This blog explains two types of bias and how it affects our every day decision making.
America seems to have a more divisive tone now than in recent years. Images are all around us with one that seems to have people quite divided: the Confederate Flag. I often have a sense of curiosity when I see this flag flown on people’s front porch, flag pole, or perhaps on their car. I wonder if the person is from the Deep South and proud of their southern roots? Are they racist and support the heritage of slavery? After all, this same flag was taken off of the General Lee from The Dukes of Hazard. Yet, until last year, it was still flying high at the South Carolina State Capital from which it was flown since the 100th anniversary of the civil war or incorporated into a state flag like Mississippi. When I looked into this further, there are several polls looking at society’s view on this flag. Many Americans view the confederate flag as a symbol of Southern pride. However, when viewed upon along racial lines, a different story is told. There are 17% of African Americans and 66% of Caucasians who think that it is a symbol of Southern Pride. Conversely, 72% of African Americans and 25% of Caucasians think it is symbolic of racism(1.)
Before reading the polls, how would I know any of this? I have a conscious bias against the Confederate Flag.
Explicit (conscious) bias is a part of all of us. It is a core part of our beliefs and expressions. Bias helps to shape our opinions and perspectives based upon life experiences. It can also affect our decision making. When biases are known, one can make choices independently, attempting to disregard them to make an objective decision. However, implicit (unconscious) biases can affect our decisions unknowingly. We are largely unaware of the effects of this type of bias. We can’t predict the effect of implicit bias upon our decisions because we are largely ignorant of them.
Implicit bias has been long studied with evidence supporting its presence in healthcare(2.) Unconscious biases against race, ethnicity(3), gender(4), weight(5,6) and disabilities(7 among others have been studied. These views are pervasive within society, industry and the medical profession at large(2.) Implicit bias has been a key contributor to health disparities, or the unequal treatment of certain populations(2). This is concerning as medical professionals strive to treat all of their patients equally with high quality care. There have been publications that link differences in actual health outcomes(8) or a lack thereof(9.) In the latter example, stronger and trusting relationships were thought to be the key mitigating factor to the effects of bias. Furthermore, increased awareness of biases can be helpful to develop more trusting and satisfying healthcare and professional encounters(4.)
Increasing awareness of biases can reduce its effect upon decision making(2.) The Implicit Association Test (IAT) is one way that you can learn more about your implicit biases. By going online you can test your association to race, gender, weight, disability, or even presidents among others. This free computerized test uses timed responses to pictures and words in order to detect implicit bias. By doing so, you can learn more about yourself and reduce the potential effects of bias within all interpersonal relationships, including professional encounters. Beware; you may be surprised at the results. However, you will be armed with information about your implicit biases that will encourage healthier and more trusting relationships. Jarret R. Patton, MD