Independence Care System (ICS) members and staff recently testified at a New York City Council oversight hearing, calling on lawmakers to amend a resolution urging the State to require medical schools to train students about implicit bias in health care. Members said that they want the resolution, which addresses bias against people based on their gender, race, age or sexual orientation, to also explicitly address discrimination against people with disabilities.
Studies have long shown that members of marginalized communities often receive sub-par treatment from healthcare providers, often as a result of implicit, or unconscious bias. This, of course, contributes to poor health outcomes. The healthcare community has begun shifting its attention to address health inequities among traditionally marginalized communities, including women, people of color, and members of the lesbian, gay, bisexual, transgender, queer and gender non-conforming (LGBTQ/TGNC) communities.
At the September 18 City Hall hearing on cultural competence in the delivery of health care services, the Council Committee on Hospitals heard testimony on Proposed Resolution 512—sponsored by City Councilmember Helen Rosenthal—to promote more culturally competent providers who are educated about implicit bias in order to better serve these populations.
ICS members discuss implicit bias
ICS members who testified described their experiences in trying to access health care, how they received subpar service due to their disabilities, and how their sexual activity and reproductive health is ignored by medical professionals. They also spoke about how ICS has worked with the City to make health care more accessible for people with disabilities.
ICS Senior Vice President of Advocacy and Women’s Health Marilyn Saviola told Committee Chairperson Carlina Rivera that educating medical students about bias is of crucial importance.
“We are dying of a lack of health provider education,” Saviola said. “Doctors are rarely taught in medical school about people with disabilities, especially those successfully living in the community.”
Saviola added that teaching medical students about implicit bias towards people with disabilities would prevent costly hospitalizations and poor health outcomes.
“People with disabilities without routine access to primary care are not receiving the benefit of early testing, diagnosis and treatment,” Saviola said. “This problem costs the person with a disability the loss of their health and independence and adds millions to the financial cost of caring for this population.”
ICS member Rosamaria Ocasio noted that until she was able to get a mammogram with the help of ICS, she experienced bias when seeking out breast cancer screenings.
“Mammography technicians didn’t understand my condition, didn’t ask appropriate questions, and basically let me know that I was a burden to them,” Ocasio said. “For years I had to worry because I could not get a valid mammogram.”
Discrimination against people with disabilities
Other ICS members urged the Committee to amend Resolution 512, saying that this will significantly support people with disabilities, while addressing bias in health care.
ICS member Manyon Lyons, who has cerebral palsy, noted several instances of discrimination, and urged the Committee to amend Resolution 512.
“When I brought my aide with me into a doctor’s office, the doctor would talk to the aide instead of talking to me,” Lyons said. “When I was pregnant with my son, a social worker asked me why I would want to keep the baby. It was so insulting.”
ICS member Michaeline Branker, a registered nurse and certified nurse midwife who has a spinal cord injury, testified that throughout her professional career, she has witnessed firsthand the bias people with disabilities face when seeking healthcare. She called for the resolution to be amended to not only include medical school students but other medical professionals as well.
“It should be aimed at individuals in nursing schools and professionals who train medical assistants, technicians, even medical receptionists and other office staff,” Branker said.
‘The resolution is not final’
Chairperson Rivera thanked ICS members for sharing their personal testimonies, noting that the Committee will take their feedback and recommendations into consideration when finalizing the resolution.
“I want to let you know that we take this feedback seriously and your recommendations to heart,” Rivera said. “The resolution is not final. It’s open to amendment. We have every intention of continuing this conversation.”