Why Do Providers Contribute to Disparities and What Can Be Done About It?


  • Received from the Center for Chronic Disease Outcomes Research, VA Health Services Research Center of Excellence (DJB, SSF, MVR), Section of General Internal Medicine (SSF), Minneapolis Veterans Affairs Medical Center; Department of Epidemiology, University of Minnesota School of Public Health (MVR); and Department of Internal Medicine, University of Minnesota (SSF, DJB), Minneapolis, Minn.

Address correspondence and requests for reprints to Dr. Burgess: Center for Chronic Disease Outcomes Research (CCDOR), VA Medical Center (1110), One Veterans Drive, Minneapolis, MN 55417 (e-mail: Diana.Burgess@med.va.gov).


This paper applies social cognition research to understanding and ameliorating the provider contribution to racial/ethnic disparities in health care. We discuss how fundamental cognitive mechanisms such as automatic, unconscious processes (e.g., stereotyping) can help explain provider bias. Even well-intentioned providers who are motivated to be nonprejudiced may stereotype racial/ethnic minority members, particularly under conditions of that diminish cognitive capacity. These conditions—time pressure, fatigue, and information overload—are frequently found in health care settings. We conclude with implications of the social-cognitive perspective for developing interventions to reduce provider bias.