Research Thesis Assignment

Carmen Major

February 16, 2021

Senior Seminar

How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States

In the United States, approximately 700 women die each year due to complications during pregnancy and delivery. The pregnancy related mortality ratio varies significantly by race. There has been a 50% increase in the US maternal mortality rate over the same time period. From 2011 to 2015, White women experience 13 deaths per 100,000 births, while black women experience 42.8 deaths per 100,000 births. The goal of this article is to review implicit bias and its impact that it can have on healthcare and health disparities.

Every three and five pregnancy related deaths could have been prevented. Implicit bias is defined as thoughts and feelings that exist outside of conscious awareness and subsequently can affect human understanding, actions, and decisions unknowingly. Implicit bias developed early in life from exposure to repeated reinforcement of stereotypes. Implicit bias has permeated into the U.S. healthcare system and is a contributing factor to the high negative maternal health outcome experienced by African American women. The Implicit Association Test is a tool that can be used to assess implicit bias. It is available online and is computerized.

Implicit bias is directly correlated with lower quality of healthcare for patients. Implicit bias can also affect how providers communicate with their patients. It is said that the reason of implicit bias in the healthcare system could be due to an overload or high stress. Being in the medical profession, one strives for equal treatment of all patients, but racial disparities are prevalent in the healthcare system. Racial disparities are prevalent because implicit bias affects the providers perception, which create inequalities in access treatment decisions, and health outcomes. Some providers hold fast believes about biological differences between African American and Caucasian individuals that increase the bias. Some believe that African American people have less sensitive nerve endings, thicker skin, and stronger bones. Due to these beliefs, providers tend to rate African American patient pain lower which results in less appropriate treatment recommendations.

Approximately one and five black and Hispanic women experience miss treatment from hospital-based care providers because of their race, ethnicity, cultural background, and or language. This has led many women to avoid the hospital if possible and utilize midwives in dollars for at home or birth center services.

It is important to improve communication and the need for healthcare providers to be aware of their own implicit biases. To resolve racial disparities in maternal health many things can be done. Practicing cultural humility eases implicit bias, promotes empathy, and edifies healthcare providers in acknowledging and respecting patient individuality. Cultural humility stresses that providers should make a connection with their patients other than assuming. Awareness of implicit bias should be incorporated in medical and nursing schools as well as residency training programs to train the next generation of healthcare providers to treat patients with respect and to provide high-quality care. Hospital systems should also implement mandatory Maternal Mortality and Morbidity reviews which can help identify areas of care that need improvement.

Reference

Saluja, B., Bryant Z. How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States. Journal of Women’s Health [Internet]. 2021; 30(2):270 -273 doi:10.1089/jwh.2020.8874