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The strangest of all encounters: racial and ethnic discrimination in US health care

Overview of attention for article published in Cadernos de Saúde Pública, January 2017
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The strangest of all encounters: racial and ethnic discrimination in US health care
Published in
Cadernos de Saúde Pública, January 2017
DOI 10.1590/0102-311x00104416
Pubmed ID

Sherman A. James


In 2003, a Committee of the Institute of Medicine of the National Academy of Sciences summarized hundreds of studies documenting that US racial minorities, especially African Americans, receive poorer quality health care for a wide variety of conditions than their White counterparts. These racial differences in health care persist after controlling for sociodemographic factors and patients' ability to pay for care. The Committee concluded that physicians' unconscious negative stereotypes of African Americans, and perhaps other people of color, likely contribute to these health care disparities. This paper selectively reviews studies published after 2003 on the likely contribution of physicians' unconscious bias to US health care disparities. All studies used the Implicit Association Test which quantifies the relative speed with which individuals associate positive attributes like "intelligent" with Whites compared to Blacks or Latino/as. In addition to assessing physicians' unconscious attitudes toward patients, some studies focused on the behavioral and affective dimensions of doctor-patient communication, such as physicians' "verbal dominance" and whether patients felt respected. Studies reviewed found a "pro-white" unconscious bias in physicians' attitudes toward and interactions with patients, though some evidence suggests that Black and female physicians may be less prone to such bias. Limited social contact between White physicians and racial/ethnic minorities outside of medical settings, plus severe time pressures physicians often face during encounters with patients who have complex health problems could heighten their susceptibility to unconscious bias.

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Mendeley readers

The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 35 100%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 8 23%
Student > Bachelor 5 14%
Student > Master 4 11%
Researcher 2 6%
Student > Ph. D. Student 2 6%
Other 3 9%
Unknown 11 31%
Readers by discipline Count As %
Medicine and Dentistry 8 23%
Psychology 5 14%
Nursing and Health Professions 4 11%
Social Sciences 4 11%
Decision Sciences 1 3%
Other 2 6%
Unknown 11 31%