Robin Glasco on Addressing Systemic Bias in Data by a Foundation on Building Equity

In an interview with The American Journal of Managed Care®, Robin Glasco, MBA, Executive Leadership Advisor of Spencer Stuart, delved into the nuanced factors that perpetuate bias in health data—the topic of her presentation during the Coalition for Affordable Quality Healthcare (CAQH) Connect conference.

Reflecting on her talk, Bridging the Gap: Ensuring Data Supports Health Equity in Complex Systems, she examined the crucial role of data in addressing urgent challenges in health care while inherent and systemic biases coexist, complicating efforts to achieve equity.

“This is the hardest piece because the system has existed for a while, but it impacts everything when we have built a foundation—we've built the walls, we've built the roof—on a platform of bias,” Glasco said.

Her long-standing career in health equity can be traced back to the bias she encountered as a young African American woman seeking health care. “There were assumptions made about me that were completely false—about my education, my diet, and my background,” she explained. These biases weren’t just spoken; they were documented in her health record.

Her experience reflects that of many Americans and the broader systemic issues of the US health system, Glasco emphasized. The problem isn’t solved by saying, “Oh, you’re Black, get a Black doctor,” she said. It’s a systemic issue, and bias exists in the tools we use, the data we collect, and the questions we ask, she explained. It’s ingrained in the system because it’s embedded in medical schooling, in the curriculum, and in the policies and procedures that were created by people, and therefore, not immune to bias.

Changing this requires a comprehensive overhaul, starting with education, she said. Foundational efforts should examine the teaching of future clinicians, the curriculum, the instructors, and all the aspects of medical education to address inherent bias.

Glasco underscored another critical area: the role of non-clinicians in health care. As someone who isn’t a clinician but works within the health care ecosystem, she observes assumptions being made beyond direct patient care. For Glasco, one solution lies in returning to the simplicity of the doctor-patient relationship.

“Of all the things within our United States that I think we should go back to is the simplicity of doctor-patient [relationships],” she said. “We have put so much in the middle—deductibles and acronyms and policy and barriers to care…—this is not an easy fix.”

Despite this, Glasco believes in being relentless in addressing the issue and failing to give up striving to improve health equity. “There’s no challenge that's too great, and I don't think this is; this is a big, great challenge, but not one we can't resolve because there are other countries who have.”