Disparity and Bias in the Field of Human Services, Research Paper Example

Abstract

This paper will identify the disparity and bias in the field of human/social services specifically as it relates to the bias of race, class and gender in human/social services delivery. Data reveals social service fields, specifically those that rely on the ethical reasoning of high tier professions where there is a significant socioeconomic barrier between the class of the service provider and the community which they serve, harbor unchecked prejudices that result in ethnic and gender disparities. The research identifies the primary consequences of these disparities and their cause. Recommendations are provided in respect to combating bias and prejudice where it’s harbored specifically within the ideologies and practices of the practitioners and managers overseeing the environments.

Introduction

This research paper will focus on the disparity and bias in the field of human/social services specifically as it relates to the bias of race, class and gender in human/social services delivery.  This paper will identify the unchecked prejudices that result in ethnic and gender disparities; the primary cause of these disparities can be attributed to poor communication between the service providers and the public due to social differences between ethnic groups; and demonstrate the same applies to the quality of human and social services provided to women when they are significantly underrepresented as employees within relevant social service fields.

Consequences of the problem (based on literature review)

As a consequence of the bias and prejudices within social service fields, ethnic groups and women lacking comparable healthcare, and educational resources related to their white male counterparts. Discrimination is primarily attributed to disparities in communication between doctors and patients depending on whether or not the doctor can identify with the patient socioeconomically. This reveals that communication with minority patients plays a significant role in influencing quality of service and overall care. Despite this fact, doctor-patient communication has not received adequate attention, specifically in relation to identifying the specific causes of the health disparities (Ashton et al., 2003). The key consequences of such a sociological barrier to healthcare and similar social services is that it creates limitations on certain races and gender classes. These are barriers and limitations that can contribute to socioeconomic disparities that already exist within these communities and further increase issues like wage and gaps. Their study assesses the role of communication in racial and ethnic disparity within health services in an attempt to identify remedies for the communication gap. The authors do point out that some of these disparities are also attributed to limitations in access to care specifically in how Latinos and African Americans tend to have lower economic status through lower income and lower quality education, giving them a higher probability of being underinsured and having a greater dependency on public health programs. These barriers result in Latinos and African Americans using services which require the use of a doctor’s order, such as operations, hospitalization, or invasive procedures which creates disparities when they arrive in the doctor’s office. The authors identify three main possibilities that could explain this occurrence, specifically attributing it to patient preference, racial bias on the part of the doctor, and poor communication.

Literature Review

In Ashton et al. (2003), the authors assess the influences impacting ethnic and racial disparities in social services, specifically those in the health sector. They point out that Latinos and African Americans utilize services that require the order of doctors at a much lower rate than their white counterparts. They further note that while patient preference and racial bias does play a role in this disparity, the impact of this influence is minor compared to the significance communication played in during the actual medical interaction between doctor and patient. They note that, “communication over the course of clinical diagnosis plays a pivotal role in decision making. Research reveals that doctors have less effective communication with minority patients than with others” (Ashton et al. 2003). Their study assesses the role of communication in racial and ethnic disparity within health services in an attempt to identify remedies for the communication gap. The authors do point out that some of these disparities are also attributed to intimations in access to care specifically in how Latinos and African Americans tend to have lower economic status through lower income and lower quality education, giving them a higher probability of being underinsured and having a greater dependency on public health programs. These barriers result in Latinos and African Americans using services which require the use of a doctor’s order, such as operations, hospitalization, or invasive procedures. These specific procedures can create bias which causes disparities when they arrive in the doctor’s office. The authors identify three main possibilities that could explain this occurrence, specifically attributing it to patient preference, racial bias on the part of the doctor, and poor communication.

The reason why Ashton et al.’s (2003) research is so significant is that “the evidence indicates that racial and ethnic disparities in health care and health outcomes are not due solely to racial bias on the part of doctors or preferences on the part of patients. Poor communication during the medical interaction may be a remediable etiology of disparities in care” (Ashton et al. 2003). By identifying communication as a key influencing factor, the authors make it more tangible to combat the issue of ethnic and gender disparities within social service settings. Due to conscious or unconscious ethnicbias, it is rational to presume that doctors harbor some aspect of prejudice and this results in them prescribing or providing different services for Latinos, African Americans, as well as in some cases women, than they do for white males. As the authors note in order for this to be true, data must reveal that, “the patient’s race and ethnicity are at times such strong influences on the doctor’s clinical reasoning and recommendations that they override the effects of diagnosis and illness severity” (Ashton et al., 2003). The authors further point out that their data reveals bias to be something that the clinical profession works very hard to reduce, but they base the premise of their main argument on the fact that there is no such thing as a completely bias free environment. Contemporary psychological research shows that bias tends to occur without recognition or intention. The authors attribute this to findings that reveal stereotypes and gender prejudice can working under time pressure, that can increase the prevalence of gender and racial or gender stereotypes. The doctors were not informed of the research question viewed and then they were given a videotape to view. When this occurred,clinical characteristics remained constant but gender and race were changed. The study revealed that despite putting these changes in place, clinicians were not found to demonstrate significant prejudice. As the study notes, “doctors were somewhat less likely to refer African-American women for cardiac catheterization than white men, African-American men, and white women. Although the effects were small, these findings establish that skin color and gender can influence doctors’ diagnostic and test-ordering proclivities” (Ashton et al., 2003). It was further found that there are other influences that can impact the quality of performance by a particular clinical practitioner than just bias against the individual’s race. The study found that ethnic and racial bias is less likely to occur in clinical settings based on racial bias alone, but that it does reveal itself in communication. The value placed on communication was found to be substantial due primarily to the impact it can have on actual quality of treatment. There was a direct correspondence between bad communication and differences between ethnicity of the patient and clinical professional.

Garb (1997), presents a study on bias in clinical judgements related to gender bias, race bias and social class bias. The study primarily focuses on psychodiagnosis of biases held by clinical practitioners. The author breaks these biases down into rating levels of adjustment based on personality traits and psychiatric symptoms to develop a possibility for prediction of behavior, and treatment planning. The author notes that through the study “replicated findings include race bias in the differential diagnosis of schizophrenia and psychotic affective disorders, gender bias in the differential diagnosis of histrionic and antisocial personality disorders, race bias and gender bias in the prediction of violence, and social class bias in the referral of clients to psychotherapy” (Garb, 1997). While it should be noted this study is nearly twenty years old, there are many socioeconomic aspects of bias utilized by clinical practitioners within their fields that are still applicable today. Most importantly, the study reveals that despite considerations of prejudice that the clinical profession may have evolved beyond standards of the past, there is ample proof many of the characteristics of the past still apply today showing that there is a wide range of bias shared. The study recommends methods of decreasing bias such as diagnostic criteria adherence, statistical prediction rules to foresee potential bias behavior that may occur in specific environments, and being aware when bias may arise.

Sen and Östlin (2007), makes a strong claim that the consequence of gender inequality within the field of mental health services is substantially damaging to women. The author notes that, “gender inequality damages the physical and mental health of millions of girls and women across the globe, and also of boys and men despite the many tangible benefits it gives men through resources, power, authority and control” (Sen and Östlin, 2007). The study reveals that people involved in taking action to make improvement in gender inequity, must focus on healthcare as a priority.  There are a variety of ways to reduce or improve access to health resources. Women’s rights to health is one of the most direct and potent ways to reduce health inequities and ensure effective use of health resources. Deepening and consistently implementing human rights instruments can be a powerful mechanism to motivate and mobilize governments, people and especially women themselves.

Logsdon, Hood, and Detry (2007) extend their research pertaining to social services into the actual aspects of the workplace. Their research reaffirms data finding that there is substantial gender and ethnic prejudice in social work fields where women and minorities are heavily underrepresented. They evaluate the impact of workplace bullying and identify its relation to gender, “the repeated, malicious, and health-endangering mistreatment of an employee by one or more other employees. Workplace bullying has been associated with negative outcomes for the individual being bullied and for the organization in which such actions take place” (Logsdon, Hood, & Detry, 2007). The authors’ further point out that bullying in the workplace can have a negative influence on the corporate culture of a company and its operations,company culture and practices (Logsdon, Hood, & Detry, 2007). The most telling aspect the study revealed is that over 40 percent of workplace bullies are women and 70 percent of women bully other women. This introduces a spin on gender conflicts within social service fields in regards to women in the workplace and their interactions with one another. The study attributes the tensions between women that result in the bullying of other women, to prejudices in the workplace and limitations on their progression professionally compared to that of their male counterparts. The study reaffirms the belief that there are barriers preventing women from gaining access to quality care in social services by shedding light on the fact that they also suffer from an unfair and more tumultuous environment in the workplace.

Gender roles substantially impact the way men and women function in society. This is predominantly due to the pressure they impose on people to live up to certain set expectations. McSally provides an example of the gender roles established by the military noting that, “men protect and women are protected. Men are strong and courageous and women are weak and emotional. Men are responsible to the state and women to their family. Men are motivated to function in the horror of war by the thought of returning to the normalcy of home as symbolized by mother, wife, sweetheart, and the nurses who care for them in battle” (McSally, 2011). The point the author makes is that these are characteristics that are broadly applied to society with no regard for the individuality of people. These gender roles create expectation and obligations that their respective adopters feel they must satisfy. This can lead to guilt and resentment as Barnett notes. “Women may feel guilty about working long hours or traveling for work because to do so violates the expectation that their families must come first” (Barnett, 2004). This is a growing issue for women in social service works, specifically in the military and public administration. The ability to overcome gender stereotypes is very difficult for women. Military service in respect to the benefits it provides citizens as well as the public services provide to the community through the utilization of the military as a source of public service.

The U.S. Military, despite presenting itself as an environment for equal opportunity, actually does not have “U.S. national security is not being pursued in mixed company consisting of all qualified American citizens; instead, existing restrictions have limited women’s full participation in the military” (McSally, 2011). These limitations are based on gender roles which have been long honored within patriarchal societies and resulted in prejudices imposed on women. Wollstonecraft notes, “Perfection of our nature and capability of happiness, must be estimated by the degree of reason, virtue, and knowledge that distinguish the individual, and direct the laws which bind society…” (Wollstonecraft, 1975). These are core suggestions for how bias can be reduced within society as a whole, and while Wollstonecrat focuses primarily on women and gender disparity, her arguments can also be applied to ethnic disparities as well. The key argument the author makes is that that the bias must be overcome by reason and this reason must be the ground on which policy is drafted. Michailidsa et al. (2012), breakdown key recommendations for some of the programs that can come out of these newly adapted ideologies, which they are argue can assist policy makers such as, “‘mentoring programs’, ‘managerial programs which identify and develop women’s potential’, ‘programs that would help women balance their work and family lives’, ‘on-site childcare facilities’, ‘refresher courses when re-entering the workforce’, ‘offering flexible working hours’, ‘women role models in the highest levels of the organization’” (Michailidisa, Morphitoub, and Theophylatou, 2012).  There are however reports that reveal changes and policies are being put in place to combat socioeconomic disparity in certain regions of the country, especially in respect to social services. The U.S. Bureau of Labor Statistics Reports do show initiatives have been working to enhance the economic conditions of the Miami area, pointing out that, “according to recent data from the Brookings Institution, however, the regional economy has done better since the end of the recession. As of March 2013, the Miami-Fort Lauderdale-Pompano Beach metro area ranks in the top half of the 100 largest regions (34th) in its economic recovery, based on measures of employment, unemployment, GRP, and housing prices” (U.S. Bureau of Labor Statistics, 2012). Expansions in both the tourists industry as well as construction and technology has resulted in a job growth trend in south Florida, specifically in in the Miami Dade region that has outpaced job growth overall in the United States. The survey also demonstrates that socially across racial demographics of Florida, people country residence report having similar experiences in regards to quality of life.  This is very telling in respect to how social services are influencing quality of life for women and ethnic groups in respect to their education and healthcare.

Conclusion

In sum, the problem of disparity and bias in the field of human/social services specifically as it relates to bias of race, class and gender in human/social services delivery was the primary focus of this report. The consequence of the bias and prejudices within social service fields, ethnic groups and women lacking comparable healthcare, and educational resources related to their white male counterparts. Discrimination is primarily attributed to disparities in communication between doctors and patients depending on whether or not the doctor can identify with the patient socioeconomically. This reveals that communication with minority patients plays a significant role in influencing quality of service and overall care. It’s recommended that more attention be placed on improving doctor-patient communication as it has not received adequate focus. It’s specifically recommended that attention be place on the process of identifying the specific causes of the health disparities (Ashton et al., 2003). If new focus is not placed the diagnosis process of disparities in healthcare, the resulting consequence will be further limitations placed on gender classes and reace in their pursuit of adequate healthcare.

References

Ashton, C. M., Haidet, P., Paterniti, D. A., Collins, T. C., Gordon, H. S., O’Malley, K., & Street, L. (2003). Racial and ethnic disparities in the use of health services. Journal of general internal medicine, 18(2), 146-152.

Barnett, R. C. (2004). Preface: Women and work: Where are we, where did we come from, and where are we going?. Journal of Social Issues, 60(4), 667-674.

Handbook, O. O. (2012). Bureau of Labor Statistics. US Department of Labor, Washington, DC.

Lavigna, B., Flato J. (2014). Millennials are attracted to public service, but government needs to deliver. Jibe, 1-3

Logsdon, J. M., Hood, J. N., & Detry, M. (2007, July). Bullying in the Workplace. In Proceedings of the International Association for Business and Society (Vol. 18, pp. 67-71).

Malin, M. H. (2009). The paradox of public sector labor law. Indiana Law Journal, 84(4), 1369-1399.

McSally, M. E. (2011). Defending America in mixed company: Gender in the US armed forces. Daedalus, 140(3), 148-164.

Michailidis, M. P., Morphitou, R. N., & Theophylatou, I. (2012). Women at workequality versus inequality: barriers for advancing in the workplace. The International Journal of Human Resource Management, 23(20), 4231-4245.

Sen, G., & Östlin, P. (2007). Unequal, Unfair, Ineffective and Inefficient Gender Inequity in Health: Why it exists and how we can change it.

Wollstonecraft, M. (1975). Vindication of the Rights of Woman. Broadview Press.