Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review

Implicit attitudes are thoughts and feelings that often exist outside of conscious awareness, and thus are difficult to consciously acknowledge and control. Negative implicit attitudes about people of color may contribute to racial/ethnic disparities in health and healthcare. We systematically reviewed evidence on implicit racial/ethnic bias among health care professionals and on the relationships between health care professionals’implicit attitudes about racial/ethnic groups and health care out-comes. Fifteen relevant studies were identified through searches of bibliographic databases and reference lists of studies that met inclusion criteria. Low to moderate levels of implicit racial/ethnic bias were found among healthcare professionals in all but 1 study. These implicit bias scores are similar to those in the general population. Levels of implicit bias against Black, Hispanic/Latino/Latina, and dark-skinned people were relatively similar across these groups. Although some associations between implicit bias and health care out-comes were non significant,results also showed that implicit bias was significantly related to patient—provider interactions,treatment decisions, treatment adherence, and patient health outcomes.

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