Systemic racism is often rooted in the implicit or hidden biases of the individuals who make up those systems. It’s present in most, if not all, social systems, including health care. Implicit bias is bias we often do not know we have. For many, it is the result of growing up in a society that through messaging, media portrayals and social groups, has shaped the unconscious image we have about people with certain characteristics, such as race.

Researchers have been examining implicit bias in patient care for some time. Consider these findings:

  • Physicians with higher implicit bias scores commandeered a greater portion of the patient-physician talk time during appointments, according to a study by Nao Hagiwara, Ph.D., at Virginia Commonwealth University (Social Science & Medicine, Vol. 87, 2013). This led to patients having less trust and confidence in their physicians, as well as a perception of lower quality care.
  • Providers with higher implicit bias scores were viewed as less supportive and not as patient centered. Patients reported having more difficulty remembering what their physicians told them, less confidence in their treatment plans and thinking would be more difficult to follow recommended treatments (Journal of Clinical Oncology, Vol. 34, No. 24, 2016).

Implicit bias is not limited to race. It also exists for other characteristics, such as gender, age, sexual orientation, gender identity, disability status and physical appearance. By definition, implicit bias is unconscious and unintentional. For this reason, when it is brought to our attention, we often become defensive, but awareness is a necessary first step in changing the assumptions we all make about other people based upon their race and/or other characteristics and being advocates for change.

In Seeing Patients: Unconscious Bias in Health Care, Dr. Augustus White offers these tips to combat implicit bias in healthcare, which can also be applied to FSSA – both in our working relationships with one another and with FSSA clients:

  • Have a basic understanding of the cultures of others.
  • See others as individuals.
  • Recognize situations that magnify stereotyping and bias
  • Confirm other people’s understanding of instructions you are providing

About Social Structures

Social structures can dictate the systems and rules we all live under. And when inequity or implicit bias exists in these systems, it can have negative ramifications. The impact can be broad as well as personal, directly effecting our neighborhoods and communities, as well as the overall health and well-being of individuals. Examples of this can be seen in health care, education, the legal system and judicial process, and even social classes. When bias exists within these systems, it can be difficult to ensure a just outcome for all.