Study: Doctors More Likely to Use Negative Language When Referring to Latinos
Racism and discrimination are among Latinos’ biggest barriers to healthcare.
Driven by years of social, structural, and institutionalized racism, Latinos and other people of color face inequities in care and mistrust of the healthcare system.
This prompts reluctance to receive life-saving care or health screenings. Putting off care can result in a delayed diagnosis and prolonged and more expensive medical treatment for chronic diseases, such as cancer, leading to worse health outcomes.
But how widespread is discrimination in healthcare?
Doctors are more likely to use negative language when referencing Black and Latino patients in medical records, according to a new study in JMIR Medical Informatics.
Let’s unpack the study and the meaning behind the results.
Language Bias Study Methodology
In “Examining Linguistic Differences in Electronic Health Records for Diverse Patients With Diabetes: Natural Language Processing Analysis,” researchers studied the medical records of Black, Latino, and white patients seen by 281 physicians across a large metropolitan area to see if they displayed language bias toward their patients.
Language bias is a tendency to favor or discriminate against certain groups via use of words that unintentionally marginalize, belittle, or offend.
The research team “wanted to know whether (they) could detect such biases in the language providers use in health records,” said Eden King, a professor of psychological sciences at Rice University and one of the study’s lead authors.
“Previous studies have shown that care providers’ biases may be part of the reason for racial disparities in health,” King said in an accompanying news release.
One such study cited by researchers was the National Healthcare Disparities Report.
Released in 2018, the report discovered that Black and Latino patients receive inferior care compared to white patients.
The report examined care based on several quality measures, including responses such as, “physicians sometimes or never showed respect for what they had to say” and “physicians sometimes or never spent enough time with them.”
Black patients reported receiving inferior care on 40% of those quality measures while Latinos reported 35% worse care.
Language Bias Study Findings
Building on that knowledge, researchers took a deeper dive into the details and indicators of racial and ethnic bias in medical care.
Doctor’s summaries for Black and Latino patients tended to contain more negative adjectives, such as “unkind,” “negative,” or “stupid,” when describing their interactions.
Black and Latino patients were also subject to more fear and disgust words, such as “intimidate,” “attack,” “cringe,” and “criticize.”
Medical notes for Latino patients contained fewer positive adjectives, such as “supportive,” “kind,” “great,” and “nice,” trust verbs, such as “affirm,” “advise,” “confide,” and “cooperating,” and joy words, such as “admiration,” “elated,” “glad,” and “pleased,” when compared to those of white patients.
Study findings point to clear language differences used for patients of color, indicating the presence of racial and ethnic bias in medicine.
“Understanding that providers’ language may indicate bias points to an opportunity to interrupt it,” King said in the news release. “If we can perfect algorithms to detect such bias, we can raise awareness in the moment of the patient-provider conversation. That awareness may be enough to encourage more equitable health care.”
Putting a Stop to Ethnic and Racial Bias
There are many ways the healthcare system can address ethnic and racial bias.
One effective way of tackling bias is by increasing cultural competency.
Cultural competency entails an understanding and respect of cultural values, attitudes, and beliefs. It should be considered when planning, implementing, evaluating, and promoting health education, resources, and interventions.
Creating accountability measures, holding mandatory training, and screening patients for the social determinants of health can positively impact the health outcomes of patients of color, such as Latinos.
There is also a lack of Latinos in medicine.
Latino providers come equipped with the cultural and social understanding many Latino patients need to receive equitable care, and some can communicate with the patient in Spanish, eliminating language barriers.
To increase the number of Latinos in healthcare, educational institutions can expand access to higher learning for people of color and create pathways to make it easier for them to enter the medical profession.
Find Out If You Have Implicit Bias
No matter who you are, you could have implicit bias.
In medical field, implicit bias could form harmful stereotypes and assumptions that could influence a patient’s diagnosis or treatment, or prevent the referral to a clinical trial, and the healthcare provide might not even be aware of it.
The best way to handle implicit bias is identifying if you have it, even subconsciously, how it impacts others, and take important steps to mitigate it.
Confront implicit bias by downloading the free Salud America! Action Pack “Health Care Workers and Researchers: Find If You Have Implicit Bias and What to Do Next.”
With the Action Pack, you can take an “Implicit Association Test (IAT)” to identify implicit bias, evaluate your results and learn how to overcome implicit bias, and give you the tools to help spread the word about implicit bias to colleagues and co-workers.
“This is one way to foster greater compassion and understanding for the impoverished and people of color. This could help lead to more equitable distribution of resources and access to health and wealth opportunity,” according to a Salud America! research review led by Dr. Amelie G. Ramirez of UT Health San Antonio.
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