Lancet article by St. Michael’s researchers calls for more thoughtful approach to gender equity than individual-focused interventions

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Lancet article by St. Michael’s researchers calls for more thoughtful approach to gender equity than individual-focused interventions

Toronto, February 11, 2019

By Ana Gajic

men and women sit at a table with their laptop computers

Implicit bias training – an intervention aimed at making people more aware of their unconscious biases – in the workplace is a valuable first step to promoting gender equity, but should not be seen as the full picture, suggest St. Michael’s Hospital researchers in a commentary published in The Lancet.

The current focus that has surfaced in academia and other professional settings on unconscious bias risks masking broader social, structural and political barriers to women’s advancement, write Dr. Cheryl Pritlove, Dr. Janet Parsons, Dr. Clara Juando-Prats and Kari Ala-leppilampi, social science researchers at the Applied Health Research Centre of St. Michael’s.

In a special issue of The Lancet, Advancing women in science, medicine, and global health, the researchers deconstruct implicit bias into three categories of implications: the good, the bad and the ugly. They note that the positives of implicit bias training include “some success in changing individual-level beliefs and actions,” but point out that analyses haven’t found it to be effective in reducing institutional inequities.

“Unconscious bias puts a lot of responsibility on the individual in an institution that is itself often structured in very gender-inequitable ways, and that sets people up to fail,” said Dr. Pritlove.

Its ugly side, according to Pritlove and her colleagues, is that unconscious bias takes the focus away from other important and intersecting contexts.

With reference to the domestic sphere, Dr. Pritlove explained that, “implicit bias training decontextualizes the fact that women still take up far more labour in the home, for example.”

“So if we focus on individuals and implicit bias to the neglect of everything else, we're not just ignoring the broader political and social systems but we're also depoliticizing gender inequity,” she said.

The researchers propose that implicit bias training can be one step in a set of many cohesive policies that consider all aspects of inequity. Meaningful interventions will need to be comprehensive and should aim to improve pay equity, transparent hiring and promotion practices, mentorship and sponsorship for women, parental leave, childcare policies, and flexible work arrangements.

“We want people to think about this differently,” said Dr. Parsons. “Our commentary asks people to step back and look at the bigger picture and not get focused on one aspect.”

The AHRC research team suggests turning to countries and institutions that have successfully implemented policies towards gender equity that are more holistic in their approach. Policies need to trickle through and intersect with entire systems: from governments, to organizations, to individuals. While the scope of this paper was focused on gender, Dr. Pritlove noted that this work needs to extend to encompass diversity on a broader scale as well.

Unity Health Toronto, Dr. Parsons said, is well-positioned to make meaningful change. In 2017, St. Michael’s implemented policies to improve gender equity in Research after a review indicated a need for a thoughtful approach. This work has been done in tandem with the University of Toronto’s Department of Medicine and is one example of a shift.

“Because we are affiliated with two large universities and have ties to many agencies, we have an opportunity,” Dr. Parsons said. “We can work to bring together multiple organizations that will align and support our approach to systemic gender equity that goes beyond just one person’s responsibility.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit

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