Newswise — The articles below will be published online March 15, 2012, at 4 p.m. (EDT) by the American Journal of Public Health® under “First Look” at http://www.ajph.org/first_look.shmtl, and they are currently scheduled to appear in the May 2012 print issue of the Journal. “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, www.apha.org, and is available at www.ajph.org.
(1) Unconscious racial stereotyping among physicians may be occurring in medical diagnoses and treatment of African American patients
Diagnoses and treatment of African American patients may be biased due to implicit stereotyping among physicians, suggests a recent study from the American Journal of Public Health.
Researchers investigated by way of a two-part study whether stereotypes unconsciously influence the thinking and behavior of physicians. The first study assessed what diseases and treatments doctors associate with African Americans; the second study presented these medical stereotypes as well as control terms to doctors as part of a computerized task, in which subliminal images of African American and white men appeared prior to each work, and reaction times to words were recorded.
The researchers found that when primed with an African American face, doctors reacted more quickly for stereotypical diseases, including an implicit association of certain diseases with African Americans. These stereotypes comprised not only diseases African American are genetically predisposed to, but also conditions and social behaviors with no biological association such as obesity and drug use.
The researchers conclude, “Our ultimate goal is to find effective ways to teach competency to medical professionals so that both explicit and implicit bias will be reduced, along with the undesirable effects of stereotypes.”
[From: “Implicit Stereotyping and Medical Decisions: Unconscious Stereotype Activation in Practitioners’ Thoughts About African Americans.” Contact: Gordon Moskowitz, Leheigh University, Department of Psychology, Bethlehem, Pa., [email protected].]
(2) Perceived discrimination is linked to increases in substance abuse among male African American adolescents
High levels of discrimination are linked to increases in substance use for African American adolescent males, indicates a study published in the American Journal of Public Health.
Researchers examined whether or not adolescents’ perceptions of discrimination are associated with increases in substance use and the processes that mediate this association. A sample of 573 African American youths residing in rural Georgia, with an average age of 16, provided data on their experiences with discrimination, substance abuse, school engagement and affiliations with substance-using peers. Perceived discrimination among male youths was significantly related to increases in substance use; this association was mediated by the contributions of perceived discrimination to decreases in school engagement and increases in affiliations with substance-using peers. Further analysis also indicated that discrimination influences substance use rather than the reverse correlation.
Another important finding of this study pointed to gender differences. Male adolescents were more strongly affected than female counterparts by perceived discrimination leading to higher risk of substance abuse.
”From a public health perspective, this has important implications because it adds to a growing body of evidence indicating that frequent experiences with discrimination during adolescence shift the alcohol and drug consumption curve so that more male adolescents in rural populations become frequent users. This shift can lead not only to driving fatalities but also to increases in other threats that substance use poses to adolescents’ mental health, school achievement, and family relationships.”
[From: "Perceived Discrimination and Longitudinal Increases in Adolescent Substance Use: Gender Differences and Mediational Pathways." Contact: Gene H. Brody, University of Georgia, Center for Family Research, Athens, Ga., [email protected].]
(3) Clinicians’ attitudes about race may influence how the patient’s medical visit goes
A new study published in the American Journal of Public Health finds that clinicians’ implicit attitudes about race are associated with markers of poor communication during patient visits and poor ratings, particularly among black patients.
In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, researchers measured clinicians’ implicit general race bias and race and compliance stereotyping with two implicit associations tests and related them to audiotape measures of visit communication and patient ratings. Researchers found that among black patients, general race bias was associated with more clinician verbal dominance, lower patient positive affect and poorer ratings of interpersonal care; race and compliance stereotyping was associated with longer visits, slower speech, less patient centeredness and poorer ratings of interpersonal care. Among white patients, bias was associated with more verbal dominance and better ratings of interpersonal care; race and compliance stereotyping was associated with less verbal dominance, shorter visits, faster speech, more patient centeredness, higher clinician positive affect and lower ratings of some aspects of interpersonal care.
The study’s authors concluded, “Interpersonal bias in healthcare is only one of the manifestations of racial discrimination in our society; however, health professionals can serve as influential advocates for social justice by encouraging open discourse about the existence of bias in healthcare and upholding the elimination of healthcare disparities as a local, national, and global priority.”
[From: “The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Rating of Interpersonal Care.” Contact: Lisa A. Cooper, MD, MPH, Johns Hopkins University, Baltimore, Md., [email protected].] ###
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