Female patient talking to a nurse

Understanding Implicit Bias in Health Care

You might have heard about implicit bias as it relates to health care in the news lately. All medical professionals in the state of Michigan will be required to receive training on the issue, but it’s a topic that everyone can benefit from learning more about.

Essentially, implicit biases are unrealized or unconscious personal biases that can affect our decision-making. Beliefs you form due to societal attitudes, the way you were raised, and other factors might make you treat people differently without you even realizing it or meaning to. This can have dangerous and unequal consequences in a health care setting.

“Every medical professional is mission-driven to heal their patient — without regard for that patient’s cultural background. But research indicates that bias does show in various ways in the delivery of health care, more often implicitly rather than explicitly,” said Daniel J. Loepp, president and CEO, Blue Cross Blue Shield of Michigan. “It benefits all medical professionals to spend time working to recognize where implicit bias may be present in the delivery of care and developing approaches to address it to the benefit of patients everywhere.”

What are examples of implicit bias in health care?

During the COVID-19 pandemic, reports indicated that African Americans with concerning symptoms weren’t tested as often as their white counterparts. Pairing that reality with less access to testing sites due to existing disparities in the health care system and other societal factors contributed to higher rates of the virus. In Michigan, African Americans represent 14% of the population, yet account for 40% of COVID-19 related deaths.

Beyond COVID-19, implicit bias can show up in the unconscious beliefs of health care providers. A survey of white medical students in 2016 showed that many believed untruths about their potential patients based on skin color. These unconscious beliefs led trainees to make different pain relief recommendations for African American patients than for similarly situated white patients.

Anecdotally, African Americans and other minority populations say they feel their health concerns often aren’t taken seriously by medical professionals, leading to distrust in the overall system.

Why is it important to address bias in health care?

Addressing bias and disparities in health care is a matter of basic human justice. Your health outcomes shouldn’t be determined by the color of your skin or the zip code you live in. On average, African Americans have lower overall life expectancy, meaning literal years of life are at stake.

Four years ago, Blue Cross Blue Shield of Michigan implemented a cross-functional Health Disparities Action Team to ensure the needs of our diverse members are being met. Through those efforts, we’re working to detect and monitor known disparities in health care while working toward policies and programs that improve health equity, cultural competency and the quality of care delivery.

Implicit bias education is another tool implemented at Blue Cross and one we’re excited to see play an important role in the health care field moving toward better care for everyone in Michigan.

“Each of us have biases. The key is that we take the time and space to understand how they show up, why they show up and ways to become more self-aware and conscious in our interactions with others,” said Bridget Hurd, senior director, Diversity and Inclusion, Blue Cross Blue Shield of Michigan. “This is a critical step as we move forward to ensure everyone has the health care they are entitled to and deserve.”

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Photo credit: Courtney Hale

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