Dismantling Institutional Racism: The Role of Behavioral Science.

Institutionalized racism embeds our systems of healthcare delivery and medical education. This produces racial healthcare disparities which have been shown to severely impact both physical and behavioral health outcomes. Efforts to address institutionalized racism often focus on individualized efforts directed towards the healthcare workforce. However, more effective system level approaches are emerging. The behavioral health sciences can play a role in dismantling institutionalized racism by providing the evidence needed to understand effects on individuals and develop targeted system level approaches.

Medicalization of poverty: a call to action for America's healthcare workforce.

As a social determinant of health, poverty has been medicalised in such a way that interventions to address it have fallen on the shoulders of healthcare systems and healthcare professionals to reduce health inequities as opposed to creating and investing in a strong social safety net. In our current fee-for-service model of healthcare delivery, the cost of delivering secondary or even tertiary interventions to mitigate the poor health effects of poverty in the clinic is much more costly than preventive measures taken by communities. In addition, this leads to increasing burnout among the healthcare workforce, which may ultimately result in a healthcare worker shortage. To mitigate, physicians and other healthcare workers with power and privilege in communities systematically disenfranchised may take action by being outspoken on the development and implementation of policies known to result in health inequities. Developing strong advocacy skills is essential to being an effective patient advocate in and outside of the exam room.

Examining the Unconscious Racial Biases and Attitudes of Physicians, Nurses, and the Public: Implications for Future Health Care Education and Practice.

Background: While studies have shown that unconscious bias (UB) is associated with racial health care disparities, its magnitude in the health care workforce has not been examined. Furthermore, there is an absence of studies examining the attitudes of health care workers toward UB, which may have implications for intervention effectiveness. This study aims to address these gaps to further understand the potential scope of impact of UB and interventions designed to address it on patient care. Methods: This study provides an analysis to understand the magnitude of UB among physicians and nurses and their attitudes. Comparisons are made to the public to infer the potential causes and influences of medical education and training on individuals' UB. Results: The health care workforce demonstrated a greater preference for whites than the public, nurses more so than physicians. UB was also shown to have significant geographic and professional variability. Nurses are more likely to agree that their UB is a reflection of the cultures they are exposed to unlike physicians who see their UB as an indication of individualistic or automatic thoughts toward people of another race. Conclusions: The UB of the health care workforce and their attitudes toward UB differ significantly from those of the general public. Current and future interventions aimed at reducing UB, to include education and policy changes, should consider these variations, especially when legislating mandates.