Cancer centre staff show ‘implicit’ bias in racial attitudes test

Anti-racist measures are needed to stamp out bias against Indigenous patients in cancer care because more than half of health service staff show a “preference for white people”, researchers have argued.

The message follows an internal survey of racial attitudes at the Peter MacCallum Cancer Centre, which treats approximately 400 new Aboriginal and Torres Strait Islander patients and about 10,000 new non-Indigenous Australians each year.

For the study, staff were asked to take a so-called implicit association test, where they responded to various images of Indigenous and Caucasian people using a list of ‘good’ or ‘bad’ words.

A Peter Mac spokesperson said the study provided a proactive deep-dive into culturally embedded attitudes across Australian society.

“It was important to participate in this voluntary study because we know we must all do more to improve cancer treatment and care for Aboriginal and Torres Strait Islander people,” the spokesperson said.

The researchers said the answers revealed approximately 60% of staff had at least some bias in favour of white Australians, with 21% showing a strong prejudice.

By contrast, just 7% of employees had a strong bias in favour of Indigenous patients, they found.

Similar results were recorded between the 328 clinical and 208 non-clinical staff who responded, a response rate of 19% across the entire Peter Mac workforce.

But men and younger workers were significantly more likely to provide answers suggestive of prejudice, the researchers said.

Writing in Australian Health Review, they stressed these results did not suggest the cancer centre was particularly racist compared with broader Australian society, adding previous studies had found even higher levels of implicit bias in the wider population.

The study’s findings were also comparable with similar tests in the USA and would likely be reflected at other cancer centres, the researchers added.

But there was still reason for concern given that a fifth of respondents showed strong bias against Indigenous patients.

“Aboriginal people are likely to interact with such employees, due to patient visits requiring encounters with several staff members,” the authors wrote.

“This is concerning, as higher race implicit association test scores can relate to poorer patient care.”

As evidence of the broader problem, they pointed to figures showing that cancer mortality had been steadily decreasing for non-Indigenous Australians over the past two decades, but had risen for Indigenous patients.

While the cancer centre had some measures in place to address racism, including a reconciliation action plan and a wellbeing centre for Indigenous patients, more needed to be done, the authors said.

Fixes could include additional support for Indigenous patients, specific staff training activities and efforts to increase recruitment and retention of Aboriginal and Torres Strait Islander staff.

“The results are from only one cancer centre and may not be indicative of other centres,” they added.

“However, we believe it is likely that implicit racial bias against Aboriginal people may be present in other centres and should be considered in plans to mitigate racism.”

Editor’s note: This story was updated on 25 May to include a statement from Peter Mac.

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