Assessment of biases against Latinos and African Americans among primary care providers and community members

Abstract

Objectives: We assessed implicit and explicit bias against both Latinos and African Americans among experienced primary care providers (PCPs) and community members (CMs) in the same geographic area.

Methods: Two hundred ten PCPs and 190 CMs from 3 health care organizations in the Denver, Colorado, metropolitan area completed Implicit Association Tests and self-report measures of implicit and explicit bias, respectively.

Results: With a 60% participation rate, the PCPs demonstrated substantial implicit bias against both Latinos and African Americans, but this was no different from CMs. Explicit bias was largely absent in both groups. Adjustment for background characteristics showed the PCPs had slightly weaker ethnic/racial bias than CMs.

Conclusions: This research provided the first evidence of implicit bias against Latinos in health care, as well as confirming previous findings of implicit bias against African Americans. Lack of substantive differences in bias between the experienced PCPs and CMs suggested a wider societal problem. At the same time, the wide range of implicit bias suggested that bias in health care is neither uniform nor inevitable, and important lessons might be learned from providers who do not exhibit bias.

FIGURE 1—

Percentage of providers and community members in each scoring category of the Implicit Association Tests for (a) Latino:White bias and (b) African American:White bias: Denver, CO, metropolitan area; May 2009-May 2010. Note. Implicit Association Test scores are conventionally interpreted as showing a group preference that is strong (≥ 0.65), moderate (0.35−0.64), or mild (0.15–0.34), or as showing no group preference (Cohen’s d = 0−0.14).