We need to talk about the blind spot in "anti-bias" and "anti-discrimination" laws
This week, A5516, a bill that would require certain health care professionals to undergo bias training, passed through New Jersey’s Assembly Health Committee.
In promoting this legislation on X, @njassemblydems asked: What if you discovered that bias affected a crucial moment in your healthcare journey?
This makes me wonder where they’ve been the last 3 years.
Assemblywoman Verlina Reynolds-Jackson, the bills sponsor, explains:
I have Crohn’s disease. I’ve had it for about 20 years. I was given the opportunity to have my infusions done at home versus outpatient where I would have to go to the hospital. I got a call from the agency saying that the nurse was cancelling because she felt uncomfortable coming to my home. And I said, what are you talking about? I was so shocked when this happened. I couldn’t believe it. And so I began to think, how can I shift this anger in to action?
The legislation, A5516, talks about bias training for health care professionals for home services. It helps you have a platform to elevate your concerns, but it also gives an organization the opportunity to improve those health care disparities.
I just love where I live at and I love my community and I want everybody to have great quality health care and access to great quality health care, whether your’e in the hospital or receiving it at home. And I think that’s extremely important. *emphasis mine
It IS extremely important that everyone have access to quality healthcare. And it’s unfortunate that Assemblywoman Reynolds-Jackson was unable to receive health care services because someone was uncomfortable coming to her home (although without more information, we don’t know why). It’s also admirable that she sought a productive and meaningful way to channel her anger and disappointment.
But A5516 fails to acknowledge one of the most significant biases impacting health care during the pandemic.
See if you can spot it:
The cultural competency and implicit bias training curriculum 1[shall be developed by the Department of Health, in consultation with relevant professional organizations, which]1 shall include, but shall not be limited to:
(1) identification and understanding of implicit biases and stereotypes related to race, ethnicity, religion, sexual orientation, gender identity, and disability;
(2) communication techniques that account for potential impacts of implicit biases;
(3) strategies for recognizing and mitigating unconscious biases in healthcare decision-making processes;
(4) review of applicable federal and State laws regarding discrimination in health care services;
(5) cultural awareness and cultural competence in healthcare; and
(6) understanding health disparities and social determinants of health.
Here’s a hint:
Individuals unvaccinated against COVID-19 (C19) experienced prejudice and blame for the pandemic. Because people vastly overestimate C19 risks, we examined whether these negative judgements could be partially understood as a form of scapegoating (ie, blaming a group unfairly for an undesirable outcome) and whether political ideology (previously shown to shape risk perceptions in the USA) moderates scapegoating of the unvaccinated.
I wonder if Assemblywoman Reynolds-Jackson realizes how many people were denied medical care and other opportunities to stay healthy (i.e. entrance to gyms and other facilities) due to their vaccination status.
Here is a video of Dr. Byram Bridle sharing details of the death of Sheila Lewis, an unvaccinated woman who was denied a life-saving transplant despite having proof of natural immunity to SARS-CoV-2.
She was a mother of four, grandmother of 2. She died at 58 years of age. She died a horrible death… slowly suffocating… She was denied a life-saving transplant because she literally had demonstrable proof of robust immunity against SARS-CoV2, but unfortunately she did not get that immunity in the “correct way.” It came by the result of a natural infection. And she lacked a piece of paper that certified two needles going into her shoulder…
This wasn’t an isolated case. During the pandemic, providing health care for the unvaccinated became controversial. Healthy unvaccinated people were denied entry into public spaces. Many lost their jobs. Surely it warrants a place in conversations about bias and discrimination.
It’s important because New Jersey is producing an abundance of legislation that focuses on a “crucial need for cultural competency”, “anti-bias” and anti-discrimination. While the desire to address this need is commendable, many of the bills, as written, are short-sighted at best and will likely contribute to further division and exclusion. Legislators must demonstrate an ability and willingness to identify, acknowledge and address bias in ALL its forms before they can hope to remedy the problems associated with them.
Similar scenarios have played out through history. Too often discriminatory behavior goes unrecognized until it’s too late because, although the playbook is the same, the impacted populations change. We often fail to see through excuses that are used to justify discrimination towards certain groups. We need to learn to recognize bias and discrimination by behavior. Because our pre-determined ideas about victims and oppressors ARE BIASES.
There’s a lot that needs to change. For one thing, much of the legislation around implicit bias and cultural competency feels cut and paste. But for now at least, let’s acknowledge the elephant in the bill. Legislation that deals with discrimination or bias must acknowledge the discrimination that the unvaccinated have endured by adding vaccination status to the verbiage of these bills, particularly those that seek to codify laws against discrimination.
Here are some of the New Jersey bills that may require amendments to account for protecting the rights of the unvaccinated:
A5516/S4047 - Requires certain health care professionals to undergo bias training.
A2261/S1248 - Establishes Task Force on Institutional Discrimination in Health Care.
A1169/S1459 - Requires discrimination prevention training for certain providers of services to senior citizens.
A1000/S1458 - Prohibits certain forms of discrimination in DOH policies concerning allocation of critical health care resources.
A1517/S3106 - Requires school districts to provide anti-bias instruction as part of New Jersey Student Learning Standards in Comprehensive Health and Physical Education; requires school districts to designate chief equity officer.
A2006 - Requires school districts to include instruction on racial discrimination and social justice as part of implementation of New Jersey Student Learning Standards in Social Studies for middle school students.
A1720/S2072 - Requires cultural diversity and implicit bias training be included in police basic training curriculum.
A1248/S2545 - Requires adoption of and training on anti-discrimination and anti-harassment policy by certain campaign committees; creates Office on Discrimination and Harassment Prevention; appropriates $2,000,000.
A4500 - Codifies protections in Law Against Discrimination for persons suffering discrimination on grounds of disparate impact.
A4648/S3317 - Codifies prohibition of discriminatory practices in real estate appraisals and requires real estate appraisers to complete anti-bias training.
A1691/S2840 - Concerns unlawful discrimination and harassment.
The good news is that some legislators are paying attention and have proposed legislation to address discrimination against the unvaccinated.
S125, sponsored by Senator James Holzapfel, “prohibits discrimination against individuals who have not received COVID-19 vaccine.”
S1973, sponsored by Senators Mike Testa and Ed Durr, “prohibits discrimination against corrections workers, first responders, and health care workers who have not received a COVID-19 vaccine or booster.”
Meaningful change takes time. But if we all keep talking, and listening, we’ll get there.
Thank you for writing about this. The issues I've had to deal with because I chose to not be vaccinated were minor to the ones mentioned above since I'm not working and only had elective surgery delayed. I put off travel for three years and found I should have put it off longer as the family member I went to see was still not ready for our differences of opinion on these subjects although they weren't openly discussed. I realized that the issues of the last three plus years have permanently altered close relationships so the grief and sheltering starts all over again.
The things that have been done to everyone under the guise of protecting us is horrific and has totally altered my view of our government, health care system, and my own ability to judge and trust people. Even though I never had COVID it changed my life anyway and for that I blame our government and politicians who used it to control people's minds. And they continue hammering us with Flu, RSV, COVID part whatever... stay fearful. I continue to resist.