A new qualitative study has shown that racial bias and fear of black men likely result in them not getting the same health care as white male patients.
Published by the Journal of Racial and Ethnic Health Disparities, the study by Ms. Marie Plaisime, a 2014 MPH graduate of Drexel University’s Dornsife School of Public Health and current Howard University doctoral student, found that health providers largely perceive black male patients with bias, fear and discomfort.
The findings described in “Healthcare Providers’ Formative Experiences with Race and Black Male Patients in Urban Hospital Environments” back up past quantitative studies that found that black men are less likely to receive cardiac medical procedures such as cardiac catheterizations and coronary angioplasties compared to white men presenting with identical symptoms.
Plaisime’s work on this study was conducted under Dr. Jennifer Taylor, associate professor of Environmental and Occupational Health in the Dornsife School of Public Health.
“Racial bias in health care is worrying because one of the highest values of medical practice is to ‘do no harm,’” Dr. Taylor said. “Whether explicit or implicit, our racial biases can direct patients to different and unequal treatments that do not make them whole. No one goes into medicine wanting this to happen, so we must look at both our personal and professional socialization to check in on how those experiences may influence our actions as caregivers.”
Participants in the study included physicians, nurses and medical students from two urban university hospitals in the United States. Interviews were conducted with them to gather qualitative data on how formative childhood, personal and professional experiences with race and black men influence interactions with male, black patients today.
Plaisime and colleagues found themes across the interviews that were reflective of personally-mediated racism. They concluded that the perception of black males and cognitive dissonance appear to influence providers’ approaches with black male patients.
Both black and white medical providers who were interviewed described situations in which black male patients were treated differently based on race.
White providers spoke of their lack of exposure to black males and described feelings of fear or discomfort in their presence. Black providers shared their frustration with media portrayal of black men, the pressure they feel to avoid confirming negative stereotypes associated with black culture, and instances of patients discriminating against them.
The qualitative nature of this study allowed the authors to explore where previous quantitative findings ended. By gaining insights into the patient-provider encounter, this study suggests the need to develop curricula in health professional schools that address provider racial bias. Understanding the dynamics operating in the patient-provider encounter will enhance the ability to address and reduce health disparities.
“Participants in this study told us they had little useful training on how to deal with their own implicit bias that may affect the quality and safety of the patient care they give,” Dr. Taylor said. “We heard that past programs took the form of a grand round seminar or one lecture in a class, and were based off of pre-existing cultural competency curricula that were incorrect, stereotypical, or insulting. I think we have a unique opportunity to redesign health care training by developing social-cultural competencies as an essential component of health professional candidates’ skillset.”