Jordan Axt

Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites

Significance The present work examines beliefs associated with racial bias in pain management, a critical health care domain with well-documented racial disparities. Specifically, this work reveals that a substantial number of white laypeople and medical students and residents hold false beliefs about biological differences between blacks and whites and demonstrates that these beliefs predict racial bias in pain perception and treatment recommendation accuracy. It also provides the first evidence that racial bias in pain perception is associated with racial bias in pain treatment recommendations. Taken together, this work provides evidence that false beliefs about biological differences between blacks and whites continue to shape the way we perceive and treat black people—they are associated with racial disparities in pain assessment and treatment recommendations. Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., “black people’s skin is thicker than white people’s skin”). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient’s pain as lower and made less accurate treatment recommendations. Participants who did not endorse these beliefs rated the black (vs. white) patient’s pain as higher, but showed no bias in treatment recommendations. These findings suggest that individuals with at least some medical training hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment.

Reducing Implicit Racial Preferences: II. Intervention Effectiveness Across Time

Implicit preferences are malleable, but does that change last? We tested 9 interventions (8 real and 1 sham) to reduce implicit racial preferences over time. In 2 studies with a total of 6,321 participants, all 9 interventions immediately reduced implicit preferences. However, none were effective after a delay of several hours to several days. We also found that these interventions did not change explicit racial preferences and were not reliably moderated by motivations to respond without prejudice. Short-term malleability in implicit preferences does not necessarily lead to long-term change, raising new questions about the flexibility and stability of implicit preferences. (PsycINFO Database Record

Understanding and Using the Brief Implicit Association Test: Recommended Scoring Procedures

A brief version of the Implicit Association Test (BIAT) has been introduced. The present research identified analytical best practices for overall psychometric performance of the BIAT. In 7 studies and multiple replications, we investigated analytic practices with several evaluation criteria: sensitivity to detecting known effects and group differences, internal consistency, relations with implicit measures of the same topic, relations with explicit measures of the same topic and other criterion variables, and resistance to an extraneous influence of average response time. The data transformation algorithms D outperformed other approaches. This replicates and extends the strong prior performance of D compared to conventional analytic techniques. We conclude with recommended analytic practices for standard use of the BIAT.

The Rules of Implicit Evaluation by Race, Religion, and Age

The social world is stratified. Social hierarchies are known but often disavowed as anachronisms or unjust. Nonetheless, hierarchies may persist in social memory. In three studies (total N > 200,000), we found evidence of social hierarchies in implicit evaluation by race, religion, and age. Participants implicitly evaluated their own racial group most positively and the remaining racial groups in accordance with the following hierarchy: Whites > Asians > Blacks > Hispanics. Similarly, participants implicitly evaluated their own religion most positively and the remaining religions in accordance with the following hierarchy: Christianity > Judaism > Hinduism or Buddhism > Islam. In a final study, participants of all ages implicitly evaluated age groups following this rule: children > young adults > middle-age adults > older adults. These results suggest that the rules of social evaluation are pervasively embedded in culture and mind.

Scientists’ Reputations Are Based on Getting It Right, Not Being Right

Replication is vital for increasing precision and accuracy of scientific claims. However, when replications “succeed” or “fail,” they could have reputational consequences for the claim’s originators. Surveys of United States adults (N = 4,786), undergraduates (N = 428), and researchers (N = 313) showed that reputational assessments of scientists were based more on how they pursue knowledge and respond to replication evidence, not whether the initial results were true. When comparing one scientist that produced boring but certain results with another that produced exciting but uncertain results, opinion favored the former despite researchers’ belief in more rewards for the latter. Considering idealized views of scientific practices offers an opportunity to address incentives to reward both innovation and verification.

Are People Living in Walkable Areas Healthier and More Satisfied with Life

Are people who live in more walkable areas healthier and more satisfied with life? This study investigates that question by using the 2005 Behavioral Risk Factors Surveillance System (BRFSS) survey, the largest telephone survey on health in the US (302,841 respondents from 989 metropolitan and micropolitan statistical areas [MSA]; 177,524 respondents from 703 MSAs had complete data). Using multilevel random coefficient modeling, we found that people living in walkable areas reported being generally healthier than people living in less walkable areas. In addition, aside from higher self-reported health, people living in walkable areas also had a lower body mass index (BMI). However, contrary to our prediction, people in more walkable areas were less satisfied with their lives than people in less walkable areas after controlling for various individual-level variables (age, gender, race, education, marital status, income, and unemployment). People who live in walkable areas are healthier but not happier than those living in less walkable areas.