PhD student Patricia Louie finds that medical textbooks underrepresent race and skin tone

Patricia LouiePhD student Patricia Louie has recently published her research based on research into the diversity of representation in the major text books assigned in medical school. Louie published the paper, together with her co-author Rima Wilkes of UBC, in Social Science Medicine. The article, “Representations of Race and Skin Tone in Medical Textbook Imagery,”  reported on the analysis of over 4,000 images from the four of the most widely assigned textbooks for first and second-year medical students in North America.  The results showed that darker skin tones were underrepresented in medical textbooks, a failing that could have implications for racial bias in clinical practice. We have posted the citation and abstract below. The full article is available online to subscribers.

Louie, P. and Wilkes, R. (2018). Representations of Race and Skin Tone in Medical Textbook Imagery. Social Science Medicine

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.

See press coverage of Louie’s research here.