african american clients’ perceptions of bias in louisiana healthcare research day 2012 school of...

AFRICAN AMERICAN

CLIENTS’ PERCEPTIONS OF

BIAS IN LOUISIANA

HEALTHCARE

Research Day 2012School of Allied Health ProfessionsRobin Steed, PhD, LOTR

How did I come up with this topic?

Background

sample

populationpositive negative

Attitudes towards African Americans

Current Study

What I did during summer vacation

Demographics

n = 9 5 female 4

male 9th grade –

college varied

occupations addictive

disorder

“What have you experienced in terms of racial bias in healthcare?”

“What contexts or situations have typically influenced or affected your experiences of racial bias in healthcare?”

Guiding Questions

Analysis of Transcripts

Basis of Discrimination Consequences (or Results) of

Discrimination Possible Solutions

Basis of Discrimination

Insurance SES Ethnicity Perceived Lifestyle

Disparity in Quality

Lifestyle

SES Insurance

Ethnicity

Insurance and Trauma Outcomes

Basis of Discrimination

Insurance SES Ethnicity Perceived Lifestyle

Disparity in Quality

Lifestyle

SES Insurance

Ethnicity

Behavioral Risk Factor Surveillance System Survey 2008, Louisiana

Fair/

Poor

Hea

lth

Heart A

ttack

Coron

ary

Heart D

isea

se

Stro

ke0

10

20

30

40

< $15 K

> $50 K

Basis of Discrimination

Insurance SES Ethnicity Perceived Lifestyle

Disparity in Quality

Lifestyle

SES Insurance

Ethnicity

Days to Dg by Insurance & Ethnicity

Private Government None0

10

20

30

40

50

60

70

80

90

100

WhiteBlackHispanic

(Hoffman, 2011)

Basis of Discrimination

Disparity in Quality

Lifestyle

SES Insurance

Ethnicity

Insurance SES Ethnicity Perceived Lifestyle

Results of Bias

Poor Communication Deferred Treatment Superficial Triage Poor Client-practitioner Relationship

Solutions

Adapt to system vs. over adaptation

Take time to provide information Institutional changes Try to understand the client’s

situation Spiritual

So what’s the bottom line?

Discussion

What does bias look like?

Lack of eye contact Hesitant to touch/no touching Washing hands after every touch Talking “around” Disrespectful language “Atta boy!” In a hurry Not explaining/ not asking /

ignoring

Implications for Practice

Medical Model vs. Sociocultural Model

Mindfulness Advocacy Effective client education materials

Implications for Future Research

ROI investigations Efficacy of community awareness

campaigns Examination of instructional

interventions for practitioners Design of client education

robinsteed.pbworks.comresearchday.pbworks.com

Questions?