Gender identity

• According to the American Library Association , Florida has the unfortunate distinction of leading the United States in book bans.
• "By donating copies of my memoir to Florida's public libraries, I hope to contribute to a culture of openness and acceptance."
• By supporting the LGBTQ+ community and standing up to censorship, Bachir demonstrates his unwavering commitment to justice and inclusivity.
• For libraries seeking donated copies, please visit salahbachir.com
  For more information or to arrange an interview, please contact Joseph Papa; [email protected] .

• Health institutions have also focused on addressing implicit bias among the next generation of providers.
• But is implicit bias training improving care quality for Black patients?
• We are a social and health psychologist and a health economist who are investigating the role that provider implicit bias plays in racial health care disparities.

What is implicit bias?

• One common misunderstanding is that implicit bias is inherently unconscious and people are unaware of their own negative feelings, beliefs and behaviors.
• In fact, research suggests that people are remarkably accurate in perceiving their own levels of implicit bias.
• At the implicit level, the ABCs arise spontaneously and effortlessly, while ABCs operating at the explicit level are intentional and effortful.

Why does implicit bias matter in health care?

• Extensive research over the past two decades indicates racial inequities in patient-provider communication stem largely from implicit prejudice among health care providers.
• This implicit prejudice manifests during medical interactions with Black patients through a wide range of communication behaviors.
• For example, providers with higher levels of implicit prejudice tend to talk more and spend less time evaluating Black patients.
• However, current research does not support the idea that providers with higher levels of implicit prejudice treat Black patients worse than white patients.

What’s wrong with implicit bias training?

• Many researchers and clinicians see implicit bias training as an essential component of medical education.
• To understand what typical implicit bias training is like, our ongoing systematic review looks at 77 studies on implicit bias training programs in U.S. health care institutions.
• However, the design of these training programs does not align with current scientific knowledge about implicit bias.

• First, while awareness of one’s biases is a necessary first step to mitigating implicit bias, it alone is not sufficient.
• Implicit bias is like a habit: it is deeply ingrained and operates without intentional control, making it challenging to recognize and change.
• Third, training effectiveness is more accurately assessed through patient outcomes, such as care satisfaction, rather than self-reflection or implicit bias scores.

How can health care systems better address implicit bias?

• Developing and implementing effective implicit bias training in health care is a scientific endeavor that requires a strong supporting structure.
• Then, after developing and testing implicit bias training programs, they examine its effectiveness across institutions and among diverse health care professionals.
• We believe this investment is a small price to pay for the invaluable progress it promises in reshaping health care for the better for everyone.

Nao Hagiwara receives funding from National Institute of Health. Tiffany Green does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• One ABC News/Ipsos survey in November 2023 showed three-quarters of Americans believed the country was on the “wrong track.” Only 23% believed it was headed in the “right direction.” And the survey was not an outlier.
• Poll after poll shows a sizable majority of the nation’s residents disapprove of its course.
• Have Americans – long seen as upbeat, can-do optimists – really grown dour about the state of the nation and where it’s headed?

An ‘astonishing finding’

“Do you feel things in the country are generally going in the right direction, or do you feel things have gotten off on the wrong track?” That question or one very much like it is well known to anyone who has glanced at a poll story or studied the data of a survey in the past 50 years.

• These public opinion surveys, often sponsored by news organizations, seek to understand where the public stands on the key issues of the day.
• Political parties and candidates often conduct their own surveys with a version of the “right direction/wrong track” question to better understand their constituencies and potential voters.
• In 2023, we worked with Ipsos to survey more than 5,000 people across the country in all those community types.
• One of the big ones: In every community we surveyed, at least 70% said the country was on the “wrong track.” And that is an astonishing finding.

Agreement for different reasons

• The community types we study are radically different from each other.
• Some are full of people with bachelor’s degrees, while others have few.
• Some of the communities voted for President Joe Biden by landslide numbers in 2020, while others did the same for Donald Trump.
• Given those differences, how could they be in such a high level of agreement on the direction of the country?
• In 2020, Biden won 86% of the vote in big metropolitan Manhattan, and Trump won 60% in aging, rural Chenango.

Opposite views in same answer

• There may be some value in chronicling Americans’ unhappiness with the state of their country, but as a stand-alone question, “right direction/wrong track” is not very helpful.
• It turns out that one person’s idea about the country being on the wrong track may be completely the opposite of another person’s version of America’s wrong direction.

Dante Chinni receives funding from the Robert Wood Johnson Foundation for his work on the American Communities Project and is a contributor to the Wall Street Journal. Ari Pinkus receives funding from the Robert Wood Johnson Foundation for the American Communities Project.

• UniCare Health Plan of West Virginia recently earned the National Committee for Quality Assurance (NCQA) Health Equity Accreditation Plus, a recognition of UniCare’s leadership in developing solutions to enhance access equitable, high-quality healthcare.
• “NCQA’s Health Equity Accreditation Plus recognizes our unwavering dedication to eliminating health disparities and ensuring access to high-quality care for everyone,” said Tadd Haynes, President, UniCare Health Plan of West Virginia.
• “This milestone positions UniCare at the forefront of advancing health equity through our innovative and impactful programs and personalized care to improve the whole health of our members.”
  NCQA Health Equity Accreditation Plus builds upon the Health Equity Accreditation designation UniCare received last year, when it was recognized among the first Medicaid plans in the nation to create a strategic framework that prioritizes health equity based on race, ethnicity, language, sexual orientation, and gender identity.
• “Organizations earning the Health Equity Accreditation Plus like UniCare Health Plan of West Virginia are leading the way in bridging this gap, and NCQA salutes their commitment.”