Michigan Now Requires Implicit Bias Training for All Health Professionals

The coronavirus pandemic continues to reveal stark health disparities across the country, particularly for African Americans. Black people are much more likely to get infected and die from COVID-19 than white individuals.

This divide is perhaps most notable in Michigan. Black people make up 40% of all COVID-19 cases and deaths in the state, even though they make up just 13.6% of the local population. The Detroit area and the surrounding suburbs have been hit especially hard. Testing centers are overwhelmed, and many patients remain in the dark about the virus.

To counter these trends, Gov. Gretchen Whitmer has just announced that all health professionals looking to get licensed in the state must participate in implicit bias training, so they will be more aware of racial health inequalities and work to prevent them. Could other states follow in their footsteps?

Getting the Virus Under Control

Michigan has long been praised for its ability to flatten the curve. Gov. Whitmer implemented some of the most restrictive shelter-in-place orders in the country, bringing the state to a standstill in March and April. Some residents were outraged by these measures, claiming they were a violation of their civil rights. Many of us may recall photos and videos of men with large guns on the steps of the Michigan Capitol Building shouting, “Don’t Tread on Me.”

Like many states, Michigan began to lift these restrictions as the coronavirus pandemic started to subside. But the state quickly squashed any progress it has made over the last month. From early June to early July, the number of new daily cases shot up from 150 to 444.

The governor and health experts now believe the state is at a “tipping point” as it approaches what many see as a potential second wave of the virus. Recent polls show that just 52% of residents plan to continue with safety guidelines, including wearing face masks and practicing social distancing. The other 48% seem to be confused or have little interest in following these rules.

This could lead to new outbreaks across the state, like the scenes we’ve been seeing in Arizona, Texas, and Florida. For now, the bulk of new cases are being attributed to young people, many of which are anxious to get out and have fun this summer.

Executive Directive 2020-7

Any outbreak in Michigan could be disastrous for the state’s African American community. Gov. Whitmer seems to be determined to prevent this from happening.

She recently created the Michigan Coronavirus Task Force on Racial Disparities. As she announced during a press conference:

“COVID-19 has taken a disproportionate toll on Michigan’s communities of color and I am confident this task force will help us identify the factors driving this disparity and to identify actions we can take to create a more equitable Michigan for everyone. Each of the task force members will provide a unique perspective and play a vital part in identifying these barriers and ensuring all Michiganders have equal access to critical resources when they need them most.”

The Task Force is trying to figure out why so many black people are dying from COVID-19 in the state, so healthcare providers can correct these trends. They are currently focusing on:

• Increasing transparency in reporting data regarding the racial and ethnic impact of COVID-19
• Removing barriers to accessing physical and mental health care
• Reducing the impact of medical bias in testing and treatment
• Mitigating environmental and infrastructure factors contributing to increased exposure during pandemics resulting in mortality
• Developing and improving systems for supporting long-term economic recovery and physical and mental health care following a pandemic

The Task Force is made up of a range of distinguished healthcare professionals across the state, including those from academia, the insurance and communications industries, as well as members from the LGBTQ, nursing, and religious communities.

One of the biggest suggestions the task force made was to mandate implicit bias training for all healthcare workers. All professionals must now participate in the training to obtain, register, or renew their medical licenses.

Executive Directive 2020-7 will work with the Department of Licensing and Regulatory Affairs (LARA) to enforce the policy. No one will receive a license in the state unless they can prove they have participated in implicit bias training. Over the next few months, LARA will coordinate with health systems across the state to lay out specific guidelines for licensing and registration.

It’s not clear what the training will include, but it will focus on all the ways providers tend to discriminate against patients of color, whether consciously or unconsciously. This may include not following up with treatment and specialists, outright denying care, overlooking symptoms and pain, and community leadership and education.

COVID-19 is disproportionately affecting black Americans in nearly every part of the country, so we may see more states get on board with this plan. It’s a small step that could transform the state’s approach to patient care.