Just Read: #WhatADoctorLooksLike – Implicit Bias in Academic Medicine – via JAMA

Where I went to medical school (University of Arizona College of Medicine), we had the typical “wall of fame” of all the previous graduating classes prominently mounted, covering the history of the school’s first class from 1967 to the present.

It was amusing to note that as you walked along the wall that the number of women in each class steadily increased, to the year after mine, when for the first time there were more women than men in incoming class.

Except that in retrospect, it wasn’t really funny.

The other thing I noticed was that the Nursing School building, erected a few years after the medical school building next to it, didn’t seem to have very many men’s rooms…

The wall showed another thing, that there were no LGBTQ human beings enrolled in this school. Except that there were. However, all the signs and signals in our curriculum and the behavior of our faculty conspired to keep this just an “allegation.”

And so…we can now measure the impact.

This issue of JAMA Internal Medicine includes three studies looking at sex and racial bias in academic medicine, and as it has been shown in many (many) other studies, the profession tends to mirror the society around it. No more, no less. This is a link to the editorial accompanying the studies, written by Molly Cooke, MD (@mollymcooke) at the University of California, San Francisco.

Cooke M, AJM A, RA G, E M, M N-S. Implicit Bias in Academic Medicine. JAMA Intern Med [Internet]. 2017 Mar 6 [cited 2017 Mar 15]; Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2016.9643

This wouldn’t be a problem (actually, it would always be a problem, but maybe not as high-stakes) if our society’s health didn’t depend on physicians who understand the life experience of the communities they serve (It does).

Another bank of studies show clearly that people learn better from people who resemble their life experience more closely. It’s just science, not an opinion. And so, when people are selected to present at grand rounds:

To the extent that those role models do not mirror the sex and racial composition of the trainee pool, we are delivering the implicit but powerful message that these leadership roles and examples of excellence are for someone else. Women, blacks, Asians, and Latinos need not apply.

I have previously posted on the environment around LGBTQ trainees, also studied, and also with outcomes that parallel these.

Just Read: Sexual and Gender Minority Identity Disclosure: “In the Closet” in Medical School

This gendered quote from a general practitioner in 1966 (the ancestors of my medical specialty, family medicine) is relevant here:

S/He does more than treat them when they are ill; he is the objective witness of their lives. They seldom refer to him as a witness…that is why I chose the rather humble word clerk: the clerk of their records.

If this is what doctors do (it is), then we have an interest in examining our biases and modulating them. And there’s science to show that can be done, too. Isn’t this century grand 🙂 .

One more from Shania Twain, because it’s my RSS feed.

She’s a geologist, a romance novelist
She is a mother of three
She is a soldier, she is a wife
She is a surgeon, she’ll save your life
She’s, not, just a pretty face
She’s, got, everything it takes

I’ll post again on the actual studies referenced.

A few thoughts about gender equality and respect in the 21st Century

2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03870
2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03870 (View on Flickr.com)

I recently finished Sheryl Sandberg’s book Lean In: Women, Work, and the Will to Lead (I know, 3 years behind the rest of society, posting on that later), at the same time I participated in a historic (in my opinion) creation of Workplace Guidelines Pertaining to Transgender and Gender Non-conforming Employees.

I had these thoughts as I was given an opportunity to co-lead (with an excellent leader who happens to be a woman) an introduction to this topic:

  1. Everyone here was made in the 20th Century
    • By definition, today’s health care workforce was born in the 20th Century. The overwhelming majority of us were educated in the 20th Century, which is where much of gender expression was imposed on society:
    • When Did Girls Start Wearing Pink? | Arts & Culture | Smithsonian@SmithsonianMag

      For example, a June 1918 article from the trade publication Earnshaw’s Infants’ Department said, “The generally accepted rule is pink for the boys, and blue for the girls. The reason is that pink, being a more decided and stronger color, is more suitable for the boy, while blue, which is more delicate and dainty, is prettier for the girl.”

    • Fashions: Baby’s Clothes – TIME | Where to buy pink clothes for boys, 1927 – Gender MystiquePink is for boys
    • BBC – Future – The ‘pink vs blue’ gender myth

      Various studies have looked at colour preferences in different age groups. In the US most have found that babies and toddlers, whether male or female, are attracted to primary colours such as red and blue.

    • Medical science is also a conspirator here. With the advent of amniocentesis in the 1980s, and with it, the ability to know a child’s sex at birth, the marketing of imposed gender expression became even more aggressive.
    • The majority of the workforce being “made” in the 20th Century of course is changing rapidly, which is going to contribute to all of the above being an even more distant memory. Since it’s not based on science, it won’t be missed by this physician.
  2. Now that we know that much of what we were taught was arbitrary and not based on science, it’s up to us to unlearn and relearn.
    • This quote really helps with that.

      Notice your defensiveness and accept the discomfort of unlearning and relearning. To be competent in this arena is the same as learning to be competent in anything else. It requires a desire to know, motivation to become informed, opportunities to practice and the willingness to correct your mistakes.

      To say we don’t have biases is to deny our humanity. We all have to practice the desire to learn, with humility. In experience this can be very difficult for people (I’ll be writing more on this, known as the “illusion of objectivity”). Sheryl Sandberg, in her book, has had similar experiences to mine:

      My own attempts to point out gender bias have generated more than my fair share of eye rolling from others. At best, people are open to scrutinizing themselves and considering their blind spots; at worst, they become defensive and angry.

      Sandberg, Sheryl (2013-03-11). Lean In: Women, Work, and the Will to Lead (Kindle Locations 2287-2289). Knopf Doubleday Publishing Group. Kindle Edition.

  3. As we implement the future, we should be aware of its impact.
    • Creating an environment that’s open to everyone versus one where people are helped to “fit in” places an employer squarely in the group of the most elite employers to work for, internationally. I am proud to be a part of one of the 407 best places to work in the United States, with a 100% rating on the Human Rights Campaign Corporate Equality Index.
    • I can’t even count the number of times our work in this space has created more opportunity for thought partnership and mindshare around health in general. Not LGBTQ health, all health, total health. I personally know people who have joined our health system because of the knowledge that we respect this population, whether or not they are a member of it. The same goes for other nationally important stakeholders I have worked with – they are drawn to people and organizations that respect every human, in all work related to health.

      Photo Friday: It’s important for a health system to score 100% on the HRC Corporate Equality Index, too

    • Changing our world to help it learn to love better is the continuation of what a nurse or doctor hopes to become when they begin their training. It’s an incredible leadership opportunity to be part of these professions when we become who we are.

Speaking of leadership opportunities. I encounter them every day, sometimes unexpectedly, and they are awesome.

Can Health Care Be Cured Of (Unconscious) Racial Bias? : NPR

A growing body of research suggests that doctors’ racial biases and other prejudices continue to affect the care patients received. Medical educators say self-awareness is an important first step.

Source: Can Health Care Be Cured Of Racial Bias? : Shots – Health News : NPR

The opening story in this NPR piece is worth listening to.

As I’ve noted on this blog before, for LGBT and especially T individuals, there isn’t just unconscious bias in health care, there is frank, open, explicit bias (see: Just Read: Eliminating physician biases against gay and lesbian people, don’t forget the “T”).

I am glad this subject is getting covered in today’s health professions schools. In the end, health systems and academia need to design bias-free and de-biasing environments for learners and faculty.

Just Watched: “Managing Unconscious Bias” , for Facebook employees

Via the magic of Twitter, I was treated to access to Facebook’s publication of their own Managing Bias training for their employees. It’s an approximately one hour video of an actual training, also broken up into modules, plus slides and references, which you can view/download on demand.

Interestingly (and authentically) the notice didn’t come from Facebook’s Learning & Development organization:

I watched the one hour training and reviewed the materials as someone who’s been studying unconscious bias for a little over a year now, with the support of Kaiser Permanente’s own National Diversity and Inclusion Organization (thank you!).

Impressed by

  • The sharing of the video of the training by Facebook. It’s hard to find companies that are this open about a sensitive topic within any organization. The video shows employees working through (and maybe exhibiting) biased behavior. This is good. It’s human.
  • The teaching approach – with a video of several employees who are different introducing themselves to an invisible viewer. I honestly thought after watching that part, “I don’t have a preference for any of the individuals.” Some of the employees in the training did, which starts a good dialogue.
  • Use of validated tools – employees were asked to take the Implicit Association Test in advance. And they were asked, not ordered to, which is the correct way to introduce the test.
  • Counteracting behaviors like having structured decision making and clear criteria are great and important, really good discussion.
  • Connection to impact, and business impact. A good job was done, in my opinion, of making a case for eliminating bias for a better company.

Things worth further exploration

How I would add to/amend (as suggested at the bottom of the web site):

  • Explain the “unconscious” nature of unconscious bias. This bias is not something you can recognize and tell yourself not to have. If it was, it would be “conscious” (or “explicit” as they say in the literature). In an audience that’s more likely to have a preponderance of scientists/engineers (doctors/nurses), it’s helpful to explain how our brain wiring results in these associations that happen so fast, you can’t ask yourself if you have them, and often you can’t notice the behavior that comes from them. (A good paper that I wrote about helps: Just Read: Unconscious bias is like an iPhone version 20 inside your brain, and walking helps manage it (?) | Ted Eytan, MD).
  • Modulate suggestions like “don’t make assumptions.” These don’t really get at the unconscious nature of bias or de-bias a workplace. Again, this bias is not conscious, you can’t talk your way out of it.
  • Add a discussion about how to de-bias a workplace
  • Lori Goler (Facebook’s VP of People), Maxine Williams (Facebook’s Global Diversity Officer) and Mike Rognlien (Facebook Learning and Development) do a great job of introducing all the topics, including the importance of giving fair credit. However, the website in which their work is housed doesn’t list their names anywhere – you have to dive into the video to get them. Model giving fair credit – these trainings are not easy to create or perform.
  • I and others had the good fortune of a session with Professor Mahzarin Banaji (@banaji), one of the developers of the Implicit Association Test, earlier this year. One thing she did that was useful, was a live version of the Implicit Association Test, using hand claps. It’s very illustrative, but takes some setting up.

Of course, I have assessed my own biases. It’s a good thing to do because we all have them, which means we are human.

It’s nice to know, even at Facebook, that to train people on something, you still need to bring them into a room and teach them. Not everything can be learned virtually. Thanks to Facebook for sharing it with the world.

If the diversity team was available on any social network to continue the conversation as part of a community committed to eliminating bias that would be great. Regardless, the commitment is visible and it’s appreciated, we’re all here to make sure everyone has the opportunity to achieve their life goals.

Just Read: Eliminating physician biases against gay and lesbian people, don’t forget the “T”

This is a study from Yale University about medical students’ explicit and implicit attitudes toward people who are gay and lesbian. Not surprisingly, medical students reflect the biases of the society around them:

Explicit and implicit attitudes among medical students 54443
A lot of bias: Explicit and Implicit attitudes among medical students against gay and lesbian individuals (Where’s the “T”?) (View on Flickr)

I created the chart above from the study data which shows that a little less than half of medical students today harbor openly negative attitudes toward gay and lesbian people. When looking at their unconscious attitudes, that jumps to 82 %.

This is about the same percentage as adult physicians’ negative implicit attitudes toward latino individuals, but more negative than adult physicians’ attitudes toward african american people. (see: Blair I V, Havranek EP, Price DW, et al. Assessment of biases against Latinos and African Americans among primary care providers and community members. Am. J. Public Health. 2013;103(1):92–8.)

What you do with it that matters

This data obviously doesn’t make people feel good about their potential treatment in health care, which can be hostile bordering on brutal (I’ll post on that in the near future).

What’s more important is that physicians and the profession in general should desire to know their biases, and do something about them. The researchers in the first paper correlated attitudes to prior contact with gay or lesbian individuals, and found that, indeed, having had positive contact was protective, as has been shown in the literature for many years.

In other words, there are things that can be done, we should not be disappointed that bias exists, we should be disappointed if it is allowed to continue unmodulated.

Enter the “hidden curriculum”

The commentary piece attached to this one brings up, again (for the nth time this month alone – must be newly popular?), the concept of the “hidden curriculum,” which has been foreign to me as a non-academic, so I appreciate it being defined here:

The compilation of implicit biases, explicit biases, institutional climate, and ingrained behaviors at an academic health center also form the foundation of the institution’s hidden curriculum, or what health professions trainees learn from what they observe and experience rather than what they are overtly taught.

This doesn’t strike me as good news, since recent research shows that the hidden curriculum seems to be promoting rather than eliminating bias (see: Just Read: Sexual and Gender Minority Identity Disclosure: “In the Closet” in Medical School | Ted Eytan, MD). For example this quote:

On my surgery rotation, we saw a male- to-female transgender patient who had “do-it-yourself ” silicone breast implants which had become infected. He [sic] was treated like a freak by the residents and attendings behind closed doors, joking at his [sic] expense. (25-year-old, third-year, lesbian, white, female, U.S. MD student)

I’d like to point out that the researchers in the study above didn’t get the pronouns right themselves when they transcribed the quote, so bias is quite pervasive.

There’s no “T” in this discussion of “LGBT”

I used the quote above to point out that while the topic of the commentary piece is “anti-LGBT” bias, bias against people who are transgender or non-conforming is not mentioned once.

The study of medical student bias did not address this bias (against transgender or gender non-conforming individuals) at all. There is currently no implicit attitudes test for people who are trans or gender non-conforming, but I understand one is being developed. It would have been useful to at least ask about explicit bias for this group, because if we think about the harm to gay and lesbian people in health care, imagine the special harm that people who are transgender face. I diagrammed it out here to assist:

Impact of implicit and explicit bias in the health of transgender persons 54442
Impact of implicit and explicit bias in the health of transgender persons (View on Flickr)

I’m wondering if academic medicine is going to follow, rather than lead, in changing the profession.

In my glass 3/4 fullness, that’s okay, the rest of us are here and we have accountability too. We have to change the health care industry’s position on providing medically necessary care, so that care is provided routinely in the first place.

In addition we need to bring a human understanding to the lives of the people we are serving, which seems quite lacking. That’s what #KPLantern is working to accomplish. Watch this space for updates 🙂 .

Papers cited:

Burke SE, Dovidio JF, Przedworski JM, et al. Do Contact and Empathy Mitigate Bias Against Gay and Lesbian People Among Heterosexual First-Year Medical Students? A Report From the Medical Student CHANGE Study. Acad. Med. 2015.

Fallin-Bennett K. Implicit Bias Against Sexual Minorities in Medicine: Cycles of Professional Influence and the Role of the Hidden Curriculum. Acad. Med. 2015.

Just Read: Blindspot: Hidden Biases that shape, and could fix, society

Blindspot: Hidden Biases of Good People Mahzarin R. Banaji (@banaji) & Anthony G. Greenwald (via Amazon.com) | (Via your local library)

(The phrase “fix society” is a reference to the tragic death of Leelah Alcorn in 2014: Transgender teen who died of an apparent suicide: ‘Fix society. Please.’ – The Washington Post)

The topic of implicit or unconscious bias is integrated into a lot of the work I am doing today. I did a pretty exhaustive review of the research last year in preparation for this presentation (Presentation: Being a Transgender Ally and Unconscious Bias ). I am about to give a refreshed version of the presentation to fellow clinicians at Kaiser Permanente (which I’ll post here).

I figured it would be a good idea to read the book version of all the papers I read and the experts I spoke to last year (much of it chronicled here, many many posts…). This is that book.

I think this is a hard topic to grasp unless you dive in, but here’s a good overview:

Reflective or explicit attitudes are those that we are aware of having (for example, Mahzarin knows that she likes Star Trek, and Tony knows that he likes bebop), while automatic or implicit attitudes consist of associative knowledge for which we may lack awareness (for example, old = bad, shared by Tony, Mahzarin, and apparently 80 percent of everyone else). The two forms need not agree, which is a circumstance called dissociation . For example, explicit or reflective “I like elderly people” can exist in the same head with implicit old = bad.

Banaji, Mahzarin R.; Greenwald, Anthony G. (2013-02-12). Blindspot: Hidden Biases of Good People (Kindle Locations 3074-3078). Random House Publishing Group. Kindle Edition.

The other important thing to know is that the study of implicit or “unconscious” bias is not a niche activity confined to doctors.


Even Eric knows it (View Source)

Actually it’s almost the opposite, with rich application in a wide variety of professional settings, most notably, the law, as well as the military. If anything, medicine, sadly, lags behind these other disciplines in applying knowledge about how the mind works.

For me, the book ended abruptly, as I had delved deeper into the topic last year (and did a follow-up review this year), and applied it in a place where it hasn’t previously been thought of, in the health of people who are lesbian, bisexual, gay, or transgender (or a combo).

However, if this is unfamiliar territory to you, start here, with this book.

What was helpful for me was the concept of identity. For the KP Lantern project, we recently did a group empathy exercise where we were asked a simple question:

How and when did you first know your gender identity?

…which really raises a lot of other questions, like where does a person’s identity come from in the first place? From the book:

…to the rapidly developing brain of the infant, which is acquiring new stores of knowledge at an exponential rate, each such interaction is a building block, reinforcing the foundation on which a more fully formed social being will one day stand. The name we give to this foundation is identity, and unique as each individual is, identity is deeply bound to the characteristics that are true of “us” as a group and differentiated from “them.”

Banaji, Mahzarin R.; Greenwald, Anthony G. (2013-02-12). Blindspot: Hidden Biases of Good People (Kindle Locations 1953-1956). Random House Publishing Group. Kindle Edition.

Gender is a strong basis for identifying oneself as a member of a group, male and female being among the earliest social category distinctions that children make. At different points in development, a child comes to know that she is, for example, female, Irish, middle-class, brown-eyed, and athletic.

Banaji, Mahzarin R.; Greenwald, Anthony G. (2013-02-12). Blindspot: Hidden Biases of Good People (Kindle Locations 1977-1978). Random House Publishing Group. Kindle Edition.

The studies of infants and young children in the book are fascinating and adds layers and layers onto ideas about things that I formerly accepted as just a given in human development.

The cornerstone of measuring implicit attitudes is the Implicit Association Test (IAT) (@ProjectImplicit), which works in magical (based on science) ways by gently short circuiting the parts of your brain connected to your stereotypes and categories of things around you. If you don’t know where to start, start by taking one of the tests, you’ll see what I mean.

I recently posted my IAT results on this blog. It’s almost a certainty that if I repeated the tests, the results would be same (and I actually did repeat the gay/straight test, with the same result).

So a person is biased, so what?

Two answers to that question:

1. Yes, so what? That’s the nature of humanity & it’s boring (to paraphrase one of the experts I spoke to).
2. What’s exciting is what you do with that knowledge, and you can do things.

The book doesn’t delve into what can be done as much as a physician type might want to (we’re programmed/biased to look for the treatment plan), but things can be done.

From modifying our own biases, to the prize, modulating and eliminating them in society.

The benefit of that is huge – all of the behaviors modulated by our biases that we are unaware of can go from preventing human potential to promoting it.

Vivienne Ming, PhD (@NeuralTheory) and I will be discussing this very topic at the upcoming XX in Health event in New York. (@XXinHealth).

The first step is to know.  I’m glad I do.

Most people, we’ve discovered to our happy surprise, would rather know about the cracks in their own minds. In the same way that they would want to know about a high level of blood cholesterol so that they can take action against it, they wish to confront potentially harmful mental content.

Banaji, Mahzarin R.; Greenwald, Anthony G. (2013-02-12). Blindspot: Hidden Biases of Good People (Kindle Locations 926-928). Random House Publishing Group. Kindle Edition.

“What good is intelligence if you cannot discover a useful melancholy?” the Japanese poet Ryūnosuke Akutagawa is said to have asked, by which he meant that knowledge that provokes a feeling of distress is only of value if it can be put to some use.

Banaji, Mahzarin R.; Greenwald, Anthony G. (2013-02-12). Blindspot: Hidden Biases of Good People (Kindle Locations 1076-1078). Random House Publishing Group. Kindle Edition.

Getting ready for XX in Health, Assessing my own biases

Ted Eytan Implicit Association Test Result 52734 - Version 2

And the result is….

XXinHealth (@XXinHealth) is happening soon (see: I AM excited to be part of XXinHealth’s sixth annual women’s retreat) and my co-host / guest star, Vivienne Ming (@NeuralTheory) has set up an impressive discussion for us:

I’m not going to lie, I’m a little anxious, as much as I am eager. Great development opportunity!

I am also human, which means I have implicit/unconscious biases that shape my behavior, as do all human beings. I’ve written about this previously, multiple times on this blog (see the full list of posts here, there are many).

One of my favorite quotes from the experts is:

“own the fact the fact that you’re not exceptional. you are in this sweet spot of judges, lawyers, police, all of whom have bias. If you care, it would make sense to find out.” – (Personal Communication Jerry Kang, JD, Professor of Law, UCLA
April 15, 2014)

So, I do care, I found out, and I’m posting my results here. It’s super easy to test yourself, just go to the Project Implicit website and follow the instructions.

The result: I have (some) biases

Here they are:

  • For Gay/Straight: “Your data suggest a strong automatic preference for Straight People compared to Gay people.”
  • For Gender/Career: “Your data suggest little or no association between Male and Female with Career and Family”
  • For Gender/Science vs Liberal Arts: “Your data suggest a moderate association of Female with Science and Male with Liberal Arts compared to Male with Science and Female with Liberal Arts”

So, I have automatic preferences for straight people (anti-gay bias), and automatic preferences for women having careers and being in science (pro-woman bias). I did notice incidentally that I had trouble associating “geology” with “science” in the tests – I kept associating it with liberal arts. That’s what happens to molecular biology majors….

The Implicit Association Test does not measure endorsed points of view, which means these are not my outward attitudes, they are the conditioning my brain has received over time. The key word is “automatic.”

There’s nothing to be ashamed of or to celebrate. Just helpful knowledge to empower my human potential and more importantly, those around me. It’s worth trying it yourself – each test takes 5 minutes, and it is validated (see the many posts of mine about this).

There isn’t a test yet around gender/transgender, and the reality is that in society today, explicit, outward bias is still tolerated against people who are transgender in a way it is not against gay, lesbian, and bisexual people. Transphobia is different than homophobia, however, its impacts are palplable, and enormous in health and health care, in my opinion.

As I discussed in the presentation I gave last year (and am about to give again: Presentation: Being a Transgender Ally and Unconscious Bias), these biases are malleable. The most important thing is to know we have them.

There is something called the “illusion of objectivity” where people tell themselves that they are objective, which actually results in more biased behavior. I am more worried/scared by this statement – “I am objective” – than any other statement made in health care.

These associations are important because they do shape our society in significant ways, from the ways we recruit and promote social and cultural minorities into employment, to a host of other opportunities that people may/may not receive because of their gender or minority status.

Vivienne, a neuroscientist and entrepreneur in this space, happens to know a lot about this, including the quantification of the costs of the lost opportunities to harness human potential. And..the literature and her work is showing that we can change the trajectory of humans, going from “finding” human potential, to enabling/creating it.

One of the best things I (or a person) can do to prepare themselves for a dialogue like this is to know who they are, including the traits that are bundled in their humanity. I welcome this opportunity to maximize my own human potential in collaboration with the entire XXinHealth community 🙂 .

Taking over the Boys club – XX Retreat — XX in Health

Presentation: Being a Transgender Ally and Unconscious Bias

Hi. I’m Ted. With Dana Beyer, MD (@DanaBeyerMD), the first trans Senate candidate in American History

This is the presentation I gave at the 2nd Annual Kaiser Permanente LGBTI Health Symposium, in Universal City, California on May 2, 2014, to 300 of my colleagues. I hope you like it.

Regarding the experience of being an ally – one of the best experiences of my professional career – I wish it upon every physician and nurse interested in making humanity a better place for all.

I began working on this back in January, when I put out a call for assistance: Crowdsource Request: Being a transgender ally and unconscious bias | Ted Eytan, MD

Thanks to everyone who offered their help, all outstanding individuals, who willingly shared their wisdom, their stories, their presence in society as examples of the future of health, even in some cases when we’ve never met in person (yet 🙂 ).

I’ll write more about the symposium in another post. If you need any of the references or materials from the presentation, feel free to contact me or post in the comments.

If you’d like to access the videos in the presentation, I published those separately: Video Friday: Edith Bunker, Transgender Ally, 1977; Jeff Platt, Ally, 2014 | Ted Eytan, MD

This presentation was also a first for me. It was the first time a patient AND their physician came on stage with me. In this case it was April Soto, MD, a Southern California Permanente Medical Group family physician. Both are/were amazing.

And of course, <3 always wins.

Rand Paul speech alludes to unconscious bias

I was impressed at this part of the transcript, widely broadcast today (i.e. I did not watch the speech, I don’t post things on this blog that are political in nature, and this should not be considered an endorsement for any candidate) which alludes to the challenge of unconscious bias in our society today, without actually calling it out.

11:07 if you look at the war on drugs 3 out of four people in prison are black or brown
11:12 but your kids and grandkids aren’t perfect either
11:15 they police don’t come to your neighborhood, you get a better lawyer
11:19 these are some injustices. we have been people been concerned about injustice
11:23 we’ve got to be concerned about people who may not be part of our group here, who may
11:28 not be here today

The research data shows that it’s not just about where police go, it’s about what their brain maps when they see the image of a person who is White versus one who is Black, unbeknownst to them. Note that he speaks about ingroup and outgroup dynamics, whether or not he realizes he is. In addition, the words of the speech may or may not lessen the impact of unconscious bias because they don’t raise awareness of bias and its sources.

Depending on your browser, you may be able to access just these few seconds by clicking on this link: Rand Paul speech at the Freedom Summit C-Span 4/12/14, Start: 11:07,end 11:28