Bias and Discrimination Flashcards

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1
Q

Define stereotype

A

o Cognitive expectancies and associations about an outgroup

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2
Q

Define prejudice

A

o Emotional reaction to someone on basis of group membership

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3
Q

Define discrimination

A

o Acting on the basis of stereotypes and prejudices; denial of equality of treatment

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4
Q

Why is early identification and treatment of ill-health important?

A

to prevent/treat negative health consequences of non-treatment

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5
Q

Why might trust in the medical profession have decreased over the last 50 yrs

A
  • heightened awareness of medical errors
  • more questioning based approach to treatment
  • experience of bias
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6
Q

What is the greatest concern affecting people with disabilities?

A

Social isolation

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7
Q

What is the NHS constitution regarding patient rights

A

Equitable treatment, regardless of race, ethnicity, etc. is a patient right

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8
Q

Give an example of institutional bias, where equitable treatment may not be delivered

A

• Denial of healthcare
• Requirement for people with obesity to lose weight (5%) before receiving surgery
o But if this isn’t met, then they’re not offered the help to loose weight (!)
• NICE recommendation to offer surgery more widely (at lower BMI values)

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9
Q

Why are older adults often disproportionately disadvantaged

A

• Less likely to be referred to specialist services
• Less likely to get the medications and tests they need
• More likely to experience poorer clinical interactions
o See Bowling (2007); Callahan et a. (2000); Hajjij et al. (2010)

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10
Q

In what way does bias affect workers within the NHS?

A
  • Minority healthcare professionals (HCPs) concentrated in lower paid jobs and over-represented in cases of misconduct
  • HCPs also suffer racial abuse by patients
  • 40% of doctors in NHS are black and ethnic minority populations
  • CONCLUSION: institutional bias exists in healthcare and affects both patients’ access to the system and treatment within it
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11
Q

Define personally-mediated bias

A

Personally-mediated bias reflects individually-based differential treatment based on group membership

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12
Q

Define institutional bias

A

Institutional bias refers to accessibility of healthcare; opportunities

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13
Q

What did the institute of medicine (2003) report reveal regarding BAME populations and treatments

A

o Black patients and minority population receive fewer procedures and poorer-quality medical care
o Effect remains even when accounting for variations in e.g., insurance, disease severity, income, education etc. (factors known to affect access to healthcare)

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14
Q

The GMC principles state doctors should not refuse or delay treatment due to a patient’s actions and shouldn’t discriminate.
Therefore if they are biased, how could this be evident?

A

At an unconscious level

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15
Q

What is an implicit attitude

A

operate at unconscious level, involuntarily formed, largely unknown to the individual

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16
Q

What is an explicit attitude

A

operate at conscious level, deliberately formed and expressed

17
Q

Give one way you may assess implicit bias

A

with the Implicit Associations Test (IAT)

18
Q

What and how does the IAT measure bias

A

strength of association between social categories (e.g., black, obese) and evaluations (good, bad) or stereotypes
• Bias is determined through speed of responding to paired associations
• Indicated by slower processing of pairs that are inconsistent with expectations

19
Q

Outline 1 study which gives evidence of the presence of bias in HCPs

A
  • Schwartz (2003): evidence of implicit obesity bias which was uncorrelated with explicit bias
  • Sabin (2008): replicated effects for racial bias
  • White-Means (2009): biases present throughout medical training- perhaps not training them well to avoid bias?
20
Q

Outline 1 study which gives evidence of the presence of bias in treatment

A

• Green (2007): vignette study of patient presenting with chest pain
o No evidence of explicit bias, but evidence of implicit bias
o Bias associated with likelihood of giving patient thrombolysis (to break down blood clots)
o More likely to administered to white patients
• Sabin (2012): Black patients implicitly associated with non-adherence
o Implications for assumptions made in consultation settings?

21
Q

Outline 1 study which gives evidence that patients may be affected by bias

A

• Todd (2000): white and black patients deemed to have similar pain levels but white patients more likely to receive pain medication
o Similar effects in other groups (Hispanics)
• Relatives of Black patients evaluate end-of-life care for family members as lower compared to Whites (Welch et al., 2005)
• Non-white patients report less satisfaction with doctor interactions than do whites (Barr, 2004) – i.e., bias translates to consultations with patients
• Doesn’t necessarily indicate bias, but..
• Implicit bias in doctors is associated with lower patient satisfaction (Cooper et al., 2012)
• Indicates that doctor bias is affecting treatment (or at least communication in treatment settings)
• Biased doctors tend to be evaluated by patients as less friendly and warm (Penner et al., 2010)

22
Q

Why does bias occur?

A

• Attentional resources are important
• Fiske & Taylor (1984) “cognitive miser”
o Human propensity to do just enough mental work to function
o Reliance on stereotypes: mentally easier than forming individuated impressions
o Stereotype-based impressions are over-simplifications – loss of individuating information
• Assumes superiority of individually-based impression formation (over-simplification of what stereotyping is- assumes its always wrong)

23
Q

Describe the activation of stereotypes

A

perceiving someone in terms of their category membership, rather than their individual attributes

24
Q

Describe the application of stereotypes

A

treating someone in terms of their category membership (e.g., expressing bias; discrimination)

25
Q

What concept could inhibit stereotype activation?

A

cognitive loading