The Impact of Primary Care Providers’ Bias on Depression Screening for Lesbian Women

Abstract

Primary care providers’ (PCPs) implicit and explicit bias can adversely affect health outcomes of lesbian women including their mental health. Practice guidelines recommend universal screening for depression in primary care settings, yet the guidelines often are not followed. The intersection of PCPs’ implicit and explicit bias toward lesbian women may lead to even lower screening and diagnosis of depression in the lesbian population than in the general population. The purpose of this secondary analysis was to examine the relationship between PCPs’ implicit and explicit bias toward lesbian women and their recommendations for depression screening in this population. PCPs ( n = 195) in Kentucky completed a survey that included bias measures and screening recommendations for a simulated lesbian patient. Bivariate inferential statistical tests were conducted to compare the implicit and explicit bias scores of PCPs who recommended depression screening and those who did not. PCPs who recommended depression screening demonstrated more positive explicit attitudes toward lesbian women ( p < .05) and their implicit bias scores were marginally lower than the providers who did not recommend depression screening (p = .068). Implications for practice: Depression screening rates may be even lower for lesbian women due to implicit and explicit bias toward this population. Training to increase providers’ awareness of bias and its harm is the first step to improve primary care for lesbian women. Policies must protect against discrimination based on sexual orientation or gender identity.

Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the US

“…Prior studies have found that implicit bias, based on socioeconomic status and race and ethnicity, may exist in health screenings. [38][39][40] Those findings suggest possible mechanisms by which the intersecting identities examined in the present study produced the differences seen in its findings.…”

“…We found that the inclusion of rural residence in our study analyses highlighted the particularly vulnerable circumstances of rural patients who have lower income (ie, Medicaid insured) and are of a racially minoritized group. Prior studies have found that implicit bias, based on socioeconomic status and race and ethnicity, may exist in health screenings . Those findings suggest possible mechanisms by which the intersecting identities examined in the present study produced the differences seen in its findings.…”

Stigma, Mental Health, and Health care Use Among Rural Sexual and Gender Minority Individuals

“…Even medical care engagement and receipt may be suboptimal, as SGMs often have concerns regarding confidentiality and acceptance, resulting in underreporting of illness and nondisclosure of risk behaviors (Bharadwaj et al, 2017; Picco et al, 2016; Tadele & Amde, 2019). Other indications of suboptimal care include findings that SGM may be less likely to receive multiple aspects of preventive care, such as screening for sexually transmitted infection (STI), cancer, and depression (Jenkins et al, 2021; Lee-Foon et al, 2022; Sha & Aleshire, 2021). Stigma thus threatens essential health care processes, such as diagnostics, treatment, and successful recovery.…”

“I don´t put people into boxes, but…” A free-listing exercise exploring social categorisation of asylum seekers by professionals in two German reception centres

“…Looking at scientific thematisations, "race"/ethnicity and gender seem to be especially meaningful in many societies. A number of categories have been thematised in the health sciences, as impacting on health and healthcare for example: "race"/ethnicity [22][23][24][25][26][27][28], gender [29][30][31], sexual orientation [32][33][34], social class [35], socio-economic status [e.g., 5], age [e.g., 36,37], body shape [38,39] as well as mental state [e.g., 40,41].…”