How Bias Works

(cc photo by adiything)

It's pretty clear that most bias happens at an unconscious level and that things like racial and gender bias are much more pervasive than we'd like to believe. Check out some of the implicit association tests available online if you don't believe me. But some of the details of how this plays out are downright scary. Consider the medical example cited in Shankar Vendatam's column on unconscious bias:

If you ask people whether men and women should be paid the same for doing the same work, everyone says yes. But if you ask volunteers how much a storekeeper who runs a hardware store ought to earn and how much a storekeeper who sells antique china ought to earn, you will see that the work of the storekeeper whom volunteers unconsciously believe to be a man is valued more highly than the work of the storekeeper whom volunteers unconsciously assume is a woman. If you ask physicians whether all patients should be treated equally regardless of race, everyone says yes. But if you ask doctors how they will treat patients with chest pains who are named Michael Smith and Tyrone Smith, the doctors tend to be less aggressive in treating the patient with the black-sounding name. Such disparities in treatment are not predicted by the conscious attitudes that doctors profess, but by their unconscious attitudes—their hidden brains.

There are a lot of quality issues in our health care system beyond the basic access issues, and in an increasingly diverse society this sort of thing is not helping to resolve them.