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People Like Us: How Our Identities Shape Health And Educational Success

A recent study found that black doctors were more effective than non-black doctors at convincing black men to use preventative health services.
A recent study found that black doctors were more effective than non-black doctors at convincing black men to use preventative health services.

A visit to a new doctor can be a stressful experience. You know the feeling. Sitting in a cold exam room, naked save for a flimsy gown, waiting for a stranger to poke and prod you. When the doctor finally enters, most of us are looking for signs that we can trust this person, that they are going to help rather than harm us.

So what is it that makes us trust doctors enough to allow them to stick needles in our skin or put us on a diet? That's what Owen Garrick wanted to know. He's a doctor and researcher in Oakland, California, and has been trying to improve health outcomes for black men. Black men have the lowest life expectancy of any major demographic group. Owen says they are dying of preventable or chronic diseases like prostate cancer.

"It's not just prostate cancer; it is cardiovascular disease, it is stroke, it is diabetes."

Owen and his colleagues wondered what it would take to get black men to go to the doctor for preventative care. They had a hunch that race might be a factor. So they ran a field study to try to answer one simple question:

Will black men take more preventative care services if they are randomly assigned to a black doctor?

They recruited men from barbershops and flea markets around Oakland. About 600 agreed to go to a clinic for a checkup.

The study found that black men assigned to a black doctor did accept more preventative services. And not by a little — by a lot.

The black doctors were about 50 percent more successful than non-black doctors at getting their patients to agree to invasive tests for diabetes and the flu shot. When it came to cholesterol screening, they were 72 percent more effective.

The real-life implications could be huge. If people in the real world responded as they did in Owen's study, the gap between blacks and whites in cardiovascular disease outcomes might shrink by nearly 20 percent.

"That could be 20 percent of people living to see their grandkids graduate from college and high school," Owen says. "That's how I think about it."

This week on Hidden Brain, we travel from medical clinics to school classrooms for a look at how shared identity creates understanding and trust.

Additional Resources:

" Does Diversity Matter for Health? Experimental Evidence from Oakland," by Marcella Alsan, Owen Garrick, and Grant C. Graziani, NBER Working Paper Series, 2019.

" The Long-run Impacts of Same Race Teachers," by Seth Gershenson, Cassandra M.D. Hart, Joshua Hyman, Constance Lindsay, and Nicholas W. Papageorge, NBER Working Paper Series, 2018.

" Patient–physician gender concordance and increased mortality among female heart attack patients," by Brad N. Greenwood, Seth Carnahan, and Laura Huang, in Proceedings of the National Academy of Sciences of the United States of America, 2018.

" A Doctor Like Me: Physician-Patient Race-Match and Patient Outcomes," by Andrew Hill, Daniel Jones, and Lindsey Woodworth, 2018.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Shankar Vedantam is the host and creator of Hidden Brain. The Hidden Brain podcast receives more than three million downloads per week. The Hidden Brain radio show is distributed by NPR and featured on nearly 400 public radio stations around the United States.
Jennifer Schmidt is a senior producer for Hidden Brain. She is responsible for crafting the complex stories that are told on the show. She researches, writes, gathers field tape, and develops story structures. Some highlights of her work on Hidden Brain include episodes about the causes of the #MeToo movement, how diversity drives creativity, and the complex psychology of addiction.
Parth Shah is an associate producer at Hidden Brain. He came to NPR in 2016 as a Kroc Fellow.
Tara Boyle is the supervising producer of NPR's Hidden Brain. In this role, Boyle oversees the production of both the Hidden Brain radio show and podcast, providing editorial guidance and support to host Shankar Vedantam and the shows' producers. Boyle also coordinates Shankar's Hidden Brain segments on Morning Edition and other NPR shows, and oversees collaborations with partners both internal and external to NPR. Previously, Boyle spent a decade at WAMU, the NPR station in Washington, D.C. She has reported for The Boston Globe, and began her career in public radio at WBUR in Boston.
Rhaina Cohen is a producer and editor for NPR's Enterprise Storytelling unit, working across Embedded, Invisibilia, and Rough Translation.