Written by: Jasmine Biju
The first step in eliminating racial inequality is to acknowledge its presence in different sectors. Preliminary research suggests that racial inequalities exist in curricular literature for aspiring physicians. Researchers from the Department of Sociology at the University of Toronto and the University of British Columbia investigated the lack of racial representation in images portrayed in textbooks from top medical schools. Their research suggests that racial inequality is present, which may contribute to the upbringing of biases in the professional medical environment.
The Atlas of Human Anatomy, Bate’s Guide to Physical Examination & History Taking, Clinically Oriented Anatomy, and Gray’s Anatomy for Students (required medical textbooks for numerous universities) were analyzed by researchers in order to confirm or deny the hypothesis of minimal racial representation in textbooks. By scrutinizing 4,146 images, they were able to derive the skin tone representation: though it is generally accepted that the racial distribution of the U.S. is 62.5% White, 20.4% Black, and 17% people of color, the skin tones depicted in the studied textbooks were 74.5% light, 21% medium, and 4.5% dark skin. This is an indicator of an overrepresentation of the white skin tone in comparison to other colors of skin pigmentation. These proportions give reasoning to potential biases that may enter the medical atmosphere.
Though many physicians deny having patient bias, statistics prove a conspicuous inequality between the diagnosis of black patients compared to their white counterparts. For instance, Black and Latino children receive fewer diagnoses of bacterial complications than white children, even if the same symptoms are shown. Similarly, women of color are not as likely to receive a referral for a mammogram or screening for breast cancer as compared to their white counterparts. These cases are a small window into the many instances of a lack of quality in the communication between a physician and a patient. It can be hypothesized that physicians, knowingly or unknowingly, have the tendency to treat patients differently despite the presence of similar symptoms.
The finding of potential biases associated with the differences in treatment based on race has developed a more critical examination of potential contributors in the medical curriculum. Though most textbooks aim to promote equality among patients, their depictions, images, and diagrams demonstrate an unequal representation of different demographics that juxtaposes the goals of equality that these institutions claim to have. The intention of underrepresenting minority ethnic and racial groups may or may not be intentional, but it still is an issue contributing to racism and health inequities. For instance, it may affect a physician’s ability to make the association between a certain disease and a patient of a specific race.
The investigation of this inequality has been focused on statistics related to racial representation in course materials, such as slideshow presentations and textbooks. In additional studies conducted by Warren Alpert Medical School of Brown University, the University of Washington School of Medicine, and the University of Minnesota Medical School, there was the discovery that people of color are underrepresented in both peripheral and textual formats. This may contribute to the reinforcement of white supremacy in medicine.
Visual forms of information are crucial in constructing our outlooks on various matters of study. An uneven representation of race and skin tones in the medical curriculum is important in explaining racial inequalities in one’s healthcare experience. For this reason, it is crucial for textbooks that are ubiquitously used in universities across America to be reformed so that it encompasses the accurate racial distribution of people within the United States.
References:
Image Source: Lown Institute
Patricia Louie, Rima Wilkes, Representations of race and skin tone in medical textbook imagery, Social Science & Medicine, Volume 202, 2018, Pages 38-42, ISSN 0277-9536, https://doi.org/10.1016/j.socscimed.2018.02.023. (https://www.sciencedirect.com/science/article/pii/S0277953618300790)
Dermatologist faces a reckoning: lack of darker skin in textbooks and journals harms care for patients of color, Patient Safety Network, 2020,
https://psnet.ahrq.gov/issue/dermatology-faces-reckoning-lack-darker-skin-textbooks-and-journals-harms-care-patie nts-color
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