Medical Graduate - Incoming Pediatric PGY-1 Resident Medical University of the Americas Oak Point, Texas, United States
Background: Implicit racial bias in community (i.e. home and school) and healthcare settings creates barriers directly impacting children. As pediatric healthcare providers, implicit bias must be addressed to result in better development and treatment outcomes in children. Objective: We aim to investigate implicit racial bias in pediatric populations in community and healthcare settings. Design/Methods: This systematic literature review analyzed articles on PubMed using the search terms “implicit bias children” OR “implicit bias pediatric.” Eligibility criteria included articles published within the last 10 years that discussed implicit racial bias in children from birth to 18 years. Articles not written in English, not readily accessible, and not set in the United States were excluded. For each eligible article, the study design, population, objectives, results, and themes were examined. Results: Of 127 articles in the initial search,16 studies met inclusion criteria and utilized the Implicit Association Test or a modified version to assess implicit bias. Out of three community setting articles, one study highlighted how implicit bias in school-aged children is influenced by parental attitudes. Another study focused on teachers’ stricter disciplinary actions towards racial minorities, resulting in worse educational outcomes. The third study designed a school intervention which improved awareness of implicit bias in healthcare providers. 14 of the 16 articles described the role of implicit racial bias in healthcare settings. Six articles expanded on providers' pro-white/anti-black bias towards pediatric patients. Two studies explained how healthcare providers who have been in practice for longer are more likely to exhibit insurance-mediated bias. Out of five articles discussing providers’ awareness of implicit bias, three studies demonstrated improved patient outcomes.
Conclusion(s): Parents, teachers, and pediatric healthcare providers influence the effects of implicit bias in the care of children in community and healthcare settings, often associated with adverse implications. Overcoming the ramifications of implicit bias requires awareness and action to abolish negative attitudes against racial minorities. Understanding the relationship between implicit bias and racial disparities while being empowered to resolve its consequences is imperative. Pediatric healthcare providers should facilitate educational conversations with children, their families, and educators that counter the development of unfavorable racial perceptions in the pediatric community.