The Role Of Implicit Bias In Racially Differential Diagnosis
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A consistent body of research has documented that Black patients receive a lower quality of care in comparison to White patients. Even when controlling for access-related factors, Black patients suffer higher rates of mortality and morbidity than White patients. The continued discrimination against Black individuals as a result of their skin color has affected, if not dominated, their health status in the United States. As a result, the concepts of “race” and “racism” deserve consideration. The African-American experience has been marked by suffering and deprivation: 246 years of slavery, 100 years of segregation and apartheid, and less than a century’s worth of freedom. Although widely accepted as a social construct, race becomes an effective tool for investigating disparities within the U.S. healthcare system. The Institute of Medicine notes that these differences result from multiple factors, but “bias, stereotyping, [and] prejudice...on the part of the health care providers” play a role (Institute of Medicine 2002, p. 667). Research suggests that implicit bias may contribute to racial health care disparities by affecting physician behavior towards individuals of certain groups and producing differences in differential diagnosis that adversely impact those individuals. Examining the role of implicit bias in racially differential diagnosis requires a comprehensive approach that takes into account the history of the African-American health experience. As such, a historical overview of race, science, and medicine is provided to serve as a framework for this examination.