Johnson Tiffani J, Winger Daniel G, Hickey Robert W, Switzer Galen E, Miller Elizabeth, Nguyen Margaret B, Saladino Richard A, Hausmann Leslie R M
Division of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pa.
Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pa.
Acad Pediatr. 2017 Mar;17(2):120-126. doi: 10.1016/j.acap.2016.08.010. Epub 2016 Sep 13.
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.
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.
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.
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.
普通人群和大多数医生对成年黑人存在隐性种族偏见。儿科医生对成年黑人也存在隐性偏见，尽管程度低于其他专科医生。目前尚无关于儿科医生或其他医生对儿童的隐性种族态度的已发表研究。我们的目的是比较在儿科急诊科工作的住院医师对成年人与儿童的隐性种族偏见，并评估偏见是否因专科（儿科、急诊医学或其他）、性别、种族、年龄和培训年份而有所不同。
我们在儿科急诊科轮班之前，使用成人和儿童种族内隐联想测验（IAT）测量住院医师的隐性种族偏见。广义线性模型比较了成人和儿童IAT分数，并确定参与者人口统计学特征与成人和儿童IAT分数之间的关联。
在91名住院医师中，我们发现他们在成人种族IAT（均值 = 0.49，标准差 = 0.34）和儿童种族IAT（均值 = 0.55，标准差 = 0.37）上都存在中度的亲白人/反黑人偏见。成人和儿童种族IAT分数之间没有显著差异（差异 = 0.06，P = 0.15）。隐性偏见与住院医师的人口统计学特征无关，包括专科。
这是第一项表明住院医师对黑人儿童存在隐性种族偏见的研究，其程度与对成年黑人的偏见程度相似。我们研究中的偏见并未因住院医师的人口统计学特征（包括专科）而有所不同，这表明儿科住院医师与其他医生一样容易受到隐性偏见的影响。未来需要开展研究，以探讨医生对父母和儿童的隐性态度如何可能影响儿科医疗保健中的不平等现象。
