In a recent episode of healthcare of a family member, we observed a healthcare provider introducing herself to the patient, announcing herself in a loud, pronounced voice.
“DO YOU SPEAK ENGLISH?”
She said this very loudly this in a hospital room after our family member just had surgery and was in a vulnerable state. It was not something we appreciated, especially since our family member has lived in the west in upwards of 40 years and was well-versed in English. It was clear that the provider made an assumption based on the visible ethnic identity of our family member.
It also makes one wonder: does the healthcare treatment you are provided dependent upon your race?
Healthcare think-tank The Advisory Board provides a short discussion that suggests this disparity actually occurs:
Racial disparities in treatment and outcomes are well-documented. For instance, a study in the American Journal of Public Health found black patients are often prescribed less pain medication than white patients when presenting with the same symptoms. And other studies have found black patients with chest pain are referred to advanced cardiac care at lower rates.
The cause, experts say, is often unconscious racial bias that is hard to identify and change.
A salient point in the article beyond that racial bias occurs in healthcare is that this bias is not avoidable. It is going to happen. It occurs regularly and subconsciously. Therefore, episodic diversity training alone might not be effective in mitigating the bias; indeed, it might be solidifying the prejudice. An NPR article on the same topic discusses further how traditional models of diversity training may actually backfire in terms of reducing prejudice and inequity:
“People who seemed to have transformative responses to those [earlier] trainings, to have that kind of ‘aha’ moment — particularly people in the dominant group, [of] whites, men, heterosexuals — often, if you talk to them a month or two later, they actually felt quite wounded by the experience,” [diversity consultant Howard] Ross says. In some cases, he adds, participants seemed to become more defensive and hardened in their biases after those early trainings, not less prejudiced.
New models propose that we accept that bias exists, that it is normal, and it is on-going. Thus, instead of shaming bias, more conscious monitoring and management for such disparities is a prescription to make sure delivery of healthcare services is equitable so that all racial and ethnic groups are provided the same access to dignity, treatment and services.
Further, the article published by NPR includes narratives of personal experiences, also discusses the implicit biases providers can have that negatively impact members of their own or similar ethnicity.
Certainly, this adds a new dimension to resolving inequity by raising awareness — we need to not only provide information and condemn bias, but also point to the tools necessary to enact change towards equity. It is certainly reasonable to extend this beyond healthcare but in other aspects and services as well.