

She said the findings reinforce other studies showing racial bias is common in the general population.

"But we have to remember people are not racist if they hold an implicit bias," she said in a statement.

Sabin used data from a study of more than 400,000 people who took an online test between 2004 and 2006 about their attitudes on race.

More than 2,500 of the test-takers said they were doctors.

Rather than overt racism, the test looks for subconscious signs of bias by asking a series of questions.

For example, people were asked to quickly say whether photos of blacks and whites were positive or negative.

"We don't call what these tests show prejudice. We talk about it as hidden bias or unconscious bias, something that most people are unaware they even possess," said Anthony Greenwald of the University of Washington, who created the test and helped with the study.

Overall, 86 percent of people who took the test said they lived in the United States. Out of 2,535 physicians, 76 percent said they were U.S. residents.

Of the entire sample, 69 percent said they were white, while 66 percent of those who said they were doctors identified themselves as white.

Doctors in all racial and ethnic groups showed an implicit preference for whites versus blacks except for black doctors, who did not favor either group.

"The implicit bias effect among all the test-takers is very strong," Sabin said. "People who report they have a medical education are not different from other people, and this kind of unconscious bias is a common phenomenon."

Sabin said the study shows diversity training should be a part of medical education in the United States.

Studies have shown blacks in the United States are more likely than whites to die from diabetes, strokes, heart attacks and cancer. Some studies have shown this disparity persists when incomes, education and insurance coverage are equal.

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