Exploring the Association of Healthcare Worker Race and Occupation with Implicit and Explicit Racial Bias

Gabriel S. Tajeu, Jewell Halanych, Lucia Juarez, Jeff Stone, Irena Stepanikova, Alexander Green, Andrea L. Cherrington

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background: Racial bias is associated with suboptimal healthcare treatment for minorities. Research focuses on bias among physicians rather than non-physician healthcare staff (e.g., receptionists). Patients spend considerable amounts of time with non-physician staff. Therefore, we investigate differences in implicit and explicit racial bias by healthcare staff race and occupation using the Implicit Association Test and Modern Racism Scale, respectively. Methods: Staff (n = 107) were recruited using the Alabama based Primary Care Research Coalition. Occupation was categorized into “medical doctors/registered nurses” (MD/RN) and “non-MD/RN” (e.g., receptionists). Results: Implicit bias scores were higher among whites compared with blacks (0.62, −0.04, respectively; p < 0.01). Among whites, non-MD/RNs demonstrated more pro-white implicit bias compared with MD/RNs (0.67, 0.44, respectively; p < 0.01). Whites had higher explicit bias scores than blacks (17.7, 12.3, respectively; p < 0.01). Conclusion: Non-MD/RNs should not be overlooked for cultural competency training, and efforts are needed to reduce racial bias among healthcare workers identified as having higher levels of bias.

Original languageEnglish (US)
Pages (from-to)464-472
Number of pages9
JournalJournal of the National Medical Association
Issue number5
StatePublished - Oct 2018


  • Disparities
  • Explicit bias
  • Healthcare staff
  • Implicit bias
  • Perceived discrimination

ASJC Scopus subject areas

  • General Medicine


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