Equity in Healthcare Activities: Self-Awareness

Implicit Bias Assessment

Every human being makes decisions informed by a lifetime of experiences, stories, family traits, beliefs, and values. Each experience informs the system of shortcuts in our brain called heuristics. Our brain’s heuristics can serve to aid us in survival, keep us safe from hazards and facilitate social interaction. They can and do contribute to subconscious aka “implicit” bias. Unfortunately, our brain’s subconscious bias does lead to disparities in healthcare treatment for minorities, women, and the LGBTQ populations. Take care! I am not accusing you of racism, sexism, or trans/homophobias. However, humble self-discovery is the first step in rooting out our own hidden implicit bias and improving known disparities in the care all people receive from EMS services.

One way we will gain access to these hidden heuristics through taking various Implicit Association Tests. These tests can be found at this URL: implicit.harvard.edu/implicit/takeatest.html or do a web search for “implicit bias test Harvard” and clicking “I wish to proceed” at the bottom of the page.

Choose 5 of these assessments at various times throughout the term. Try not to do them all in one sitting. You do not need to do all of them! Only 5/10.  You can choose any five assessments out of the tables below.

Privilege Assessment

For the next step in self-awareness circle any of the privileges that you benefit from. Remember, privilege is something that gives you an advantage that you didn’t necessarily earn.

Adapted from: “Do the Work!” by Bell & Schatz

• White
• Fair/light-skinned
• Middle class
• Upper middle class
• Rich
• Land-owning
• Home-owning
• College-educated
• Conventionally attractive
• Good at taking tests
• Thin
• Tall
• Thick in the “right” places
• Hearing
• Seeing
• Live in a “safe” neighborhood
• Debt-free
• Nondisabled
• Have a good relationship with the police
• Straight
• Cisgender
• Not the first in my family to go to college
• Christian
• US Citizen
• Feel safe walking home at night
• Cultural history was part of regular school curriculum, not just an elective
• Inherited money
• Have a trust fund
• Between the ages of 18-60
• Grew up with access to children’s books, TV and movies with characters who looked like me
• Reading this in my first language
• Tall
• A cis man
• Have health insurance
• Housed
• Employed
• Married
• Blue-eyed
• Green-eyed
• Have an “American” sounding name
• Blond-haired
• No speech impediment
• Full head of hair
• Athletic
• Good teeth
• Can pay rent every month
• Always able to pay utility bills
• Never been in prison
• Laugh easily
• Not worried about money
• Have “connections” with “friends in high places”
• Understand the stock market
• Often put in charge of things
• Everybody in my home has their own room
• Have a well-worn passport
• Have employees
• Are an actual billionaire
• Regularly fly first class
• Get to doctor appointments easily
• Have time for hobbies and leisure
• Aren’t afraid of a medical bill
• Clothes sold in stores fit my body
• Regularly get a good night’s sleep
• Are or have been the president of the United States
• Have gotten away with yelling at a cop
• Own a professional sports team
• Am George Clooney
• Right-handed
• Parents are alive, married and nice to me
• Get invited to cool parties
• Car registration is paid
• Are offended by the term “Karen”
• Feel mildly annoyed by parking tickets
• Took a selfie with a cop while storming the US capitol
• Own multiple functioning cars
• Not afraid to show ID
• Can easily access buildings I need to go into
• Know how to swim
• Understand memes
• Have a strong wi-fi connection
• Can easily access fresh food
• Not kept up at night by the sounds of sirens and gunshots
• Not worried about family members getting deported
• Friends and family share my belief systems
• Do not have an accent, drawl or other identifiable geographical speech pattern

Next discuss your results with a class member who also has completed the assessment.

Engaging Others

Within your community of people (EMT school, work, social circle), identify two individuals who are not exactly like you. They may be different in age, gender, skin color, personality. Ask if you can interview them about their healthcare experience. After you gain consent, use these questions to spur a discussion about how each of us experiences healthcare differently:

• How do you interact with healthcare professionals? Do they listen to you? Do you get your needs met? Do you have to repeat yourself to be heard? Why or why not?
• Do you have health insurance? How is it paid for? Have you ever had a big medical bill? Do you need to travel to get to healthcare? How do you get there?
• Do you feel like you get enough to eat? Is there ever a time when you don’t have enough food? How far do you have to travel to get to a grocery store?

Education

Take some time to read one of the below articles or books on race, gender, age, size, or social status, and their experience with healthcare that interests you. You may also choose one of your own. If you select one of your own, please be sure it is more than a blog post, preferably a peer-reviewed article. Tell your team about it. Why did it interest you?

• Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, a report by the Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care.
• How to Be an Anti-Racist, a book by Ibram X Kendi.

• Class Matters, a book by correspondents of the New York Times.

• The Problem with Race Based Medicine, by Dorothy Roberts, on YouTube.

• Allegories on Race and Racism, by Camara Jones, on YouTube.