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ALA Midwinter Institute–Implicit Bias, Health Disparities and Health Literacy: Intersections in Health Equity

Mackenzie Ahlberg Elliot
Mid-Continent Public Library

Kathi Woodward
Springfield-Greene County Library

The ALA Office for Diversity, Literacy, and Outreach Services; the Public Library Association; and the National Network of Libraries of Medicine, Pacific Northwest Region, sponsored a half-day institute at ALA Midwinter in Seattle, WA, on January 25, 2019. Kathi Woodward and Mackenzie Ahlberg Elliot attended through funding from the National Network of Libraries of Medicine, MidContinental Region.

Photo of attendees

MCR  ALA MidWinter Pre-conference Attendees

Kathi became especially interested in health literacy after attending the Health Information for Public Librarians Symposium in Atlanta last May. She was excited to participate in the pre-conference, hoping to expand her knowledge about how to help patrons increase their health literacy, and to learn more about the disparities in health care.

Mackenzie approached the pre-conference from the perspective of mental health, having received training from a local medical center regarding trauma-informed care. She was fascinated by the connections between mental health, physical health, and behaviors and was thrilled to learn more about the connections between unconscious bias and disparate healthcare and health literacy in her community.

The day began with University of Miami pediatrician Dr. Kimberly Reynolds giving the keynote address. Dr. Reynolds presented the factual basis of the impact racial implicit bias has on disparities in health care. She stated that doctors with low explicit bias but high implicit bias consistently received the lowest patient satisfaction ratings, as doctors may avoid eye contact, be unfriendly, or speak over patients. Dr. Reynolds provided an easy mnemonic device to CHECK biases: Connect (identify and acknowledge bias), Honor (recognize when bias has been activated), Engage (disconfirm biases), and Communicate with Kindness.

Dr. Linda Ko, the director of the Health Communication Research Center at the University of Washington, spoke next. Kathi notes that Dr. Ko helped her think about the best ways to reach different audiences with health information.

Hearing about the Together We Stride program that works to reduce obesity among Hispanic children in the Lower Yakima Valley of Washington State was especially interesting. It could easily serve as inspiration for part of a summer reading program in public libraries, where both Kathi and Mackenzie currently work.

Aileen Luppert, MLIS, Managing Librarian from Spokane County Library District, was the next speaker. She encouraged the audience to think about librarians as information navigators. Her staff members acted as health care navigators until the uninsured rate had decreased sufficiently, and they were able to change gears and shift their focus to building community partnerships. Kathi’s library will be working with community partners when her city’s mental health status report is released.

The final speaker, Michele Spatz, MS, of NNLM’s Pacific Northwest Region, helped us think about the impact of health literacy, how it can outweigh other predictors in determining health. She emphasized that health literacy is multidimensional, including competencies in print (reading and writing), oral (listening and speaking), and numeracy (dosing, scheduling, and calculations). With many societal forces working against health literacy, the context and timing of programs and messages matters.

Immediately following the speakers was a small group discussion facilitated by Jeff Turner, JD, Human Resources and Organizational Development Consultant for Praxis HR. Participants shared their experiences with implicit biases interfering with great customer service and the opportunities in their libraries for addressing health inequities.

The day was full of insights and important discussions that inspired both Kathi and Mackenzie to take the information back to their libraries in Missouri. Kathi named the discussion of implicit bias as the most meaningful to her workplace. She has been encouraging her department members to take the Harvard Implicit Bias tests (https://implicit.harvard.edu/implicit/takeatest.html). Kathi’s library district is working with the National Alliance on Mental Illness (NAMI) to begin offering staff trainings related to serving patrons who are experiencing mental illness. She hopes that NAMI’s training and an increase in awareness of implicit bias will help her library decrease barriers to service.

Mackenzie appreciated the CHECK method Dr. Reynolds presented for addressing implicit bias. It’s a very handy model for working through the associations that we all carry around while still giving voice to the fact that we need to become aware to do better. Mackenzie’s library system is working with local unconscious bias trainers to develop an all-day, all-staff development training on the topic of inclusion. She hopes that as library staff become more aware of their implicit biases, they can move toward being more responsive to the real health needs of their communities.

In March, Robin Newell and Levi Dolan presented at the monthly Breezing Along with the RML session about their experiences attending the ALA Midwinter Pre-conference on implicit bias and health disparities. If you would like to hear about their experiences, check out our recording at https://youtu.be/zmCowkJcOlY

The MidContinental Messenger is published quarterly by the Network of the National Library of Medicine MidContinental Region

Spencer S. Eccles Health Sciences Library
University of Utah
10 North 1900 East, Building 589
Salt Lake City, Utah 84112-5890

Editor: Suzanne Sawyer, Project Coordinator
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This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services, National Institutes of Health, National Library of Medicine, under cooperative agreement number UG4LM012344 with the University of Utah Spencer S. Eccles Health Sciences Library.

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