Ethnic healthcare disparities: The role of physicians' prejudice and outgroup dehumanisation

In the present work, we investigate ethnic disparities in medical contexts in Italy, by examining immigrants (N = 95) and Italian patients (N = 95), who evaluated the quality of medical care they received from their physician. The respective Italian physicians (N = 19) were also examined in order to identify, with a multilevel analysis, predictors of patients' adherence to physician's treatment recommendations. For physicians, prejudice and humanity attributions toward immigrants were assessed, with both self-report measures and the Implicit Association Test. For patients, besides adherence, we assessed satisfaction with care, trust in the physician, and teamness perceptions (i.e., the perception of being in the same team with the physician, in trying to solve a patient's clinical problem). We found that physicians displayed prejudice and dehumanisation toward immigrants, but only in the implicit measures. In the explicit measures, in fact, physicians evaluated immigrants more positively than Italians and did not differentiate the two groups on humanity attributions. As to patients' perspective, Italians and immigrants generally judged positively the quality of medical care, with immigrant patients showing even more satisfaction with care and adherence to treatment recommendations than Italian ones. Finally, results showed unique effects of physicians' attitudes and humanity attributions on adherence of patients belonging to the two groups. Results suggest that, although healthcare disparities are not evident in ethnic minority vs. majority patients' perceptions, physicians' humanity attributions may contribute to the prediction of relevant healthcare outcomes among patients.