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Oral Concurrent Session 4 - Health Equity and Policy
Oral Concurrent Sessions
Expedited Sessions
The mechanisms of disparities in maternal and perinatal health between migrant and native women are multiple and remain poorly understood. One hypothesis is the existence of implicit biases among caregivers through which the women’s ethno-racial belonging can influence medical decisions and engender healthcare disparities. Their existence and their role in the generation of non-medically justified differential care is being more and more documented in the United States but remains largely unexplored in Europe. The aims of the BiP research program are to test and quantify the existence of implicit biases toward African migrant women among obstetric care providers and to explore the association between implicit biases and differential care.
Study Design:
This study is a web-based survey to which French obstetricians, midwives, and anesthetists were invited to take part by eight professional societies and networks. The potential existence of implicit biases toward African versus French was quantified through Implicit Association Tests (IAT) for valence and strength. The association between implicit biases and clinical decisions was then assessed using six clinical vignettes. For each, the patient’s origin, African/French, was suggested by using typical surnames.
Results:
The survey was completed by 887 professionals. The IATs showed that caregivers in the three professional categories had strong implicit biases with a preference for French versus African women in terms of valence, while they implicitly tended to attribute more strength to African women. We did not observe any association between Patient’s name (French vs. African), caregiver’s biases (implicit valence or strength) and the behavioral intention captured through vignettes responses.
Conclusion: This study shows a high level of implicit racial biases among obstetric care providers, but these biases were not associated with differential clinical decisions. This research program opens in France a field of research on certain forms of health discriminations that must be pursued and completed.
Elie Azria, MD, PhD
INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University
Paris, Ile-de-France, France
Priscille SAUVEGRAIN, PhD
INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University
Paris, Ile-de-France, France
Olivia Anselem, MD
Department of Obstetrics and Gynecology Port Royal , Cochin Hospital, AP-HP, Paris, France
Paris, Ile-de-France, France
Marie-Pierre Bonnet, MD, PhD
APHP
Paris, Ile-de-France, France
Catherine Deneux-Tharaux, MD, PhD
Université de Paris, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, DHU Risks in Pregnancy
Paris, France, France
Anne Rousseau, PhD
UVSQ
Paris, Ile-de-France, France
Juliette Richetin, PhD
University di Milano Bicocca
Milano, Lombardia, Italy