Health Care Providers’ Negative Implicit Attitudes and Stereotypes of American Indians


Research suggests that implicit biases held by health care providers may play a role in perpetuating health disparities. However, minimal work has examined the presence of providers’ negative implicit attitudes and stereotypes of American Indians. The current work examined implicit attitudes and stereotypes toward American Indians among 111 health care providers using the Implicit Association Test. Results revealed evidence of negative implicit attitudes toward American Indians. In addition, results showed that providers implicitly stereotype American Indians as noncompliant. This effect was moderated by self-reports of cultural competency and implicit bias training experience such that those reporting cultural competency or implicit bias training reported lower implicit stereotyping than those reporting no cultural competency or implicit bias training. Moreover, medical students reported lower implicit stereotyping than medical residents and practicing physicians. Implications of providers’ implicit biases on treatment of American Indian patients and implicit bias reduction research are discussed.

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    There were 113 participants initially, however the data from 2 participants were removed from analysis for exhibiting high error rates (>30%) on at least one of the IATs [34].

  2. 2.

    Although this manuscript uses the term “American Indians” in the absence of specific tribal affiliations, the term “Native American” was used in the IATs to match previous research.

  3. 3.

    Although the sample size for some of the racial identity categories was limited, were explored potential difference by splitting the sample between White (n = 59) and non-White/other (n = 49) participants. The 3 participants who did not provide racial/ethnic identity information were not included in this analysis.


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This research was funded by the Spirit of Inquiry Research Award through the Honors College at the University of Arizona.

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Correspondence to Colin A. Zestcott.

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Zestcott, C.A., Spece, L., McDermott, D. et al. Health Care Providers’ Negative Implicit Attitudes and Stereotypes of American Indians. J. Racial and Ethnic Health Disparities 8, 230–236 (2021).

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  • American Indian
  • Implicit
  • Attitudes
  • Stereotypes