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. Author manuscript; available in PMC: 2022 Jun 7.
Published in final edited form as: Annu Rev Public Health. 2022 Jan 12;43:477–501. doi: 10.1146/annurev-publhealth-052620-103528

Figure 2.

Figure 2

Interactions between structural determinants and provider implicit bias. The vicious cycle: Structural determinants of implicit bias in the practice environment support biased decision making. Structural determinants of health in the community further impair outcomes in marginalized populations, leading to confirmation of the practitioner’s implicit bias. Health disparities are exacerbated. The virtuous cycle: A favorable practice environment regarding structural determinants of implicit bias supports unbiased clinical decision making. Favorable structural determinants of health in the community further enhance patient outcomes, positively reinforcing unbiased practice. Health disparities are reduced.