1. Unconscious Bias Lori Byrd, MS Presentation to the Family Planning Annual Meeting September 14, 2016

2. “Human beings tend to be unable to estimate how biased they are.” Jean-Francois Manzoni

3. Unconscious/Implicit bias “Refers to a bias that we are unaware of, and which happens outside of our control. It is a bias that happens automatically and is triggered by our brain making quick judgments and assessments of people and situations, influenced by our background, cultural environment and personal experiences.” Equity Challenge Unit (ECU): 2013 Unconscious Bias in Higher Education Report

4. Definitions  Schemas  Stereotypes  Stereotype threat  Priming  Interpersonal Discrimination  Racial Anxiety

5. Schemas  Structured framework of how we think  Templates of knowledge and expectations  Modifiers are used when object differs from schema

8. Stereotypes  Schemas used to categorize a person  Can be positive or negative attributes

9. Stereotype threat  Internalizing stereotypes of own  Worry about confirming the stereotype

10. Priming  Based on previous association or experience  Expectation what we should see

12. What words would you use to describe an older adult?

14. Interpersonal Discrimination  Also called micro-aggressions  Identity-related slights or insults towards people  Verbal, behavioral or environmental  Intentional or unintentional

15. Statements And Actions Saying ”You are so articulate” to a person of color “You speak English very well.” “I don’t see color.” Speaking “baby talk” with a middle-aged patient who uses a wheelchair Mistaking a woman physician wearing a stethoscope as a nurse Asking a man, “Do you have a wife?” Message You are not American or you are a foreigner. It is unusual for someone from your race to be intelligent. Assuming that all people are heterosexual. Denying a person of color’s racial/ethnic experiences. People with a disability is lesser in all aspects of physical and mental function. Woman are less capable and successful than men. Martinez D. 2015 Understanding Micro-agressions

16. Racial Anxiety  Stress response before or during interactions  Fear of experiencing bias from someone else  Fear of actions will be perceived as prejudice  Fear of being met with distrust or hostility

17. Unconscious Mind

18. Tables Picture created by Roger Shepard, Oxford and Stanford University

19. Bias at Work

20. Tiers of Bias  Individuals  Biased speech and behaviors toward others  Institutional  Policies and practices that perpetuate inequality  Structural  Broad systems that are against a group or groups of people

21. Internal Work Biases  Human Resources  Work environments  Program development  Policy development  Team development and dynamics  Interpersonal interactions

22. Potential Family Planning Biases  Socioeconomic status  Racial  Age  Religion  Sexual orientation

23. Implicit Bias Increased by:  Stress or overload  Time pressure  Multi-tasking  Ambiguous qualifications  Incomplete data Not Reduced by:  Good intentions  External motivations  Avoidance  Self-perceived objectivity

24. How do we overcome our biases?

25. Acknowledge our biases  Think about interactions  Be aware of attitudes  Acknowledge uncomfortable situations and awkwardness  Review processes & protocols

26. Implicit Association Test Implicit Project: https://implicit.harvard.edu/implicit/ Researchers from Harvard University, the University of Virginia, and the University of Washington

27. Increase our exposure  Interact with people outside of your group  Expose ourselves to materials/situations that go against bias/stereotypes

28. Interrupt our patterns  Catch ourselves in the act  Walk away from a situation or discussion  Avoid all, every, none, you, them  Stop interpersonal discrimination

29. Look at the data  Trends  Overrepresented  Underrepresented  Prejudice for or against

30. Individualize your interactions  Put yourself in others’ shoes  Think of each person as an individual  Cultural Humility vs Cultural Competence

31. Create safe environment  Talk about bias to provide forum for discussion  “Isn’t it funny, how…?”  Have an attitude to change the environment/situation, not the people

32. Fortunately for serious minds, a bias recognized is a bias sterilized. Benjamin Haydon

33. We’ll end with this… https://www.youtube.com/watch?v=DW ynJkN5HbQ

34. References  Equity Challenge Unit. Unconscious Bias in Higher Education. 2013. http://www.ecu.ac.uk/wp-content/uploads/2014/07/unconscious-bias-and-higher- education.pdf  Dian Finnerty, MS. Exploring the Influence of Unconscious Bias in Our Work and Lives: The Research, the Impact, and Strategies to Override; Culturally Responsive Health Care in Iowa Conference, June 5, 2015.  Jessica MacFarlane. Achieving Health Equity – By Addressing Implicit Bias, Racial Anxiety and Stereotype Threat. National Association of Chronic Disease Directors Webinar, April 28, 2016.  Kristin Maschka. How I Learned to Love Unconscious Bias. TEDx Talks. YouTube. September 10, 2015.  Howard Ross. Proven Strategies for Addressing Unconscious Bias in the Workplace. Diversity Best Practices. CDO Insights. 2008: 2(5).  Howard Ross. Everyday Bias: Identifying and Navigating Unconscious Judgement. Talks at Google.YouTube. November 16, 2014.  Stone J, Sjomeling M, Lynch CI, Darley JM. Stereotype Threat Effects on Black and White Athletic Performance. Journal of Personality and Social Psychology. 1999; 77:6, 1213-1227.  Martinez D. Understanding Micro-aggressions. Culturally Responsive Health Care in Iowa Conference. June 5, 2015.  Rhodes R. End-of-Life Care in Diverse Populations: Providing Care with Sensitivity and Humility. Culturally Responsive Health Care in Iowa Conference. June 3, 2016.