A new empirical study conducted by researchers at Yale School of Medicine, the University of Hartford, and New York University shows how bias is embedded in the very ways healthcare organizations operate.
Published in Clinical Psychological Science, the study reveals how organizational-level biases affect how patients and even providers are viewed — and in ways that can produce racial and ethnic inequities.
The authors specifically focused on mental health organizations, detailing how they may systematically transmit bias and racism through common bureaucratic processes — and in some cases through staff merely doing their job.
The study revealed an equally disturbing finding: Staff can often remain unaware of this transmission process and, yet, may simply need to meet their work requirements to perpetuate it — a process that the authors termed “bureaucra-think.”
The authors concluded that, over time, this can lead to care becoming “system-centered” rather than person-centered, let alone equitable.
“We hope that this study aids community members, providers, and policymakers vying for greater equity in healthcare,” said Miraj U. Desai, PhD, assistant professor of psychiatry at Yale School of Medicine and the paper’s first author. “At the same time, while the study focused on health settings, we firmly believe that it has direct relevance for institutions and systems outside of healthcare – offering concrete evidence and novel concepts to address how inequity can flourish in very hidden ways.”
The study carries major implications for healthcare and other organizations and suggests novel structural targets for intervention. It also signals a paradigm shift for psychological science, as it demonstrates how structural bias and racism partly depend on collective psychological processes, which psychological science has typically neglected in favor of individualist or internalist accounts. The study thus offers a robust scientific and practical framework to help psychology, healthcare, and related fields address structural bias and racism.
Other authors include Nadika Paranamana, MA (University of Hartford); John F. Dovidio, PhD (Yale); Larry Davidson, PhD (Yale); and senior author Victoria Stanhope, PhD (NYU). Funding was provided by the National Institutes of Health and the Yale Center for Clinical Investigation.