Implicit associations = STEREOTYPES.

Guest blogger Nora again; howdy! With a short (for me) post!

Some of you may have seen this article about how “implicit associations” (i.e., biases) impact medical treatment already. The gist of it is this:

In the new study, trainee doctors in Boston and Atlanta took a 20-minute computer survey designed to detect overt and implicit prejudice. They were also presented with the hypothetical case of a 50-year-old man stricken with sharp chest pain; in some scenarios the man was white, while in others he was black.

“We found that as doctors’ unconscious biases against blacks increased, their likelihood of giving [clot-busting] treatment decreased,” said the lead author of the study, Dr. Alexander R. Green of Massachusetts General Hospital. “It’s not a matter of you being a racist. It’s really a matter of the way your brain processes information is influenced by things you’ve seen, things you’ve experienced, the way media has presented things.” (emphasis mine)

And that, boys and girls and gender-transcendants, is why stereotypes are bad.

(I’m struck by the study author’s insistence that this is not racism, however. I’ve never quite understood why people attempt to put such distance between “holding racist attitudes” and “being a racist”. That smacks of denial to me, or at least an oversimplification, implying that the only true racism is intentional and that the only true racists are cackling goateed Voldemort wannabes. I understand that “racist” is an ugly label; I understand that people don’t like getting slapped with it. But there’s a speculative fiction writers’ concept that applies here: if it looks like a duck and quacks like a duck, calling it a “shmeerp” isn’t going to make people think it’s an alien or a fantasy creature. If you talk like a racist and think like a racist, and it causes you to withhold lifegiving treatment like a racist… well, hell, what else should we call you?)

The article goes on:

The best way to combat those impulses is by acknowledging them, specialists said, suggesting that medical personnel take a test to measure unconscious bias, such as one at implicit.harvard.edu.

“The great advantage of being human, of having the privilege of awareness, of being able to recognize the stuff that is hidden, is that we can beat the bias,” said Mahzarin R. Banaji, a Harvard psychologist who helped design a widely used bias test.

So here’s a challenge, folks. Follow the link in the article, and take one of the Implicit Associations Tests. There are several for race/skin color, some for gender, some that touch on other “isms”. You don’t have to reveal the results to anyone else; this isn’t a contest to show off how __-ist you are or aren’t. But as the article suggests, one of the best ways to shake off the attitudes we’ve all absorbed from being immersed in biased societies is to become aware that you have these attitudes, and what they are. Then they’re easier to fight.

27 Responses

  1. I think those are useful tests.

  2. I’m struck by the study author’s insistence that this is not racism, however. I’ve never quite understood why people attempt to put such distance between “holding racist attitudes” and “being a racist”. That smacks of denial to me, or at least an oversimplification, implying that the only true racism is intentional and that the only true racists are cackling goateed Voldemort wannabes.

    Not this time. The Implicit Associations Test checks for bias.

    The best parallel I’ve come up with is a car that drifts to the right because it needs a wheel alignment. The test actually exposes the preconscious stuff.

  3. I’m unsure of the usefulness of these tests. I found that it had much more to do with hand/eye coordination than racial bias. But then again, I took the Judaism test and I’ve even understood the logic of antisemitism.

  4. P6, I am halfway between agreeing with you an agreeing with Nora. I think that in our culture at the moment the word racist is *supposed* to only apply to your Voldemort/KKK types and not to people who just have a bias. However, the main problem with race relations is that we have stopped calling racism that isn’t lynching-level racism by that label. We call it bias or ignorance or whatnot. However, by using language that side-steps the problem, we’re generating more problems. Instead of equating racism with ONLY Jim Crow or slavery or lynching or the KKK and thinking of it as what it is – bias against racial groups and the power to back up and act on that bias – we can work toward fixing the problems. That doesn’t have to include horrible hatred but also doesn’t let people off the hook and use squirmy language.

  5. I don’t have a problem with your understanding of racism.

    I went to a lecture by Dr. Benaji when she went big-time public. She made the point that she was using “bias” as a technical, statistical term. Part of the reason is the test is useful in areas beyond race and gender. Part of the reason is many you really wouldn’t think of as racist have high bias scores. They compensate.

    She is aware, though, that “bias” steers non-statisticians straight to race and gender. Orlando Patterson like to lost his damn mind over it. And I’m not sweating the folks that compensate for their bias. I’m only concerned when it manifests.

  6. Huh, interesting tests and interesting results. And thanks for explicitly requesting we not turn this into a contest or comparison.

    I’d be interested to know how much knowledge about the test skews it. I was trying to go quickly and give my true reactions, but underneath it all was the thought, “This is a test. I need to be even-handed.”

  7. Hi. I was linked here from another blog; I’m especially interested in this test, because I did a university research paper on the IAT a few years ago.

    Just answering a few questions:

    The IAT is not extremely affected by hand/eye coordination. It throws out statistical outliers as well as the first few loops (they’re considered ‘practice’) and does not decrease or increase in accuracy with the number of times it is taken by a specific person. It’s measuring the milliseconds it takes your brain to connect ideas such as ‘scholarship’ with ‘female’ or ‘good’ with a specific race, and measures your own reaction time against your own results, not other peoples’ times. Even trying to be “even-handed” doesn’t really work, since you can’t consciously measure those milliseconds in your head.

    It’s been proven time and time again (I had to do A LOT of reading about this) that just being made aware of your biases, even if you deny them, does a lot towards dispelling their effects.

    I’m not saying that the IAT doesn’t have its flaws, but as a measurement of unconscious bias, it is an exemplary diagnostic tool.

  8. Kate — Thanks for the info. I showed the guys at work and we had an argument over how accurate it was and that clears up one of the problems.

  9. P6,

    My comment about calling racism what it is was more in reference to the medical-treatment study’s results (that doctors tended to withhold life-saving treatment from blacks if they had an unconscious racial bias). I think there’s a strong link between *internalized racism* and bias. Everyone in this country has internalized some racist ideas; it’s one of the things we absorb in early childhood, like gender roles. When I read the article, one of the most interesting and sad results that jumped out at me was that *black* doctors were equally likely to withhold treatment from black patients, and to hold the same biases as the rest of the doctors in the study. If that’s not prejudice + power — life and death power, no less — I don’t know what is. It’s rare for black people to be able to act on their racist beliefs in a truly powerful way, but sometimes it does happen, and when it does I think we should call a spade a spade.

  10. Kate, thanks for that information.

  11. I tend to think that bias is a form of racism or sexism. I tend toward the belief that nearly everyone raised in America is both racist and sexist, to different extents, because the problems in our society are systemic and omnipresent.

  12. When I read the article, one of the most interesting and sad results that jumped out at me was that *black* doctors were equally likely to withhold treatment from black patients, and to hold the same biases as the rest of the doctors in the study.

    Okay, but I can’t treat internalized racism the same as racism one is conscious of.

    Once they are aware of it, they do become responsible for it, though.

  13. Wow, what an amazing set of tests. I’ll have to take my time and go through all of them. ^^

  14. […] the tests are online @ implicit.harvard.edu/. i took a couple of them, it was fun & interesting. i encourage you to take one, or several. also visit the continuing conversation @ the ABW’s blog. […]

  15. I can’t treat internalized racism the same as racism one is conscious of

    And I’m not saying you should. They’re different problems and need to be dealt with in different ways. But what I’m saying is that they should be acknowledged as having the same root cause, and ultimately the same effect. Whether you passively allow racism (in the form of internalized racism) to affect your thoughts and behavior, or whether you actively embrace and/or enable it, it’s still all racism. Calling the passive version something other than racism minimizes it, when in fact it may be just as damaging as the active kind. (Honestly I think it’s worse.)

  16. Gah, missed this other part of your comment, P6 —

    Once they are aware of it, they do become responsible for it, though.

    I think *awareness* of one’s bias has nothing to do with whether you should be held responsible for it. If you’re going into a career in which you’ll be having a significant impact on other people’s lives, you have a responsibility to those people to check yourself for bias. A doctor would (or should) think nothing of having an annual physical to make sure they’re not bringing any dangerous diseases or medical conditions near their patients, right? Yet the more biased doctors in this study are bringing in some diseased thinking, and it’s also threatening the health and welfare of their patients. So I think they’re responsible from the moment they start practicing as doctors, whether they’ve confronted their biases or not. That’s the moment when they *should* check themselves for bias, and any other condition that might do their patients harm.

  17. I took the test. The first test it gave me was a black and white people test. Next it gave me a Jewish versus other religions test. Then it gave me Coke vs. Pepsi. What? I skipped that and took a test about rocks and trees and lines. Then I took a man and woman and science and liberal arts test. All interesting results!

  18. You know, those tests are testing other things, too. For example, after the racism test it has some questions about politicians. When I took it, it asked who I was planning to vote for. When my husband took it, it showed him faces of politicians and asked him to rate them.

  19. I think *awareness* of one’s bias has nothing to do with whether you should be held responsible for it. If you’re going into a career in which you’ll be having a significant impact on other people’s lives, you have a responsibility to those people to check yourself for bias.

    On a practical basis, it hasn’t been possible to check yourself for bias in this fashion until. well, the Implicit Association Test. I don’t see a way to hold people responsible for what they are genuinely unaware of.

    Don’t mistake this for forgiveness of the flaw. I just see them like a dangerous machine I must work with.

  20. This reminds me of the book “Racism without Racists” by Eduardo Bonilla where he basically did a bunch of case studies on the implicitly racist behaviors of white people, and how while none of them thought their actions were racist, they all had racist policies. What’s worse is that there’s no one to “blame” because there’s no blame assigned. It’s sad really. Good blog. Peace …

  21. I’ve seen and taken the implicit bias tests before. I hope this isn’t violating the don’t turn this into a contest principle, but I’m puzzled by my results. I seem to get a mild to moderate bias in favor of whites over blacks. Sorry, but there it is. Fairly expected for a US-American I’m afraid. However, I also get–consistently, repeatedly, on multiple occasions including when I’m cheating in the other direction–a strong association between whites and deadly weapons. WTF? I like white people well enough, but expect a knife in the back from them? Hmm…maybe not so inaccurate.

    The problem of different treatments in black versus white patients is a nasty one. I’m actually writing a paper on changes in survival for a particular type of cancer (which I can’t name until the data is published and therefore considered public, so let’s just call it disease X). The news for disease X is generally good. Far more people survive it now than did even 5 years ago. However, blacks who contract X are less likely than whites to be cured and the gap is widening not decreasing over time. There are some very minor possible biological reasons for this, but basically, the main reason is probably prejudice and worse treatment of black versus white patients*. But how do I say this in a way that won’t make the journals dismiss me as a left-wing nut who sees racism everywhere? Yes, I know, it is everywhere, but I need to get people who don’t believe that to listen to me so that they’ll change their treatment strategies. If anyone has any thoughts, I’d highly appreciate hearing them.

    *Though this may not all be on the level of doctors’ prejudices. More blacks than whites have no or inadequate health insurance and blacks, particularly young men, are more likely to be incarcerated and therefore have terrible health care. Among other institutional or societal level problems.

  22. […] blogger at The Angry Black Woman thinks if the label fits, wear it: “I’ve never quite understood why people attempt to put […]

  23. I also get–consistently, repeatedly, on multiple occasions including when I’m cheating in the other direction–a strong association between whites and deadly weapons.

    I’d guess, with no means whatsoever of testing the hypothesis, that you have an association with weapons and power.

    the main reason is probably prejudice and worse treatment of black versus white patients*. But how do I say this in a way that won’t make the journals dismiss me as a left-wing nut who sees racism everywhere?

    By listing racism last in the list of causes, for instance, ‘Various social and institutional problems with disproportionate impact. In addition, observations, interviews and anecdotal evidence show the personal racial biases of medical staff (or whoever) weigh heavily in the outcomes.’

    Just list the causes they can’t or won’t dispute first.

  24. Just wanted to say I’d never heard the term gender-transcendent before, and am totally appropriating it. That is effing awesome – thanks!

  25. Good one, P6. Thanks. I’m not sure about the weapons=power thing, though. It could be, unconscious associations being what they are, but my first conscious association with most weapons is simply fear. The attraction of danger, perhaps?

  26. I’m not sure about the weapons=power thing, though.

    Hey, I get to pull one out of my ass once in a while…

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