Unconscious Bias in Medicine: Is it “black and white”?

On Thursday, January 28 and Tuesday, February 9, WHEP will be holding a two part seminar series on the topic of unconscious bias and its impact on medical care and health outcomes.  We will begin with a conversation about discrimination, racism, and systemic bias in our healthcare system (and society at large), recognizing that we all hold unconscious stereotypes that may influence our clinical decision-making and contribute to disparities in healthcare.   

With the help of a panel of Drexel physicians, we will then explore how we as healthcare professionals and patient advocates can strive to deliver the best care and ensure the best outcomes regardless of a patient’s race, ethnicity, sex or socioeconomic status.  The only way to overcome bias is to talk about it, become more self-aware, and make changes in the way we practice medicine. 

We invite you to join the conversation!  

To peak your interest before the seminars, check out some of these resources:

TED Talks

 https://www.youtube.com/watch?v=RBow84OuZ-E

 https://www.youtube.com/watch?v=GNhcY6fTyBM

Articles

Levels of racism: A theoretic framework and a gardener's tale.  American Journal of Public Health. 2000; 90:1212-1215.    http://www.cahealthadvocates.org/_pdf/news/2007/Levels-Of-Racism.pdf

#BlackLivesMatter: A Challenge to the Medical and Public Health Communities. The New England Journal of Medicine. 2015; 372: 1085-1087. http://www.nejm.org/doi/full/10.1056/NEJMp1500529

White coats for Black lives: medical students responding to racism and police brutality J. Urban Health 2015; 92(6): 1007-1010.   http://link.springer.com/article/10.1007%2Fs11524-015-9993-9

Black Lives Matter: A Commentary on Racism and Public Health.  American Journal of Public Health. 2015: 105:e27-e30.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504294/pdf/AJPH.2015.302706.pdf

                                                                                                                              Judith Wolf, MD

                                                                                                                    Associate Director, WHEP

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Can PCOS increase the risk for autism?

Autism spectrum disorder (ASD), a very emotionally charged and controversial issue, has spurred numerous studies investigating potential genetic and environmental etiologic factors.  One popular hypothesis is that prenatal androgen (e.g. testosterone) exposure may modify brain development and contribute to the development of ASD.  

The basis for this hypothesis comes from the fact that polycystic ovary syndrome (PCOS), an endocrine disorder affecting ~ 5–15% of women, is characterized by ovarian dysfunction, increased androgen production, and metabolic disturbances such as obesity and insulin resistance.  Women with PCOS manifest increased circulating levels of androgens as well as hyperinsulinemia during pregnancy. This has been associated with abnormal placental steroid production and increased testosterone in amniotic fluid. 

Along these lines, a recently published study from Sweden (see below) postulates a link between maternal PCOS and an increased risk of autism in their children.  In the study, 24,000 children with autism were compared with 200,000 without the disorder from a health and population register database. The study found that children born to mothers with PCOS had a 59% greater risk of autism development - a risk that further increased if the mother was also obese.

So where does this research leave us?  Like many other preliminary studies, it requires confirmation.  And remember that "association" does not mean "causation".  Nevertheless, the study should prompt further investigation into the potential role of sex steroids in the etiology of ASD.

                                                                                                                                        Judith Wolf, MD

                                                                                                                        Associate Director, WHEP

                                                                                                                          

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Kosidou K, Dalman D, Widman L, et al. Maternal polycystic ovary syndrome and the risk of autism spectrum disorders in the offspring: a population-based nationwide study in Sweden.  Molecular Psychiatry (2015), 1–8.   http://www.nature.com/mp/journal/vaop/ncurrent/pdf/mp2015183a.pdf

                                                                                                                     

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