[Music] [Music] back in 1954 the social psychologist Gordon alport published a book the nature of prejudice it had more than 30 chapters across hundreds and hundreds of pages it was a real feat of scholarship and you might think well sure back in those days racism was rampant he had a lot to explain and yeah the situation wasn't great polling firms have been asking people questions about race for a long time so we can peer back into history in the US for example in 1958 just a few years after alport's book on Prejudice came out Gallup asked people if they approved or disapproved of marriage between white and black people only 4% of people approved of interracial marriage but when we look at polling today the message couldn't be more different when Gallup asked Americans about interracial marriage in 2021 94% of people approved now that remaining 6% is wild to me but still 94% is about as close to consensus as you get a Pew survey from last year found that 74% of white Americans agree with efforts to address racial inequality or even think they haven't gone far enough so that's a huge change over time racism has receded a ton right well sort of the beliefs people Express even that they're truly committed to might not be the whole story I recently learned about this experiment that some economists did a few years ago on eBay that online auction site they bought up hundreds of old baseball cards not the rarest most sought-after cards but not junk either they spent around $10 for each one and a few weeks later they posted those same cards for sale themselves they used exactly the same descriptions as when they bought the cards starting bids were always 9 and they were on the site for 7 Days sold to the highest bidder but uh so why am I telling you about some economists side hustle well they got sneaky if you've ever bought a thing on the internet you know that you usually get to see that thing before you decide to buy so they needed to take pictures of the cards they were selling and in a real amateur move they would just hold a card in their hand against a solid background and snap a photo voila it was no anel Adams but it would do but here's the thing this was all very intentional because it wasn't always the same hand holding the card sometimes it was a white guy holding the card and sometimes it was a black guy holding the card but people noticed and we know they noticed because even though those hands meant nothing at all the cards that happened to be held by a black hand sold for less than the cards that happened to be held by a white hand the financially prudent economists that they were they also checked to see how much profit they made in their resale game and they lost money overall this was a study not a business but the cards lost more value when they were held by a black seller than by a white seller and I could highlight all sorts of studies like this where Modern people's everyday ordinary decisions are affected by race but but what what I thought I I thought we were done with prejudice and racism the polls look at the polls people are saying they abhor racism and want equality could they really still be subject to bias at least some of the time I suppose alport's nature of prejudice is still relevant after all in a retrospective some psychologists wrote that books written a decade ago are typically considered to be outdated yet half a century after its publication the scope and endurance of the nature of prejudice's influence has been nothing short of remarkable we still need a psychology of prejudice and by the way that quote comes from a piece co-written by a guy named Jack deido and that name sounds so familiar has he been on the show [Music] before you're listening to opinion science the show about our opinions where they come from and how we talk about them and if you didn't figure it out today's guest is AC video and what a guest he is he's an ameritus professor at Yale University and he's spent his career really defining how psychologists have thought about Prejudice it was super fun to talk to him for the podcast we talk about his early days in the field studying what makes people help each other in times of need his pioneering work with Sam gerner on the idea of aversive racism or the possibility that people can be consciously opposed to Prejudice but still have lingering negative feelings about marginalized groups and his more recent work on how bias can creep into medical care so no more blabbing from me let's get right to it to get us started maybe you could tell us a little bit of that backstory so if you zoom all the way back to the the origin story like you know you were doing work on racial attitudes back in the 70s when uh you know I think probably the field had a probably different relationship with that area of research than it does today so I'm curious like when you start out as a budding psychologist were you planning on making a career out of studying racial attitudes or like what what was your initial inclination that got you into this whole mess yeah no I had no intentions of of studying racial attitudes I I actually got into it through the helping Behavior route as an undergraduate in fact um and as an undergraduate my very first study which turned out to me my very first publication was on on helping Behavior and um you know I had personal experiences related to discrimination and racial discrimination um uh when I was in college I was an intern at a what's called an um a better chance program where there were black and uh latinx uh high school students that I tuted but when I got to graduate school the kind of like the very first day Sam gerner who was my advisor at the University of Delaware sat me down and said um what our goal is is for me to convince him to do the work I'm interested in and for him to convince me to do the work he's interested in and I put helping behavior on the table and he put um uh racial attitudes on the table and that was what the next you know five decades uh basically our work together has been that kind of merger of of that kind of of interest that have been uh reciprocal and exciting because it's a good push and pull what was it about helping behavior that I maybe I missed that part like why was that the thing you put on the table um as an undergraduate I had to do a a research thesis and um in a class I was with uh three other people that we had to do a project um most of whom I really didn't know and um in the project I was just um impressed of how the shared stress we had of having to come up with a project uh brought us closer together and and how helpful we were you know strangers who people who started out as strangers suddenly became close confidants and and uh had very valuable exchanges um which led to us coming up with a project on um helping behavior and and that's been actually a a theme that's gone through uh all my research is looking at how uh we identify with other people affects whether or not we help them and when we help them if you so I think sometimes you know people have their own idea of what helping Behavior means so when you talk about helping Behavior like what are the sorts of things that you've like looked at whether people help or not like what do you mean by helping um yeah I I I would say the kind of things we looked at was things that were uh very trivial and spont aneous so my very first study was about um someone knocking over a 100 pencils a jar of 100 pencils to see if people would pick them up and how much they would help and in the ways they responded um and then on the Other Extreme we looked at emergency interventions staging emergencies that were seemingly life and death and to see how people would respond in in those kinds of very um pressing situations where the stakes were very high um and then we try to figure out too is why are people helping are you helping mainly to help yourself to feel better about yourself are you really motivated to um put someone else's welfare um as primary over yours and that would be called altruism you mentioned these emergencies and they always strike me as the great theater of social psychology sometimes when they get pulled off uh can you give us an example of like one of those early studies where you did this like what did you have to pull off in order to put people in that position yeah I mean you know sort of I I grew up in Psychology in the kitty genoves the person who was um uh killed while 38 people uh witnessed the event and no one called the police Dolly and Latin were writing books about why you know why people don't help and and people were talking about bystander apathy um and so what tried to do was create the kinds of life and death emergencies and what we did was we basically in one Paradigm had people what participants would be doing would be thinking that they're going to be participating in an ESP experiment with another person in another room they would go by the room they would see a messy room piled with a whole bunch of um chairs and other things it was like a storage room we said that's where the person will be sending it and then while they were receiving the ESP messages uh all of a sudden there'd be an interruption where the other person who was actually tape recorded would say gee those chairs look like they're going to fall um the remarkable coincidence and then there'd be this large uh crash of chairs falling um down and sometimes we would have the person groan and moan um obviously in pain sometimes they would call for help and sometimes you would just hear the loud crash but but in all cases you just sat there in silence when they were trying to receive ESP messages so the the experiment was clearly interrupted um but most people really believed that that was an actual emergency so uh you mentioned so Sam was the one who put the racial attitudes on the table do you have a sense of where that came from like was that was that stuff that he was doing already at the time yeah he had he had actually um published some of the earliest work on aversive race ISM a subtle form of racism and um basically when I came in relatively early after he had started that research and our collaborations were really about trying to develop the idea of a reversal racism and I'll explain what aversive racism is um many of the people who were studying racial attitudes at the time and as you said there weren't a lot of people studying racial attitudes um it was u a very interesting time period because it was post Civil Rights era there were a lot of changes going on but yet it wasn't um the kind of topic that people found a high priority and in fact some prominent psychologists told me not to study racial attitudes because they said race is too complicated and it's too applied so um they encouraged me to pursue other things but uh it turns out I'm stubborn um and thing about being an academic is you get to pursue the questions you want to pursue so um aversive racism was basically trying to go from the idea of who's prejudiced trying to think that that the old approach was if we could just identify who's prejudiced um I would call it the cancer approach you can cut them out um and Society will be uh uh better and pure from there on out but what a of racism was trying to do was not look at the the attitude so much of the people who were open bigots but the many people who said they weren't Prejudice who probably truly believed that they they weren't prejudiced but they were still discriminating often in subtle ways uh and complex ways so it was really about the perpetuation of bias among what we called um those people who are well-intentioned is there I'm curious where that idea stems from so so that's a you were able to establish pretty well that that's something that happens but in those beginning days was it sort of like a curiosity looking at data where you're like well why are people saying one thing but doing another or or more of like a hunch of like I don't know I keep hearing people say that they're they're over the this issue and yet like I just don't I don't believe them for one reason or another so like where what's the Genesis of this kind of inclination that that maybe people hold these Divergent at the same time yeah I mean it it was basically around you know the bread and butter of social psychology at the time was studying attitudes and we studied attitudes because they predict behavior um but when we got into the domain of racial attitudes uh what people said um their attitudes were um what people said even why they were doing what they were doing didn't match their actual Behavior so there was this big disconnect um I would say in our data first of all that the attitudes weren't predicting Behavior but in in our interactions with participants um now in in the emergency study that I I mentioned to you I described one of the things we found was that when uh people were exposed to that emergency and it was a black victim or a white victim they were more likely uh to diffuse responsibility that is they were more likely to believe that if there were other people around these other people would intervene and so they chose not to help um the black person uh uh so they helped the black person less than the white person in that situation but when you when I talked with them afterwards um and we discussed why they made the their decisions they they generally avoided talking about the race of the victim when the victim was black um even when I showed them information that the victim was black many of them didn't IED that they even noticed the race of the person so clearly something was happening that um was inconsistent not only with what they were saying but this is to me the important U aspect of aversive racism um the behavior was inconsistent with what they believed their attitudes were what they believed they believed in in many ways and that made it really intriguing to me so so how how how is it that someone can believe themselves to be unbiased and unprejudiced and still find themselves in these situations where their decisions are betraying those values yeah I mean that was our big question you know know and and one of the the challenges at that time is that um people talking about unconscious um was was frowned upon in social psychology because unconscious sounded Freudian d psychodynamics uh and you know this is post Skinner you know we have to look at Behavior we have to just take things that face value you know that's the gold standard and if people you don't want to be deal with introspection basically so that was kind of the challenge is that um how can you explain this if you don't have unconscious attitudes so that led Sam gon and I to proposed that people had unconscious attitudes and the whole idea behind this was that actually rather than asking who's Prejudice we would ask ourselves um why does prejudice exist in the in the first place and when we looked at the psychological theories about why people might develop Prejudice and you've done podcasts on it I've seen them um uh very well like social identity theory is that we value members of our own group more than other groups and that's a universal response um that we have grown up in a society that is racist founded on the proposition that all men were created equal and it took us over 200 years to pass a legislation guaranteeing that so um basically what we concluded is that there are a lot of reasons why people would be biased um so the bias is likely to be in most people and so the question was what would lead people to say they're not biased and that's where we began to say that there may be this dissociation between what what they think and what they believe at some very basic level and what they think and believe at very conscious level and so we posited for a number of years that there were these unconscious biases that were driving many people so it wasn't that they were lying to us about their attitudes they just weren't aware of the depth of their their their biases but when we just say the real quickly here the problem with that approach for many years was uh this when I would speak to an audience I would say on the one hand we have over at bigots who say they're Prejudiced and are prejudiced on the other hand we have a vers of racists who say they're not prejudiced but are really prejudiced so that means I just called all the white people in the audience prejudiced okay um which is not a good way to endear yourself to your audience um but also not a great way to to do science because you know you don't want to condemn races of people who are white or black or any group and that's what we were doing and so Sam and I both sort of independently did some projects where we tried to look at uh cognitive measures what comes to mind most quickly um he used one particular technique I developed another technique and we began to do studies that showed back in the early 80s um that many people people have this most people have this dissociation most white people where they appear nonprejudiced in what they say very consciously but we could see the evidence of these implicit biases Prejudice and stereotypes in our other measures and some of those implicit biases were predicting Behavior better than what people said that of course um evolved into the work on the IAT which we didn't do uh greenall BAGI did and that really became the gold standard of measuring the implicit biases um so that's kind of how this sort of evolved it's kind of like bumping into things that you don't understand taking a step back trying to guess what would happen next um and then listening to what was going on in in in the literature and trying to uh adapt what other people were doing to to sort of come at something from a different direction it it's funny as I think if you as someone who is quick to adopt the implicit association test is sort of like the implicit bias arises and then there's like a you know trickle of research that becomes an explosion of research and some of those earlier studies are uh ones that you were involved in and I realize now that like oh well it's because you were already kind of doing it it just became an opportunity for you to pull it into the work that you were already building and so it was sort of it must have been like I'm curious to get your ti like when you saw this measure emerge did it click immediately like oh my God that's the thing that's the thing we've been talking about or did it take some time to realize like oh actually we' we're act we're arriving at the same idea independently yeah I mean some of it is you know in the early days I would say you know preat I had attended a small conference that maub banagi was there um I had talked to Tony Greenwald and um so I wasn't surprised with what they were developing they were telling what they were developing um and it wasn't unrelated to you know to what I was doing it was just better than what I was doing um so I was a quick adopter for that um because I already sort of believed the point that they were making um but I also believe that they had a much better measure in terms of something more uh reliable something more stable um and I know the IAT has received a lot of criticism but it predicts behavior and that's what I wanted um and it it to me is the idea that in Academia it's not a race where you have winners and losers um it really is a team effort in terms of what comes out of it and I've always had a good relationship and never felt competitive and they um never expressed any kind of feeling of competitive with me and um that's the nice thing about social psychology it's not Zero Sum where one person wins and the other the person loses they come up with a great idea and I get to borrow it ah it also so the evolution of this helps clarify for me one of the things about the aversive racism kind of the history of it that I've sometimes have a hard have had a hard time grappling with which is that it so my understanding is that in the earlier days some of the studies were essentially saying that like if someone expresses explicitly and openly uh like a non-prejudiced attitude they could go on to to show uh bias in their decision-making and that's a versive racism like that's just the phenomenon whereas with the development of these measures it gets more sophisticated where you're saying well aversive racism is really like it's not a universal truth of psychology but it is what we would expect among people who both openly say they're nonprejudiced but Harbor measurable autom negative reactions does that make sense so it sort of began as a more kind of broad brush picture and became a little bit more of a nuanced picture does that is that right absolutely and I would say two other things to the Nuance one is the the argument that I think is pretty well established now is that it's rooted in normal the negative component is rooted in normal processes it's socialization processes it's ingroup outgroup bias it's not about good people and bad people it's about being human and the other part of this uh I want to come back to know and just merge what you said with what I said it's also possible that there are white uh people who were not prejudiced implicitly and explicitly and that's an important to acknowledge and it's important it's an important research question because you want to ask how can how can people be nonprejudiced well start with looking at the people who are nonprejudiced and we found that those who are low and implicit low and explicit were also low in discriminatory Behavior as well so it really it completes the picture and um again that's the exciting thing is that you know people talk about defending their theories um I don't want to defend a theory um and I would always tell my students that my participants are smarter than me so we should listen to them and it produces that kind of evolution that you were just talking about from this kind of universal approach and you know um uh a blunt very blunt in approach to something that's much more nuanced and I think much more productive the the other Nuance too that I might be worth emphasizing is is it the case that aversive racism just predicts biased Behavior no matter what or are there certain ways in which this kind of duality of implicit explicit attitudes shows up in people's decisions where other times people might not actually be expected to discriminate even if they Harbor these implicit biases yeah I mean that that's a really good question the way I you know we try to conceive of this is that you know we have implicit biases and we have explicit biases you and we have uh explicit ways of being non-prejudiced too but it's not the um unconscious of the implicit system and implicit it doesn't necessarily mean unconscious but it's much more automatic uh but let me just explain this for a minute that uh implicit biases occur because they're overlearned habits of mind okay they're not it's not about the ego and the ID and all these other things it's about it's an energy saving device that allows us to make decisions quickly um which is important from an evolutionary point of view that if we have to contemplate every decision we would have been en a long time ago basically but um we all develop all sorts of implicit um ways of thinking that are very functional so for example if you drive the same route to work every single day have you ever had the experience that all of a sudden you find yourself in the parking lot um and you know what you had been doing that day was driving implicitly okay you it was overlearned you make this route every single day but it doesn't mean that if something runs out in front you're going to keep driving and what it did was it freed you up to think all the way to work about all the other things that you needed to think about consciously that day a presentation meeting with somebody so we have these two systems that are not in Conflict they work together and what that means is sometime one is going to take precedence over another and what we hypothesize and we found over and over again is when you put people in a situation where right and wrong is clearly defined where appropriate behavior is clearly defined then the explicit system assesses that and that's how you behave so you you go and do what you think is the right thing because you know what the right thing is it takes precedence but if you put people in a situation where right and wrong is not clearly defined or um um situations are complex where there's no right answer then implicit system gives you the first step in a particular direction and it affects what you look at what you attend to what you interpret let me just give you one quick research example we would give participants um uh information about an applicant for a job they believe that their input would would affect the job outcome the applicant was either black or white and in some cases the applicant had impeccably strong credentials in other cases they had a mixture of good credentials and bad credentials but arguably they were good enough for the job based on pretesting that we did when the applicant was uh had impeccably good credentials no discrimination against the black applicant implicit biases don't have any effect there uh but when the applicant uh has mixed credentials what we found is there was a bias against the black relative to the white applicant and other researchers lean son H had showed that uh more implicitly biased people would be uh tend to take the minority candidate and rate them lower and what happens there is the when it's ambiguous you go with you gut feeling that gut feeling is reflective of your implicit biases and so what people would do is particularly those more implicitly biased is when the applicant was a majority group member you would attend to and pay attention to the good aspects of the VA the CV um and when the applicant was a minority and the participant was white then people would be attending more to the weaknesses of the candidate and so when you ask them why did they recommend hiring one candidate over another they had credentials to point to good for the white bad for the black and so they would say it had nothing to do with race it has everything to do with credentials and so that brings the sort of implicit biases um it depends on the situation which is the meet and potatoes of social psychology but it's a very predictable kind of result where good people will do good things when they know what to do but in a world that's complex there's a lot of leakage and and in a way that people can sort of say well I like I can prove to you this wasn't racially biased because look at all of these great things this person did it strikes me that aversive racism is sneaky in this way in that it provides a cover story for bias it sort of like gives people this out where there it's a process by which people can justify the decisions they make as non-biased yeah and that's exactly right I mean that's a great summary of it because it it you know there is something you can point to legitimately but it still doesn't mean that it's even and and the reality is um even if your bias is subtle it's bias and it has negative outcomes and let me just tell you one other negative outcome that that um doesn't jump out in the literature but it's one that we find is that one of the dangers of reversive racism is what I would say cultural miscommunication and mistrust so let's just take the the study I just mentioned to you um if you are the person doing the hiring you see two candidates a white and a black candidate and your biases lead you to to look differently at the two candidates and their credentials so um what happens is the first you're the first interviewer you interview this person and you say yeah what we're really looking for is someone who has a science degree not a Humanities degree and of course that's the white person over the black person you walk away from that situation with a clear conscience race had nothing to do with it now that person goes for another interview that black person goes for another interview they get another white interviewer and that white interviewer says you know you're really very good but we're looking for someone with sales experience not someone who doesn't have it and I'm sorry you're very good but we're hiring somebody else and then that black person goes to a third interviewer who comes up with another as you said rationalization which can be totally different um so now three white interviewers walk away saying there's no bias here and certainly I'm not biased but from the perspective of the black candidate what ties those three experiences together it's race it's not experience it's not a technical degree it's not whatever the third explanation was and so white people tend to see racism nowhere um because it's not in our realm of experience but people people of color that see this bias over and over again they see it from a very different perspective because the most logical ponus reasonable explanation for why they didn't get these three jobs is not any of the individual explanation it's race and so that leads to this um what I would call racial distrust and I'll just say one of the things I learned from this is when I interact with a white person um because I'm I I typically assume my default is they trust me when I interact with a person of color what I've learned is they don't see me as the way I see me they see me as a white person and all the experiences that they've had should lead to distrust and so uh what I assume is that the person I'm interacting with doesn't trust me I accept that I understand why but that means my initial activities in our interaction is trust building or at least acknowledgement that you may not trust me and so I can't be colorblind in my Approach in the way I interact with people because color matters that is a very useful in I was going to one of my things I was going to ask you was like what have you learned about yourself from this program of research and and you went right for it which is great my my my last question about Avers of racism though is uh why why is it called that I I I always struggle with with the the terminology so what is it that is aversive here it it's it it actually came out of a term that somebody else that Sam um uh mentioned years ago and Sam adopted so uh and so the definition has sort of there's a mythology behind what it really means but I would say that there's um uh one of the aspects of it is that it's a kind of racism that those who have it would find aversive because it's so inconsistent with our self-image it's inconsistent with our values and so it's in it's a kind of racism that we experience aversively when we um sense that we have it the other version of this that Sam um you know again it's these theories always evolve but one of the things that uh Sam's early work on aversive racism showed is that when you put white people in a situation um where the Norms were clear there would be no discrimination but what many white people would choose would be to avoid black people entirely because then they never get put in that difficult situation and so they avoid and they would typically would find interactions with black people aversive and therefore would avoid them so um and probably next week people come up with another this might be a good time to shift gears and talk about uh some of the more recent work on applying I think the same kind of insights but in a particular domain so so you've done a lot of work in recent years on um how these kinds of racial biases can play out in a medical context and so where did that perspective where did that interest come from and and why is this a domain where it might be especially useful to study these Dynamics yeah um the interest again so many of my interests just sort of snuck up on me um and and there's a lot of chance in it uh back in around 2000 um I got involved with a National Academy of Sciences and Institute of medicine report on um uh racial racial disparities in health care and on this panel uh someone invited me and uh I think I'm a person of low self-esteem when someone invites me I get flattered oh National Academy I'll go um but actually it was it was a very transformative experience for me because I got to learn a lot about medicine but it was also transformative is I got to contribute a lot in the book um uh I was the only social psychologist talking about implicit bias at the time and um that report got has gotten a lot of attention over the years and introduced the idea of implicit bias in medicine um and the reason that's so important is in terms of the linkage is that people go into medicine because they want to help people people go into medicine and become very well educated and well-educated people tend to be liberal and have hold values of of equality um but the at the same time what we is big and persistent racial disparities in health um across our history infant mortality rates about as bad now uh in terms of disparities as it was 20 years ago 30 years ago 50 years ago so how can you reconcile good people and these disparate outcomes and again many people wanted to blame the victim oh it's because of um um people not um doing healthy things uh but what we're also beginning to see is there seemed to be you know I I talked about mistrust a few minutes ago but there was high levels of medical mistrust of people of color why again people would say oh look at historically there were these experiments on black people uh that's the reason but what but there was also some interesting evidence that showed for example that um they interviewed patients going to see a doctor for the first time and they they F the patient filled out a questionnaire about how much they trusted the doctor before they went into the room and met the doctor and then they filled it out as they were again as they were leaving and what they found was that white people tend to trust their doctor a lot before they meet him and trust him a lot after they meet him black people trusted the doctor before they met them not quite as much but they trusted the doctor less after they met the doctor so that's nothing about history you know not directly about history but something is going on in that interaction that's undermining it and so um you know I had this interest and wrote some papers on it and then Lou Penner my uh good friend and collaborator um he moved from University of South Florida from a psychology department to a Cancer Institute with his wife and um you know research and friendships tend to go together research collaborations and so uh gave me access to um uh research populations and resources and Lou took a great lead in most of the research where we um converted him to a verse of racism and let me just say he's going to ask me about this and it led to the publication of this book Cambridge University 2023 available on Amazon Lou is the one who who set this up and so I I I'm this is a Direction Shad out cuz I know that he's listening to this uh so so you've enough work to fill a book uh what are the kinds of things that you do like once you have access to this kind of participant population what are what are the first questions that you go like well we have to first establish this what do those first days look like yeah the the first thing is um you know again the challenges with the medical there are practical challenges with the medic medical community in a sense that one is that um and I had done some work with the military I would say that that it's like this too is that um they believe that they're not prejudiced they know when they're hot they're not prejudiced they again you know they're well-educated well-intentioned people uh so to bring in researchers to show that they might be prejudiced is a it's big is a big lift um in some ways um because it's it's yeah inviting people to challenge the way you think and tell you're not as good as you you believe you are um but um The Leverage that Lou and his wife Terry alre had in certain clinics um allowed us to tape recordings video record um interactions with doctors and patients and one of the first things we did um in one of the earlier studies was we measured doctors implicit and explicit racial attitudes and then uh we recorded their uh interactions with patients and then we asked some questions after the interaction um of the doctor like specifically how much did you try to include the patient uh in this medical decision making and then the patient was asked questions like uh how friendly did you find the doctor and how much do you trust the doctor and kind of the key finding we had there was was this that if you think about four different theoretically groups of people of which there were mainly three types you have people who are low and explicit Prejudice and low and implicit Prejudice and we did find doctors in that category you have doctors who are high in explicit Prejudice and high in implicit Prejudice and we found a few doctors in that category um the next category we found we typically find doctors are those who are low they say they're not in explicit say they're not Prejudice but do have have implicit biases and by the way doctors have the same level of implicit bias on the average as the average person who takes the IAT okay and then there's a fourth category that doesn't really exist but only theoretically in the model which is people who say they're Prejudice explicitly but don't have implicit biases but the bottom line here was this um doctors who were more explicitly Prejudice were more likely to admit that they didn't involve their patient in decision making black patient so I'm only talking about black black patients here um so they were willing to say I didn't I I didn't work that hard to involve the patient the black patient in decision making that's a conscious attitude but the implicit attitudes of the doctor predicted how friendly patients and respected patients felt with the doctor so doctors who are more implicitly biased communicated less friendliness and um being less respectful to Black patients but the biggest place of mistrust was um the black patients tended to trust doctors who were low and explicit and implicit Prejudice the most there was a lot of trust for low Prejudice there was um much less trust in a doctor who was high prejudiced High explicit and high implicit but the lowest level of trust was the Doctor Who said they wasn't they weren't prejudiced L explicit but who had implicit biases and so that level of mistrust was because the doctor would be sending mixed signals saying the right things but then non-verbal Behavior would undermine what they were saying and when you get those mixed messages you don't trust people and medical trust is so important to whether or not you adhere to the medical recommendations how you interpret the medical recommendations whether you recommend the doctor and whether or not you even return to the doctor so that was saying that even in situations uh like that um where people where the doctor wants the patient to get better and the patient wants to get better the averse of racism is undermining the effectiveness of that interaction to be clear too so it's not as though these patients are learning directly that like oh my doctor on a Sur said that they're not prejudiced but implicitly they are it's just that these doctors who who happen to be people who would Voice Low Prejudice and score high on Prejudice on an implicit measure are just engaging in this interaction in such a way that they're just sending these mixed signals right they're like you have the recordings right it's not that they're saying necessarily stuff about race or stuff about these sorts of things but they're just handling this situation in a way that puts these part these patients kind of illes right and you know in subsequent work I'll just say that you know you you've got to understand you I I don't want people to think that this work is about beating up on doctors um it's not again it's not about good or bad um but we also find that if black patients who tend to be high on uh mistrust uh who have experienced a lot of discrimination are particularly attuned to that kind of negative Mis match that subtle bias and therefore they push back on it and then you get this interaction becomes the worst interaction because the doctor doesn't understand whe why the patient is pushing back and makes negative attributions and the patient um um is suspicious of the doctor and the doctor's actions and it begins to spiral and nobody has talked about race you know that's not on the table we're talking about a medical condition and we're talking about interactions that often last maybe 15 to 20 minutes but you know when you have a lifetime of experiences both white people and black people that can trigger a lot of things very quickly since you have the recordings of these interactions do you have a sense of what is going on in these conversations that that is not facilitating a smooth interaction you know we struggled with that you know um we struggled with that a lot I mean it it's uh um and one of the problems is one of the challenges is this um and we found this within other research not in a medical setting is that um the explicit attitudes of white people tend to predict how verbally friendly they are the implicit attitudes tend to predict our non-verbal Behavior and the non-verbal Behavior can be anywhere from voice tone um posture um IC cont contact with the person um angle of of interaction there are so many multiple channels I I can tell you with not so much in the medical um work but in the um general research whenever we try to key on on particular measures you know is it eye contact is it um uh somebody's posture uh the individual behavior is weren't as good predictors as if you ask people to look at the tapes and said how friendly is this person what we found is those global that people have to integrate it and it's because people show their behaviors in different ways we show our version sometimes people are very facially expressive and sometimes we're not um so it's it's it trying to tap into what it is specifically has been very hard but we know people can detect it and when we look at the patients and we look at what observers say they tend to match so so we have this dilemma of well-meaning doctors who are nevertheless conveying not optimal signals do we do we have a sense of what to do about it like how could how could we make this situation better yeah um that's the big challenge so let's let's work through the problem for a minute so what we've argued is that uh most white Americans grow up in a society um where where uh first of all uh because we're human we Value white people more than black people on average uh in group um and social identity um second of all we've been socialized um uh in terms of our history about the um higher status of white people over black people and stereotypes of white people being more positive than black people and the argument is that implicit biases are automatically activated um they're difficult to overcome that you can't suppress them um you can you're not a slave to them right I mean I tell people the example is I go into the supermarket I'm hungry I want to eat it I see apples I like apples but I don't eat an apple in the supermarket because I know what's wrong in the middle of the night I'll be driving down the road I get a red light Nobody's around I will stop at the red light you know even though I want to get home uh when not a slave to our implicit biases but um when they're activated they move us in a particular direction one of the things I've learned with my research and i' spent a lot of time uh working with colleagues um in Europe is that I don't talk about American racism to European audiences they don't get it you know someone raises the hand and says so why does one drop of black blood determine someone's fate and makes no sense so um one of the things we think about is that if we just take the the case that race is important in America because we've been told race is important as we've grown up in America um but the reality is we socially categorize on the basis of so many other different dimensions um on gender um height on age um you know and it's not that my friends in Europe don't have biases you know my friends in in Northern Italy talk about the southern Italians um you know I came my relatives came from Southern Italians but suddenly they feel they can talk to me about it but you know they have these biases that and um they we all have these group biases but we can categorize people on many different dimensions and what I want to say is this that uh in answer to your question Sam and I Sam Gart and I did work on the common in group identity model and the idea is if we can make our common identity Salient we can notice race but it's not going to drive our interaction so one of the things I'll just say quickly here is that what we did in some of the work with Lanner and Sam gner is that in a clinic we asked doctors and patients we gave them a lot of materials that emphasized in one condition um that they were on the same team we had posters doctors you know have information you want and patients have information that doctors want um that you are trying to solve the same problem we had little um uh reminders because they were like yellow uh pins yellow pens yellow everything that you were part of the yellow team and then in another part of the clinic uh it was just standing of care and what we found is that once you got doctors and patients thinking about the them being on the same team they were now suddenly acting as an ingroup and that ingroup led to more positive interactions greater trust among black patients and greater trust that black patients had of their Physicians who in that condition of same team led to Greater adherence to the medical recommendations down the road so the idea here is uh I don't want to be thought police I don't want to change people in some fundamental way I just want to help them become better and the way to do it is to say there are more important things in this situation than race and if you can think about what those more important things are and how you have them in common then all your ingroup biases are going to benefit that interaction because they no longer divide you they're going to bring you together and you're going to trust people more you're going to like people more you're going to care about people more um and so the idea is to think about proactively positively what you can do rather than keep telling people that they're not good enough that is a nice hopeful inspirational note to end on so I think I'm going to call it right there and just say thanks so much for taking the time I've been a fan of of the work that you've done for for so long and it was great to get a chance to talk oh great and thank you I know you're you're watch but i' I've looked at all you know I won't say all your podcasts but you do a great job and I really appreciate [Music] it all righty big thanks to jack toid for taking the time to talk about his work I've been such a fan of his approach to science and he's mentored some incredible people in the field too so I was lucky he was up for coming on the podcast as I mentioned briefly shout out to Lou Penner Jack's colleague who suggested having him on the show this is is a good chance to plug the book that Lou and Jack and others wrote that came out a few months ago it's called unequal Health anti-black racism and the threat to Americans Health there's a link to it in the show notes to find out more about this show go to opinion science podcast.com follow the show on whatever social medias are left and subscribe to the show with your favorite podcast purveyor so you don't miss anything and you know what speaking of big things ahead the podcast schedule is a little wonky over the next couple weeks but it's for good reason so in 2 weeks you don't don't get a new episode sorry but I will drop the trailer for a special podcast series on how psychology changed the game for how economists think about things 2 weeks after that all five episodes of that series will show up in the podcast feed that's right multiple hours of delight handed to you for free all at once 2 weeks later we're back to the opinion science schedule you know and love new interviews every other Monday okay do you've got your planner all filled in great thanks for listening today and I'll see you when I see you for more opinion science bye-bye [Music]