Biased language in hospital records appears to harm patient care and disproportionately affects Black patients, according to research examining more than 2,300 hospitalizations across 29 medical centers.
Researchers found stigmatizing language in about 5 percent of medical documentation, but its presence was twice as common in records of Black patients compared to White or Asian patients. Black patients had stigmatizing language in nearly 10 percent of their records, while White patients had such language in fewer than 4 percent of cases.
Patients experiencing housing instability faced even higher rates, with stigmatizing language appearing in 15 percent of their medical records compared to 5 percent for patients with stable housing.
The study defined stigmatizing language as notes questioning patient credibility, using racial or social stereotypes, expressing disapproval of patients, or describing them as difficult. Critically, patients whose records contained such language experienced diagnostic errors at double the rate of other patients.
When stigmatizing language appeared in medical records, it correlated with nearly twice the odds of delays in care at presentation and nearly four times the odds of communication breakdowns between medical staff and patients or their families.
Researchers suggest the biased language may reflect clinician prejudices that interfere with gathering patient information, communicating effectively, and making sound clinical judgments. The findings highlight how documented bias in medical records creates measurable harm, particularly for Black patients and those facing housing challenges.
See: “Stigmatizing Language, Patient Demographics, and Errors in the Diagnostic Process” (April 15, 2024)
