TY - JOUR
T1 - Comparison of Physician Implicit Racial Bias Toward Adults Versus Children
AU - Johnson, Tiffani J.
AU - Winger, Daniel G.
AU - Hickey, Robert W.
AU - Switzer, Galen E.
AU - Miller, Elizabeth
AU - Nguyen, Margaret B.
AU - Saladino, Richard A.
AU - Hausmann, Leslie R M
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background and Objectives The general population and most physicians have implicit racial bias against black adults. Pediatricians also have implicit bias against black adults, albeit less than other specialties. There is no published research on the implicit racial attitudes of pediatricians or other physicians toward children. Our objectives were to compare implicit racial bias toward adults versus children among resident physicians working in a pediatric emergency department, and to assess whether bias varied by specialty (pediatrics, emergency medicine, or other), gender, race, age, and year of training. Methods We measured implicit racial bias of residents before a pediatric emergency department shift using the Adult and Child Race Implicit Association Tests (IATs). Generalized linear models compared Adult and Child IAT scores and determined the association of participant demographics with Adult and Child IAT scores. Results Among 91 residents, we found moderate pro-white/anti-black bias on both the Adult (mean = 0.49, standard deviation = 0.34) and Child Race IAT (mean = 0.55, standard deviation = 0.37). There was no significant difference between Adult and Child Race IAT scores (difference = 0.06, P = .15). Implicit bias was not associated with resident demographic characteristics, including specialty. Conclusions This is the first study demonstrating that resident physicians have implicit racial bias against black children, similar to levels of bias against black adults. Bias in our study did not vary by resident demographic characteristics, including specialty, suggesting that pediatric residents are as susceptible as other physicians to implicit bias. Future studies are needed to explore how physicians' implicit attitudes toward parents and children may impact inequities in pediatric health care.
AB - Background and Objectives The general population and most physicians have implicit racial bias against black adults. Pediatricians also have implicit bias against black adults, albeit less than other specialties. There is no published research on the implicit racial attitudes of pediatricians or other physicians toward children. Our objectives were to compare implicit racial bias toward adults versus children among resident physicians working in a pediatric emergency department, and to assess whether bias varied by specialty (pediatrics, emergency medicine, or other), gender, race, age, and year of training. Methods We measured implicit racial bias of residents before a pediatric emergency department shift using the Adult and Child Race Implicit Association Tests (IATs). Generalized linear models compared Adult and Child IAT scores and determined the association of participant demographics with Adult and Child IAT scores. Results Among 91 residents, we found moderate pro-white/anti-black bias on both the Adult (mean = 0.49, standard deviation = 0.34) and Child Race IAT (mean = 0.55, standard deviation = 0.37). There was no significant difference between Adult and Child Race IAT scores (difference = 0.06, P = .15). Implicit bias was not associated with resident demographic characteristics, including specialty. Conclusions This is the first study demonstrating that resident physicians have implicit racial bias against black children, similar to levels of bias against black adults. Bias in our study did not vary by resident demographic characteristics, including specialty, suggesting that pediatric residents are as susceptible as other physicians to implicit bias. Future studies are needed to explore how physicians' implicit attitudes toward parents and children may impact inequities in pediatric health care.
KW - implicit bias
KW - pediatric health care disparities
KW - physician implicit attitudes
KW - racial bias
KW - racial disparities
UR - http://www.scopus.com/inward/record.url?scp=85005996193&partnerID=8YFLogxK
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U2 - 10.1016/j.acap.2016.08.010
DO - 10.1016/j.acap.2016.08.010
M3 - Article
C2 - 27620844
AN - SCOPUS:85005996193
VL - 17
SP - 120
EP - 126
JO - Academic Pediatrics
JF - Academic Pediatrics
SN - 1876-2859
IS - 2
ER -