In a press conference Thursday, Michigan Gov. Gretchen Whitmer announced the signing of an executive order requiring all health care professionals to undergo implicit bias training to obtain or renew their licenses.
The governor also voiced her support for the incorporation of implicit bias training into university and medical curriculum to reduce racial disparities in the health care system.
The order comes after Whitmer recommended implicit bias training for law enforcement officers last month.
“The evidence shows that training in implicit bias can make a positive difference. … We are taking action to improve racial equity across Michigan’s health care system,” Whitmer said.
According to Dr. Randolph Rasch, the dean of Michigan State’s College of Nursing, the concept of implicit bias is widely misunderstood.
“(Implicit bias) is an unconscious, negative classification of individuals or groups of individuals based on some physical attribute,” Rasch said. “The key piece is that based on that unconscious thought about how we think of people … we make decisions, and we act on those decisions, not recognizing that it’s based on something that we don’t really understand.”
Rasch said that while we normally hear about implicit bias in terms of race, it can also be used regarding gender, body weight and the standard of beauty, among others.
In the health care system, however, implicit bias can be the determining factor in whether someone lives or dies.
“There’s data that shows … that implicit bias exists and has an impact on the quality of care that people of color receive,” Michigan Department of Health and Human Services, or MDHHS, Chief Medical Executive Dr. Joneigh Khaldun said. “Whether it’s not offering the same treatment plan, dismissing a patient’s complaints or not being sensitive to cultural differences, implicit biases absolutely show up in medical interactions and then can lead to negative health outcomes.”
Racial disparities and implicit bias in the health care system have been present “for centuries,” Khaldun said.
“We’ve seen … the disproportionate impact that COVID-19 has had on people of color in Michigan, and particularly Black people,” Khaldun said. “Black people have been disproportionately infected by and are dying from COVID-19 in Michigan and across the country — this is the sad truth, but it’s in no way a surprise.”
As of July 9, Black people account for 20,310 of Michigan’s total 75,063 COVID-19 cases and 2,375 of the 6,271 deaths, according to the Michigan coronavirus website.
Despite only 14.1% of the state’s population being Black, more than 27% of COVID-19 cases and nearly 38% of COVID-19 deaths in Michigan have occurred in the Black population.
Additionally, Black women are also three to four times more likely than white women to die from a pregnancy-related condition, and a Black baby is two to three times more likely than a white baby to die before their first birthday in Michigan, Khaldun said.
According to Lt. Gov. Garlin Gilchrist, implicit bias training is a necessary step to eliminating racial disparities and racism not only in the health care system, but in other societal institutions, as well.
“We’re taking a broad look at how state tools and programs can be refocused and optimized to address and overcome the systemic racial injustices that have baked inequality into the reality of too many Michiganders,” Gilchrist said.
Director of the Department of Licensing and Regulatory Affairs, or LARA, Orlene Hawks said the department is committed to working with licensing boards to implement new rules requiring implicit bias training.
“It is our expectation that these efforts will ultimately underscore the commitments of the health care workforce to understand and address implicit bias,” Hawks said. “As a result, we anticipate improvements in quality of care, relationships with communities and ultimately, better health outcomes.”
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