Evidence map›Paper›PMID 25748764›Full record

ArticleJournal of the American Board of Family Medicine : JABFM

Unconscious biases: racial microaggressions in American Indian health care.

Melissa L Walls, John Gonzalez, Tanya Gladney, Emily Onello

Abstract read
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In one paragraph

Article in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  9. Cardiovascular Disease Risk Factors in the Native American Population.Journal of cardiovascular development and disease · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Melissa L WallsFrom the Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School-Duluth, Duluth, MN (MLW); Department of Psychology, Bemidji State University, Bemidji, MN (JG); Department of Sociology and Criminal Justice, University of St. Thomas, St. Paul, MN (TG); Department of Family Medicine/Community Health, University of Minnesota Medical School-Duluth, Duluth, MN (EO). mlwalls@d.umn.edu.
John GonzalezFrom the Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School-Duluth, Duluth, MN (MLW); Department of Psychology, Bemidji State University, Bemidji, MN (JG); Department of Sociology and Criminal Justice, University of St. Thomas, St. Paul, MN (TG); Department of Family Medicine/Community Health, University of Minnesota Medical School-Duluth, Duluth, MN (EO).
Tanya GladneyFrom the Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School-Duluth, Duluth, MN (MLW); Department of Psychology, Bemidji State University, Bemidji, MN (JG); Department of Sociology and Criminal Justice, University of St. Thomas, St. Paul, MN (TG); Department of Family Medicine/Community Health, University of Minnesota Medical School-Duluth, Duluth, MN (EO).
Emily OnelloFrom the Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School-Duluth, Duluth, MN (MLW); Department of Psychology, Bemidji State University, Bemidji, MN (JG); Department of Sociology and Criminal Justice, University of St. Thomas, St. Paul, MN (TG); Department of Family Medicine/Community Health, University of Minnesota Medical School-Duluth, Duluth, MN (EO).

Funding

Mental Health and Diabetes among Ojibwe AdultsR21MH085852 · NIMH · UNIVERSITY OF MINNESOTA · PI WALLS, MELISSA L. · 2010 to 2011
$426k
NIMH NIH HHS MH085852NIMH NIH HHS R21 MH085852
6 · The paper itself

Abstract

purposeThis article reports on the prevalence and correlates of microaggressive experiences in health care settings reported by American Indian (AI) adults with type 2 diabetes mellitus (T2DM).

methodsThis community-based participatory research project includes two AI reservation communities. Data were collected via in-person article-and-pencil survey interviews with 218 AI adults diagnosed with T2DM.

resultsGreater than one third of the sample reported experiencing a microaggression in interactions with their health providers. Reports of microaggressions were correlated with self-reported history of heart attack, worse depressive symptoms, and prior-year hospitalization. Depressive symptom ratings seemed to account for some of the association between microaggressions and hospitalization (but not history of heart attack) in multivariate models.

conclusionsMicroaggressive experiences undermine the ideals of patient-centered care and in this study were correlated with worse mental and physical health reports for AIs living with a chronic disease. Providers should be cognizant of these subtle, often unconscious forms of discrimination.

Indexed as

Community-Based Participatory ResearchIndians, North AmericanChronic DiseaseDiabetes Mellitus, Type 2FemaleHealth Services AccessibilityHumansMaleMiddle AgedPatient-Centered CarePrevalenceUnited StatesCross-Cultural CarePatient-Centered CarePopulationsUnderserved

Identifiers

PMID25748764
PMCPMC4386281

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.