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How unconscious biases can lead to care providers misdiagnosing their patients
Amna Shahzad
Introduction
Racism has continued to prevail in our society, even into the 21st Century; however, protests and riots have erupted over the United States of America to bring change and terminate this perennial issue. As doctors, nurses, and other healthcare workers have joined the protests, more light has been shed onto the neglected topic of health disparities also known as health inequities.
Health Disparities Defined
To understand health disparities, it’s important to define it since the need for an explicit definition regarding health disparities has increased over the years as only vague definitions are provided in the medical field. This greater need for clarity is paramount when discussing health disparities since the “ambiguity about the meaning of health disparities and health equity could permit limited resources to be directed away from the intended purposes” (Braveman). An explicit definition was provided by the Healthy People 2020 in 2010 as they defined health disparities as “… a particular type of health difference that is closely linked with economic, social, or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic -status, gender, age, or mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.”
This information helps us define health disparities into words, but in a real-life scenario, health disparities occur when care providers misdiagnose or prescribe incorrect medication to patients due to their conscious or unconscious biases regarding the patients’ characteristics which are non-related to their health. This is most common when care providers underestimate the pain of various social groups, primarily African Americans (Sabin).
The Root Causes of Health Disparities
Even though such injustice exists in the medical field, it’s important to note that these disparities are not always “intentional misdeeds: health care providers do not decide that some groups deserve pain relief while others should suffer. Instead, 2 inequities are the product of complex influences, including implicit biases that care providers don’t even know they have” (Sabin). Implicit biases in care providers are often the result of the influence of people, the environment, and the media they surround themselves with. These biases are most prominent in “cases of medical ambiguity - as when pain isn’t caused by an obvious physical condition such as a traumatic injury - providers rely more heavily on their own judgment” and the way their patients express their pain (Sabin).
Often, care providers are influenced by the stereotypes portrayed by the media. Beliefs such as “black people’s nerves endings are less sensitive than white people’s” or “black people’s skin is thicker than white people’s” are believed by many medical students and residents according to a study published in 2016 by the Proceedings of the National Academies of Science (Sabin). These beliefs eventually lead to care providers misdiagnosing their patients and underestimating their pain.
The lack of empathy from the care providers is believed to be the second root cause of health disparities, more specifically when it comes to the care providers’ “ability to accurately assess and respond to a patient’s suffering…” (Warraich). This second root cause might underlie the lack of representation in the medical field since “there is a rich body of research showing that we feel another’s pain most acutely when we feel like they are part of the same group: when they support the same soccer team, adhere to the same religion — and, many studies shows, belong to the same race” (Warraich). As an example, given that only 5 percent of American physicians and 6 percent of nurses are black, the majority of black patients are treated by clinicians of a different race.
In recent years, many improvements have been made in academic medicine regarding educating future care providers about implicit biases and injustice in health care (Sabin). More awareness is being spread about health disparities, which may lead to creating more educational programs regarding this crucial topic. There’s still a lot that we, as a nation, need to accomplish to terminate this issue, however, acknowledging 3 that many patients are misdiagnosed due to their characteristics such as race and gender is a great step forward.
Bibliography
Braveman, Paula. “What Are Health Disparities and Health Equity? We Need to Be Clear.”
Public Health Reports (Washington, D.C. : 1974), Association of Schools of Public
Health, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC3863701/.
Sabin, Janice A. “How We Fail Black Patients in Pain.” AAMC, 6 Jan. 2020,
Warraich, Haider J. “Racial Disparities Seen in How Doctors Treat Pain, Even among
Children.” The Washington Post, WP Company, 11 July 2020,
www.washingtonpost.com/health/racial-disparities-seen-in-how-doctors-treat-p ain-
even-among-children/2020/07/10/265e77d6-b626-11ea-aca5-ebb63d27e1ff _story.html.