Targets and Effects of Bias

00:06 This is a big one, too. We think about who gets targeted in terms of bias? We target people based on lifestyles, I talked about that a little bit when I talked about social status, when we tied together socio and economic status.

00:21 Religious beliefs and affiliations.

00:23 People with certain health conditions, and we can add COVID-19 to that.

00:28 Previously, it was people with mental health conditions, people with HIV or AIDS, people with sickle cell.

00:34 How do we do that? We use to have the stigma when HIV/AIDS came about.

00:41 I was a part of that newness of that.

00:43 And, you know, the picture was painted that these people are dirty and you don't want to touch them, they have the plague, don't be around them, and we dehumanized people.

00:52 And so I'm so happy to see that an evolution has truly happened in terms of HIV and AIDS.

00:59 Sickle cell, what happens? People who have substance use disorders, what happens? Same thing with sickle cell.

01:06 We think they're all pain seekers, drug seekers, all those types of things and we label people and then we tend to allow those biases, labels, and stereotypes to impact how we approach care of these people and marginalizing them.

01:21 And, obviously, we talked a lot about some of the others, race, ethnicity, nationality, ability.

01:27 Criminal record, we label people based on that.

01:31 So, we could call a person who was incarcerated, right? And, yes, again, once we talked to people we develop so much broader perspective.

01:40 And then body image or body weight.

01:42 Body composition is another big one that we don't often talk about but that's a huge thing that people get targeted for in terms of bias, marginalization, and stigmatization.

01:55 And as a result, one of the key things as we contribute to so many mental health issues because of bias, so people have reduced hope, lower self-esteem.

02:07 If you already have some psychiatric symptoms, it can exacerbate those symptoms, causes difficulties in social relationships.

02:16 And going back to something I said earlier, I'm not going to reveal some of those diverse things about myself that are invisible if I already feel like you're going to judge and weaponize it.

02:29 A reduced likelihood of staying in treatment, no matter what it is, so if you fear that you're going to go into a situation and be mistreated, then you're probably going to avoid that situation and that's very important in terms of healthcare, rehab, and those types of things.

02:46 Reluctance to get help or treatment is less likely if people feel like they're going to be judged.

02:54 Social isolation and shame, that's horrible but that happens sometimes.

03:00 People are already prideful and they won't ask for help because of that, the shame of it, and then you isolate yourself.

03:07 I mentioned earlier about noncompliance which is also a judgmental word because we don't ever think about the why of that, we just think about the what.

03:17 We always need to be thinking of three things, what, why, and how.

03:21 The how is how do I help myself to be a better person and how do I help other people to get out of those situations? I can't do that unless I have conversations unless I'm honest.

03:32 Unless I label things exactly what they are so that we could develop those treatment plans.

03:38 So stigma non grata, I like to say that. Stigma is not welcomed in the space of being a human, in being able to be a healthy human in all aspects of humanity.

03:50 And going back to that why, what, and how, in terms of just towards stigma, what are some of the core layers of stigma? Bias, prejudice, and stereotyping.

04:00 And then I just showed you a bunch more.

04:03 And think about it from an impact standpoint.

04:06 This is what you can do as a healthcare provider.

04:09 What happens as a result of me stigmatizing a patient? A few examples could be discrimination, health disparities, health inequities.

04:17 And how can I help? Those are the interventions.

04:21 Anti-stigma should be my focus so what, what am I going to do in terms of my treatment plan? Intervene and help undo some of that stigma and have those healthy relationships with patients and have them to continue to do what they can, I guess in terms of accessing care, participating in their care.

04:41 So, some things you can consider in terms of stigma, how are healthcare professionals supporting patient in-person care and making healthcare systems more comfortable for the people we serve? So, the reason why I said patient in-person care, because, every time we show up, we're not necessarily a patient, right? Johns Hopkins is talking about person care, and I think that's great especially when someone's not sick, right? If I'm not sick, then I'm showing up. If I'm showing up for wellness, showing up as a person, so that in my head, would be what person care might look like but it's your role to think about how you can support people in making these systems comfortable so people will access and also consistently be a part of their own health process.

05:28 And what can we do better? Always think about that.

05:32 We should always be thinking about our goals in terms of improvement and what interventions we can develop in partnership with patients, families, communities, and populations, to improve approaches to our care and those health outcomes from marginalized populations.

05:50 One of the biggest pieces to all of this though in the transformation is leaning away from my comfort zone into our growth zone.

05:58 And we can't do that until we really commit to the transformational journey.