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Preschools, Hospitals, and Job Interviews—The Impact of Implicit Bias

NPR’s recent report on implicit bias among preschool teachers was heartbreaking... but not surprising. In 1999, researchers used a similar technique to uncover implicit bias in health care by presenting identical vignettes of patients with cardiac symptoms to cardiologists. The 8 patients all had the same symptoms, the same exam and laboratory findings, but differed in race and gender. In findings that paralleled this study among preschool teachers, doctors were less likely to refer black men and women for the medically appropriate standard of care than white patients. Sadly, we’re seeing the consequences of these biases today through the substantial disparities in health outcomes in the U.S. based on race and ethnicity. The 5-year survival rate for lung cancer, for example, is 20 percent lower for black patients than for white patients. The same pattern holds for HIV—despite accounting for only 12 percent of the U.S. population, black men and women account for 45 percent of new HIV diagnoses but are less likely to be retained in treatment.

But doctors and preschool teachers aren’t the only ones who have these unconscious biases—we all do (if you are skeptical, consider taking this self-assessment—chances are you will be surprised), and we all impact our communities through our actions. Do you evaluate grant proposals? Decide who’s on the steering committee for a collaborative effort? Choose speakers for an event? Review employment applications? Grade students?

All of these choices present an opportunity to mitigate the effects of bias in your work. This is where some of the techniques (courtesy of the Kirwan Institute’s 2014 report on implicit bias) we're trying at FSG to overcome our own implicit biases can come into play:

  • Counter-stereotypic training to develop new associations through visual or verbal cues
  • Get intergroup exposure, particularly to counter-stereotypic individuals, e.g., male nurses, elderly athletes, or female scientists
  • Educate yourself about implicit bias
  • Build in accountability: “the implicit or explicit expectation that one may be called on to justify one’s beliefs, feelings, and actions to others”
  • Consider contrasting viewpoints and recognize multiple perspectives
  • Engage in deliberative processing, particularly during situations in which decision-makers may face time constraints or a weighty cognitive load (use equity primes to engage with intention)

We are finding these approaches helpful, but we know we can always do more. What approaches do you use to address implicit bias in your work? How do you talk to colleagues and peers about biases? Please share any experiences, guidance, or resources in the comments below.