Campbell Crystal N
DNP Nurse Anesthesia Degree Program Betty Irene Moore School of Nursing, University of California Davis, 2570 48th Street, Sacramento, CA, 95817, United States of America.
Int J Equity Health. 2025 Apr 7;24(1):97. doi: 10.1186/s12939-025-02464-9.
The United States (U.S.) spends the highest amount on healthcare globally, at $12,434 per capita, yet experiences poor health outcomes, including lower life expectancy and higher rates of preventable mortality. With a life expectancy of 76.4 years, the U.S. lags behind other high-income countries, which have an average of 81.1 years. Health inequities, especially among marginalized racial and ethnic groups, contribute significantly to these disparities. Implicit bias among healthcare providers plays a critical role in perpetuating these inequities, resulting in misdiagnoses, undertreatment, and patient mistrust.
This paper examines the role of implicit bias in healthcare disparities, its impact on marginalized populations, and the ethical responsibility of healthcare providers in mitigating bias. It explores the neuroscientific and psychosocial mechanisms of implicit bias and its effects on patient outcomes.
A literature review was conducted using PubMed, APA PsycNet, JSTOR, ProQuest, and Google Scholar. The search included peer-reviewed articles from 2008 to 2025 discussing implicit bias in healthcare, its effects on marginalized groups, and evidence-based mitigation strategies. Exclusion criteria included responses and commentaries.
Quantitative findings on implicit bias mitigation strategies show mixed results. Counter-stereotypic strategies and intention-setting interventions reduced Implicit Association Test (IAT) scores by 0.15 at 4 weeks and 0.17 at 8 weeks. However, some strategies, like stereotype replacement and intergroup contact, consistently showed measurable positive effects. Qualitative findings revealed that simulation-based training and perspective-taking significantly increased self-awareness, empathy, and behavioral changes in healthcare providers. Mindfulness meditation and emotional regulation techniques helped reduce stress and bias in high-pressure settings. These findings suggest that while some strategies are effective in the short term, long-term success requires ongoing training, continuous reflection, and practical application in clinical practice.
Health inequities in the U.S. are a public health crisis, disproportionately affecting marginalized groups. These disparities are preventable, yet persistent due to systemic issues. Healthcare providers must address implicit biases and commit to unbiased, ethical care. Institutions must prioritize health equity through inclusive cultures, comprehensive bias training, and accountability, exemplified by efforts like UW Medicine's bias incident reporting.
美国在全球医疗保健方面的支出最高，人均达12434美元，但健康结果却很差，包括预期寿命较低和可预防死亡率较高。美国的预期寿命为76.4岁，落后于其他高收入国家，这些国家的平均预期寿命为81.1岁。健康不平等，尤其是在边缘化的种族和族裔群体中，是造成这些差距的重要原因。医疗保健提供者的隐性偏见在使这些不平等长期存在方面起着关键作用，导致误诊、治疗不足和患者不信任。
本文探讨隐性偏见在医疗保健差距中的作用、其对边缘化人群的影响以及医疗保健提供者在减轻偏见方面的道德责任。它探讨了隐性偏见的神经科学和社会心理机制及其对患者结果的影响。
使用PubMed、APA PsycNet、JSTOR、ProQuest和谷歌学术进行文献综述。搜索范围包括2008年至2025年的同行评审文章，讨论医疗保健中的隐性偏见、其对边缘化群体的影响以及基于证据的缓解策略。排除标准包括回应和评论。
关于隐性偏见缓解策略的定量研究结果喜忧参半。反刻板印象策略和设定意图干预在4周时将内隐联想测验（IAT）分数降低了0.15，在8周时降低了0.17。然而，一些策略，如刻板印象替代和群体间接触，始终显示出可衡量的积极效果。定性研究结果表明，基于模拟的培训和换位思考显著提高了医疗保健提供者的自我意识、同理心和行为改变。正念冥想和情绪调节技巧有助于在高压环境中减轻压力和偏见。这些发现表明，虽然一些策略在短期内有效，但长期成功需要持续培训、不断反思以及在临床实践中的实际应用。
美国的健康不平等是一场公共卫生危机，对边缘化群体的影响尤为严重。这些差距是可以预防的，但由于系统性问题而持续存在。医疗保健提供者必须解决隐性偏见问题，并致力于提供无偏见的道德护理。机构必须通过包容性文化、全面的偏见培训和问责制来优先考虑健康公平，华盛顿大学医学中心的偏见事件报告等努力就是例证。
