Kuruppu Yumal, Rupasinghe Thrangani, Jayasinghe Saroj
Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Belihuloya, Sri Lanka.
Asian Bioeth Rev. 2021 Nov 6;14(2):207-212. doi: 10.1007/s41649-021-00195-x. eCollection 2022 Apr.
Racial bias and language discrimination are recognized in the health sector in countries such as Sri Lanka. This may extend to images used in health communication and educational literature. We analyzed the racial and ethnic representation in a sample of newspapers and websites related to health obtained over a period. Most of the human figures in health-related messages in newspapers had an overrepresentation of Caucasians. This trend was absent in websites where 73% of the images of Sri Lankans. The reasons for this pattern could be due to the availability of image-quality photographs and exposure to a norm that is racially biased. For example, a majority of images in medical textbooks and prestigious journals are of white Caucasians. A predominance of such images could have two impacts. At an individual level, it would affect acquiring skills of visual diagnoses. At a societal level, it may reinforce a view that most forms of health-related knowledge are created in the West and could add to existing discrimination based on skin color (i.e., colorism). The latter is a known psychosocial stressor that contributes to psychological distress among socially disadvantaged populations and promotes behaviors adverse to health and residential segregation. These may contribute to poorer physical, mental, and infant health outcomes in dark-skinned individuals compared to lighter-skinned in the USA and Canada. Such discrimination within the health system would compromise basic human dignity, disempower patients, and violate the principle of autonomy. Sri Lankan media, the healthcare profession, and educationists need to recognize the relevance and importance of using images that appropriately reflect the realities of their own environment, its people, and patients.
在斯里兰卡等国家，卫生部门存在种族偏见和语言歧视现象。这可能延伸到卫生宣传和教育文献中使用的图像。我们分析了一段时间内获取的与健康相关的报纸和网站样本中的种族和民族代表性。报纸上与健康相关信息中的大多数人物形象中白种人占比过高。而在网站上这种趋势并不存在，网站上73%的人物形象是斯里兰卡人。这种模式的原因可能是高质量图像的可得性以及受到种族偏见规范的影响。例如，医学教科书和著名期刊中的大多数图像都是白种人。这类图像占主导地位可能有两个影响。在个人层面，它会影响视觉诊断技能的获取。在社会层面，它可能强化一种观点，即大多数与健康相关的知识都是在西方创造的，并且可能加剧现有的基于肤色的歧视（即肤色主义）。后者是一种已知的社会心理压力源，会导致社会弱势群体出现心理困扰，并促进行为不利于健康和居住隔离。与美国和加拿大肤色较浅的人相比，这些可能导致肤色较深的人在身体、心理和婴儿健康方面的结果更差。卫生系统内的这种歧视会损害基本的人类尊严，剥夺患者的权力，并违反自主原则。斯里兰卡媒体、医疗行业和教育工作者需要认识到使用能恰当反映本国环境、人民和患者实际情况的图像的相关性和重要性。
