Recognizing Privilege and Bias: An Interactive Exercise to Expand Health Care Providers' Personal Awareness

Despite increasing awareness of the social determinants of health, health care disparities among sociocultural groups persist. Health care providers' unconscious bias resulting from unrecognized social privilege is one contributor to these disparities.

In 2009, Henry Ford Health System initiated the Healthcare Equity Campaign both to raise employees' awareness of inequalities related to the social determinants of health and to increase their motivation to reduce them. After conducting awareness-raising activities to increase employees' understanding of the social determinants of health, a curriculum team developed the interactive Privilege and Responsibility Curricular Exercise (PRCE) and incorporated it into a series of trainings. The team designed the exercise to enhance participants' awareness of privilege in their lives and work, to improve their understanding of the impact of privilege on their own and others' lived experiences as a step beyond cultural competence toward cultural humility, and to encourage them to leverage their advantages to reduce health care inequities.

About 300 participants of diverse professional and personal backgrounds from across the health system completed the training between the spring of 2009 and the spring of 2012, and many provided qualitative feedback about the exercise. Evaluations showed the exercise's potential as a powerful learning experience that might enhance a variety of equity- or diversity-related trainings, and also showed that participants considered the PRCE a highlight of the training.

The PRCE is worthy of additional study and could prove valuable to other organizations.