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Representations of race and skin tone in medical textbook imagery

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  • Louie, Patricia
  • Wilkes, Rima

Abstract

Although a large literature has documented racial inequities in health care delivery, there continues to be debate about the potential sources of these inequities. Preliminary research suggests that racial inequities are embedded in the curricular edification of physicians and patients. We investigate this hypothesis by considering whether the race and skin tone depicted in images in textbooks assigned at top medical schools reflects the diversity of the U.S. population. We analyzed 4146 images from Atlas of Human Anatomy, Bates' Guide to Physical Examination & History Taking, Clinically Oriented Anatomy, and Gray's Anatomy for Students by coding race (White, Black, and Person of Color) and skin tone (light, medium, and dark) at the textbook, chapter, and topic level. While the textbooks approximate the racial distribution of the U.S. population - 62.5% White, 20.4% Black, and 17.0% Person of Color - the skin tones represented - 74.5% light, 21% medium, and 4.5% dark - overrepresent light skin tone and underrepresent dark skin tone. There is also an absence of skin tone diversity at the chapter and topic level. Even though medical texts often have overall proportional racial representation this is not the case for skin tone. Furthermore, racial minorities are still often absent at the topic level. These omissions may provide one route through which bias enters medical treatment.

Suggested Citation

  • Louie, Patricia & Wilkes, Rima, 2018. "Representations of race and skin tone in medical textbook imagery," Social Science & Medicine, Elsevier, vol. 202(C), pages 38-42.
  • Handle: RePEc:eee:socmed:v:202:y:2018:i:c:p:38-42
    DOI: 10.1016/j.socscimed.2018.02.023
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    References listed on IDEAS

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    1. Sales, Christopher S. & Schlaff, Anthony L., 2010. "Reforming medical education: A review and synthesis of five critiques of medical practice," Social Science & Medicine, Elsevier, vol. 70(11), pages 1665-1668, June.
    2. Van Ryn, M. & Fu, S.S., 2003. "Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health?," American Journal of Public Health, American Public Health Association, vol. 93(2), pages 248-255.
    3. Harburg, E. & Gleibermann, L. & Ozgoren, F. & Roeper, P. & Schork, M.A., 1978. "Skin color, ethnicity, and blood pressure. II. Detroit whites," American Journal of Public Health, American Public Health Association, vol. 68(12), pages 1184-1188.
    4. Perreira, Krista M. & Telles, Edward E., 2014. "The color of health: Skin color, ethnoracial classification, and discrimination in the health of Latin Americans," Social Science & Medicine, Elsevier, vol. 116(C), pages 241-250.
    5. Saha, S. & Arbelaez, J.J. & Cooper, L.A., 2003. "Patient-Physician Relationships and Racial Disparities in the Quality of Health Care," American Journal of Public Health, American Public Health Association, vol. 93(10), pages 1713-1719.
    6. Harburg, E. & Gleibermann, L. & Roeper, P. & Schork, M.A. & Schull, W.J., 1978. "Skin color, ethnicity, and blood pressure. I. Detroit blacks," American Journal of Public Health, American Public Health Association, vol. 68(12), pages 1177-1183.
    7. Veenstra, Gerry, 2011. "Mismatched racial identities, colourism, and health in Toronto and Vancouver," Social Science & Medicine, Elsevier, vol. 73(8), pages 1152-1162.
    8. Feagin, Joe & Bennefield, Zinobia, 2014. "Systemic racism and U.S. health care," Social Science & Medicine, Elsevier, vol. 103(C), pages 7-14.
    9. Dubbin, Leslie A. & Chang, Jamie Suki & Shim, Janet K., 2013. "Cultural health capital and the interactional dynamics of patient-centered care," Social Science & Medicine, Elsevier, vol. 93(C), pages 113-120.
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