Health-care providers hold biases based on

sexual orientation, study says

Findings highlight need for more training of

providers in cultural sensitivity

University of Washington Health Sciences/UW Medicine

In the first study that looks at a variety of health-care providers and their implicit attitudes towards lesbian women and gay men, researchers found there is widespread implicit bias toward lesbian women and gay men. The study finds that moderate to strong implicit preferences for straight people over lesbian and gay people are widespread among heterosexual providers.

Learn about the unique stress and
traumas faced by LGBTQ youth.

Findings highlight need for more training of providers in cultural sensitivity

University of Washington Health Sciences/UW Medicine

In the first study that looks at a variety of health-care providers and their implicit attitudes towards lesbian women and gay men, researchers found there is widespread implicit bias toward lesbian women and gay men. The study finds that moderate to strong implicit preferences for straight people over lesbian and gay people are widespread among heterosexual providers.

In the first study that looks at a variety of healthcare providers and their implicit attitudes towards lesbian women and gay men, researchers found there is widespread implicit bias toward lesbian women and gay men.

The study, "Health care providers' implicit and explicit attitudes toward lesbian women and gay men," published in the American Journal of Public Health finds that moderate to strong implicit preferences for straight people over lesbian and gay people are widespread among heterosexual providers. Also lesbian and gay health providers expressed implicit and explicit preferences for lesbian and gay people over straight people. Bisexual providers were found to have mixed preferences, mental health providers held the weakest implicit bias for heterosexual people over lesbian and gay people and nurses held the strongest implicit bias for heterosexual people over lesbian and gay people.

In short, healthcare providers, similar to others in society, hold a bias for people who shared their own sexual identity.

Lead researcher, Janice Sabin, UW research associate professor in biomedical informatics and medical education, said that clinical care of the LGBT population is a somewhat neglected area in curriculum in nursing, medicine and other areas of healthcare education.

"We want all providers to be proficient in treating diverse populations, including the LGBT population," she said.

Rachel G. Riskind with the Department of Psychology at Guilford College in Greensboro, N.C., and Brian A. Nosek with the Department of Psychology at the University of Virginia in Charlottesville, were co-authors on the study.

Researchers used results from the Sexuality Implicit Association Test developed to assess presence of implicit bias towards either heterosexual or homosexual individuals. The test captured demographic data and implicit association test results for more than 200,000 participants between May 2006 and December 2012. Test takers were asked to indicate their explicit preferences towards heterosexual, lesbian and gay people by endorsing statements ranging from "I strongly prefer straight people to gay people to "I strongly prefer gay people to straight people." The study categorized healthcare respondents by their profession ¬¬¬-- medical doctor, nurse, mental health provider, other treatment provider or non-provider --to assess attitudes specifically from healthcare providers.

Test takers voluntarily accessed the Sexuality Implicit Association Test on Project Implicit, a non-profit organization founded in 1998 by three scientists -- Tony Greenwald (University of Washington), Mahzarin Banaji (Harvard University), and Brian Nosek (University of Virginia). Project Implicit provides a "virtual laboratory" for collecting data on the Internet in a mission to educate the public about hidden biases or thoughts and feelings outside of conscious awareness and control.

Sabin said, "training for healthcare providers about treating sexual minority patients is an area in great need of attention."

"For healthcare organizations that aim to serve these populations, these data suggest an opportunity to examine methods likely to mitigate implicit biases, such as eliminating discretion from decision-making, use of clinical guidelines, awareness of personal bias as self-caution, organizational policies that promote objective decision-making, and inclusion of counter-stereotypical experiences in educational programs," the authors conclude.

While this study found implicit bias among healthcare providers, Sabin said future research should examine how providers' implicit and explicit preferences toward sexual orientation affect delivery of care to members of sexual minority populations.

Learn about the unique stress and
traumas faced by LGBTQ youth.

Tyler Skagg's Death: Behind the Exploding Opioid Crisis

How drugs affect the brain in deadly ways. Click here.

According to the coroner's report, Los Angeles Angels pitcher Tyler Skaggs died from accidental overdoes of fentanyl, oxycodone, and alcohol. With an unprecedented death toll, unique strategies needed to reverse tide, study finds.

August 29, 2019

 

August 29, 2019

RAND Corporation

The sudden appearance of the drug fentanyl in the US has driven up overdose deaths dramatically, even as the abuse of heroin and other opioids has shown signs of stabilizing. In the most-comprehensive analysis yet of the crisis, researchers urge that innovative new strategies be pursued because the epidemic is unlike others that have struck the nation.

    

FULL STORY

---

The U.S. overdose crisis worsened dramatically with the arrival of synthetic opioids like fentanyl -- now responsible for tens of thousands of deaths annually -- and the problem requires innovative new strateges because the epidemic is unlike others that have struck the nation, according to a new RAND Corporation study.

"This crisis is different because the spread of synthetic opioids is largely driven by suppliers' decisions, not by user demand," said Bryce Pardo, lead author of the study and an associate policy researcher at RAND, a nonprofit research organization. "Most people who use opioids are not asking for fentanyl and would prefer to avoid exposure."

While fentanyl had appeared in U.S. illicit drug markets before, production was limited to one or a few capable chemists, and bottlenecks in production and distribution slowed the drug's diffusion. Law enforcement was able to detect and shut down illicit manufacture to contain these outbreaks.

RAND researchers found that today's synthetic opioid surge is fueled by multiple sources. Mexican drug trafficking organizations smuggle fentanyl into the U.S., and China's pharmaceutical and chemical industries are inadequately regulated, allowing producers to advertise and ship synthetic opioids to buyers anywhere in the world.

While traditional criminal organizations play a role in the spread of fentanyl, the internet also has made it easier to traffic these drugs and to share information about their synthesis.

Overdose deaths involving fentanyl and other synthetic opioids have increased from about 3,000 in 2013 to more than 30,000 in 2018. These deaths have remained concentrated in Appalachia, the mid-Atlantic and New England.

"While synthetic opioids have not yet become entrenched in illicit drug markets west of the Mississippi River, authorities must remain vigilant," said Jirka Taylor, study co-author and senior policy analyst at RAND. "Even delaying the onset in these markets by a few years could save thousands of lives."

For U.S. policymakers, nontraditional strategies may be required to address this new challenge. The researchers avoid making specific policy recommendations, but advocate consideration of a broad array of innovative approaches such as supervised consumption sites, creative supply disruption, drug content testing, and increasing access to novel treatments that are available in other countries, such as heroin-assisted treatment.

"Indeed, it might be that the synthetic opioid problem will eventually be resolved with approaches or technologies that do not currently exist or have yet to be tested," said Beau Kilmer, study co-author and director of the RAND Drug Policy Research Center. "Limiting policy responses to existing approaches will likely be insufficient and may condemn many people to early deaths."

RAND researchers say that since the diffusion of fentanyl is driven by suppliers' decisions, it makes sense to consider supply disruption as one piece of a comprehensive response, particularly where that supply is not yet firmly entrenched.

How drugs affect the brain in deadly ways. Click here.