Abstract Body
Purpose: Australian cancer care providers deliver inequitable access and outcomes for Aboriginal peoples [1]. Systemic and personal racism experienced by Aboriginal patients are thought to contribute to these inequities [2,3]. We examine implicit bias in employees at a metropolitan hospital in Victoria using an Australian Race (Aboriginal-White) Implicit Association Test (IAT), in an attempt to understand a potential factor for inequitable outcomes of Aboriginal cancer patients.
Methods and Materials: All employees at a metropolitan hospital in Victoria were invited to take part in a web-based, cross-sectional study using an Australian Race IAT. The results were analysed using R (version 3.5.0) to calculate mean IAT scores for the whole group and sub-groups of gender, age and occupation. A bootstrap resampling process was applied to understand patterns of the lowest and highest threshold scores.
Results: 538/2871 participants (19%) completed the IAT between Jan - June 2020. The mean IAT was 0.147 (SD 0.43, P< 0.001, 95%CI 0.11-0.18). 60% had a preference for white Australians over Aboriginal peoples. There was no significant mean difference in IAT scores between sub-groups of gender, age or clinical/non-clinical employees. 21% of employees, (95%CI 17.65-24.53) had moderate to strong preference for white Australians over Aboriginal peoples, compared to 7.1% with moderate to strong preference for Aboriginal peoples over white Australians (95 %CI 5.01-9.09).
Conclusion: Inequitable cancer survival for Aboriginal patients has been well established and cancer is now the leading cause of mortality [4]. This paper documents the presence of racial bias in employees at one metropolitan hospital in Victoria. We argue that this cannot be understood outside the history of colonialism and its effects on Aboriginal people, healthcare workers and our society. Further research is required to evaluate measures of racism, its impact on health care, and how to eliminate it.