Explicit and implicit disability attitudes of healthcare providers.

Abstract

Purpose/Objective: Health care providers’ attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers’ clinical decision making, less research has focused on providers’ attitudes about disability. The aim of this study was to examine providers’ explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people’s explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna’s (2008) model of two-dimensional prejudice to compare provider’s explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers’ explicit and implicit attitudes. Results: While on average, provider’s explicit attitudes (M = 4.41) indicated little prejudice, their implicit attitudes (M = 0.54) revealed they moderately preferred nondisabled people—they were aversive ableists. Correlates of providers’ explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability). Conclusions/Implications: This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study’s findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities.

Diversity, Equity, and Inclusion Efforts at a Departmental Level: Building a Committee as a Vehicle for Advancing Progress

“…The interested reader is encouraged to review previously mentioned papers (e.g., Hardeman et al, 2016a, b). It is outside the scope of this paper to further detail each specific type of discrimination and antidiscrimination work within those specific areas; these could easily be (and are) their own papers (e.g., disability: Meeks & Herzer, 2016;Meeks & Jain, 2018;Meeks & Neal-Boylan, 2020;VanPuymbrouck, Friedman, & Feldner, 2020;sexual orientation: Hill et al, 2020a, b;Lu et al, 2020;Vargas et al, 2020;gender: Agrawal, Madsen, & Lall, 2019;Borlik et al, 2021;Richter et al, 2020). Specific DEI terms used in this paper are defined above to ensure a common understanding.…”

Health promotion to people with disabilities: case report from two University extension projects

“…Even though most healthcare providers indicate having nothing against people with disabilities, the overwhelming majority display implicitly prejudices towards this specific public (VanPuymbrouck, 2020).…”

How Should We Build Disability-Inclusive Medical School Admissions?

“…6,7,8,9,10,11,12,55 Increasing representation among students, trainees, and physicians with disabilities so as to be more reflective of the people they serve can also mitigate harmful effects of clinician bias on colleagues, patients, and their loved ones during clinical encounters. 56,57,58,59,60,61 There is value in the disabled person's dual lived experience as a patient and as a professional that can motivate clinicians and colleagues to be more informed practitioners, the medical profession to be more just, and society to resolve health care disparities.…”