In a new study, doctors showed a subconscious favoring of whites over blacks -- an unwitting bias that may refine explications of persistent racial disparities in US health care. However, it is too early to know if there is a direct link to the quality of care provided to blacks, said researchers, who presented their findings on Tuesday to the American Public Health Association's 136th Annual Meeting & Exposition in San Diego.

Researchers used data from a 2004-2006 study in which more than 400,000 people took an online test about their racial attitudes. The sample included 2,535 self-identified doctors, of whom 76 percent were US residents and 66 percent were white.

The test sought subconscious signs of bias and included an exercise in which participants were asked to quickly rate photos of whites and blacks as positive or negative. Except for black doctors, physicians in all racial and ethnic groups showed an implicit preference for whites versus blacks. Black doctors did not favor either group.

"We don't call what these tests show prejudice. We talk about it as hidden bias or unconscious bias, something that most people are unaware they even possess," said study team member Anthony Greenwald of the University of Washington, who created the test.

"The implicit bias effect among all the test-takers is very strong," said Janice Sabin of the University of Washington-Seattle. "This supports speculation that subtle race bias might affect health care, but does not imply that it will," Sabin said.

Nonetheless, the findings support many other studies showing that implicit racial bias is common in the general population, and that diversity education should be part of a medical education in the United States, Sabin said.

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