Since the 1990s, researchers have examined how unconscious mental processes may be contributing to the serious differences in health care outcomes between black and white patients. These disparities are real and quite serious. Black people fare worse in healthcare outcomes in virtually every category, including chronic diseases, cancer, heart disease, diabetes, and strokes. Furthermore, studies show that racial and ethnic discrimination are associated with adverse health outcomes, including elevated blood pressure, higher instances of substance abuse, and obesity.
Studies of implicit bias among physicians reveal that physicians hold the same biases at the same rates as the general public, tending to favor white people over black people and Latinos. Tests also showed that doctors tend to hold stereotypes of black patients as uncooperative, which can lead to differences in the kind of care they prescribe.
Racial anxiety also helps shape healthcare outcomes. Even if a doctor prescribes the same care to black and white patients, if racial difference shapes their interactions with patients, it can lead to worse health outcomes. Physicians working with patients of color tend to be less empathic, to move faster through their appointments, and are less likely to encourage patients to participate in medical decision making. African Americans experience greater levels of distrust towards white counselors in clinical settings and black patients have been shown to be less likely to schedule appointments and more likely to delay or postpone appointments with white doctors. Clearly, the creation of remedies that address implicit bias, racial anxiety and stereotype threat in health care is urgently needed.
In our report Telling Our Own Story we document how narrative can positively impact healthcare outcomes, while Transforming Perception lays out many of the various factors that contribute to discrimination in health care.