Embedded Bias: How Medical Records Sow Discrimination

Link: https://khn.org/news/article/electronic-medical-records-doctor-bias-open-notes-treatment-discrimination/

Excerpt:

Narrow or prejudiced thinking is simple to write down and easy to copy and paste over and over. Descriptions such as “difficult” and “disruptive” can become hard to escape. Once so labeled, patients can experience “downstream effects,” said Dr. Hardeep Singh, an expert in misdiagnosis who works at the Michael E. DeBakey Veterans Affairs Medical Center in Houston. He estimates misdiagnosis affects 12 million patients a year.

Conveying bias can be as simple as a pair of quotation marks. One team of researchers found that Black patients, in particular, were quoted in their records more frequently than other patients when physicians were characterizing their symptoms or health issues. The quotation mark patterns detected by researchers could be a sign of disrespect, used to communicate irony or sarcasm to future clinical readers. Among the types of phrases the researchers spotlighted were colloquial language or statements made in Black or ethnic slang.

“Black patients may be subject to systematic bias in physicians’ perceptions of their credibility,” the authors of the paper wrote.

That’s just one study in an incoming tide focused on the variations in the language that clinicians use to describe patients of different races and genders. In many ways, the research is just catching up to what patients and doctors knew already, that discrimination can be conveyed and furthered by partial accounts.

Author(s): Darius Tahir

Publication Date: 26 Sept 2022

Publication Site: Kaiser Health News

Looking Beyond Sex

Link: https://theactuarymagazine.org/looking-beyond-sex/

Graphic:

Excerpt:

With nonbinary genders recognized on legal documents, customers are beginning to ask for forms and applications to include nonbinary options as well—so they’re not forced into a false selection. Even so, a person still could make an inaccurate selection. A customer falsely selecting a nonbinary gender is slightly less risky for the insurance company than selecting a false binary gender, as nonbinary rates are likely to fall somewhere between male and female to ensure they’re not discriminatory.

In the end, providing false information on an insurance application is fraudulent activity regardless of the question. Many of the states that include nonbinary gender markers on birth certificates and/or driver’s licenses already require the individual to sign an affidavit stating that they are not changing their gender marker for a fraudulent purpose. The benefits of including options for nonbinary customers and the potential for more accurate risk evaluations hopefully will outweigh a possible increase in fraudulent activity.

Author(s): Erin Sheriff

Publication Date: July 2020

Publication Site: The Actuary, SOA