What is Bias in Health and Social Care

What is Bias in Health and Social Care?

Diversity, Equality and Inclusion

Care Learning

4 mins READ

Biases are preconceived notions or attitudes that can influence a person’s thoughts, behaviours, and interactions, often subconsciously.

In health and social care, biases can significantly impact the quality of care provided and the overall wellbeing of service users.

Different Types of Bias

Here’s a closer look at the different types of biases and their implications:

Implicit Bias

Implicit bias refers to the attitudes or stereotypes that unconsciously affect our understanding, actions, and decisions. These biases can be especially concerning in care settings as they can influence interactions with service users without the care worker even realising it.


  • Unequal Treatment: Some service users might receive more attentive care and better support than others based on gender, race, age, disability, or other characteristics.
  • Communication Barriers: Implicit biases might lead to misunderstandings or reluctance to address concerns properly.
  • Trust and Rapport: Service users may sense bias and feel mistrustful or dissatisfied, hindering the therapeutic relationship.

Confirmation Bias

Confirmation bias is the tendency to search for, interpret, and remember information in a way that confirms one’s preconceptions.


  • Diagnostic Errors: Care workers may overlook critical information or symptoms because they do not align with their pre-existing beliefs.
  • Poor Decision-Making: This can result in inadequate care plans based on incomplete or selective information.


Stereotyping involves having generalised beliefs about a particular group of people, which can lead to over-simplified and often inaccurate assumptions.


  • Reduced Individualised Care: Care workers may unfairly assign attributes to individuals based on stereotypes rather than seeing each service user as unique.
  • Discrimination: This can lead to unfair treatment, exclusion, and unequal opportunities for service users from marginalised groups.

Cultural Bias

Cultural bias occurs when care workers favour their own cultural norms and values over those of others.


  • Lack of Cultural Competence: It can result in care practices that are insensitive or inappropriate to the needs of individuals from different cultural backgrounds.
  • Inequitable Services: Service users from minority cultures may feel alienated or underserved.


Ageism is prejudice or discrimination against individuals based on their age.


  • Elderly Bias: Older adults might not receive adequate consideration for active treatment plans and may instead be prescribed palliative care more quickly than younger individuals.
  • Youth Bias: Younger individuals may have their concerns dismissed or not taken seriously.

Gender Bias

Gender bias refers to the preferential treatment or prejudice against individuals based on their gender.


  • Service Disparities: Men and women might receive different levels of care or have their symptoms interpreted differently.
  • Undermining Professionalism: Gender bias can affect professional dynamics and teamwork within care environments.

Addressing Bias in Care Work

It’s crucial to recognise and address biases to ensure high-quality, equitable care for all service users.

Strategies include:

  • Training and Education: Regular training on cultural competence, anti-discrimination, and awareness of implicit biases.
  • Reflective Practice: Encouraging care workers to reflect on their own attitudes, seek feedback, and remain open to learning.
  • Diverse Workforce: Promoting diversity within the care team to bring various perspectives and mitigate single-lens biases.
  • Policy and Procedure: Implementing policies that actively address and mitigate bias, incorporating checks and balances in care delivery.
  • Patient-Centred Care: Focusing on individualised care plans that respect and respond to the unique needs of each service user.

Example of Bias in Care Homes

Here are some concrete examples of how biases can manifest in care homes:

Racial Bias

Care homes may demonstrate racial bias, intentionally or unintentionally, which affects the quality of care for residents of different ethnic backgrounds.


  • Communication Barriers: Staff may not make adequate efforts to communicate effectively with non-English speaking residents or those from different racial backgrounds, leading to misunderstandings and suboptimal care.
  • Cultural Insensitivity: Failing to provide culturally appropriate food options or to respect cultural practices and traditions can make non-white residents feel neglected or misunderstood.

Age Bias

Often called ageism, this bias leads to discrimination against individuals based solely on their age.


  • Neglect: Assuming that older residents are incapable of being actively involved in decision-making about their own care, thereby limiting their autonomy and agency.
  • Activity Limitations: Automatically excluding older residents from engaging in physical or social activities based on their age rather than their physical condition or personal preferences.

Gender Bias

Gender bias affects the care provided to residents based on their gender, often reflecting societal stereotypes.


  • Assumptions about Interests: Assuming female residents would prefer activities like knitting, while male residents are directed towards more active or mechanical tasks, thereby limiting personal choice and reinforcing stereotypes.
  • Unequal Access to Care: Men might receive less emotional support or conversation, assuming they are less in need of emotional care compared to women.

Disability Bias

This bias involves prejudices against individuals with disabilities, leading to inadequate or inappropriate care.


  • Overprotection: Non-disabled staff might overly protect residents with disabilities, limiting their independence and ability to participate in daily activities.
  • Underestimation of Capabilities: Assuming that residents with cognitive impairments are incapable of understanding their care plans or participating in discussions about their own health needs.

Socioeconomic Bias

Bias based on socioeconomic status can affect the level of care residents receive.


  • Resource Allocation: Residents who are perceived as coming from wealthier backgrounds might receive preferential treatment, such as more attentive care or priority in receiving new or better equipment.
  • Judgmental Attitudes: Staff may unconsciously give less attention or compassion to those they perceive as lower-income or believe are less deserving of high-quality care.

Sexual Orientation Bias (Homophobia)

Bias against residents based on their sexual orientation can lead to discriminatory practices and hostile environments.


  • Lack of Inclusivity: Failing to recognize and support the romantic relationships or partnerships of LGBTQ+ residents, such as not allowing a same-sex partner to visit or stay overnight.
  • Discriminatory Behavior: Staff making inappropriate comments or showing discomfort when dealing with LGBTQ+ residents, leading to feelings of isolation and distress for those residents.

Religious Bias

Bias related to religious beliefs can result in care that is insensitive to the religious needs and practices of residents.


  • Ignoring Religious Practices: Neglecting to accommodate residents’ religious practices, such as providing time and space for prayer, or dietary requirements during religious observances.
  • Lack of Respect: Making offhanded comments or jokes about a resident’s religious beliefs, creating a disrespectful and hurtful environment.

Bias in care homes can significantly impact the wellbeing and quality of life of residents.

By recognising, addressing, and actively working to mitigate these biases, care homes can create a more equitable, respectful, and supportive environment for all residents.

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