The impact of neighborhoods and friendships on interracial anxiety among medical students and residents: A report from the medical student CHANGES study

• Published in: Health services research 2023-08, Vol.58 (4), p.229-237
• Main Authors: Plaisime, Marie V., Jipguep‐Akhtar, Marie, Locascio, Joseph J., Belcher, Harolyn M. E., Hardeman, Rachel R., Picho‐Kiroga, Katherine, Perry, Sylvia P., Phelan, Sean M., Ryn, Michelle, Dovidio, John F.
• Format: Article
• Language: English
• Subjects: Analysis; Anxiety; Anxiety - epidemiology; Black white relations; Changes; Child; Childhood; Children; Cognitive ability; College students; Colleges & universities; Cooperative learning; diversity equityand inclusion (DEI); Evaluation; Friends; Friendship; Group composition; Habits; Health aspects; Humans; Influence; Internet; Internship and Residency; interracial anxiety; Interracial relationships; Longitudinal studies; Marginality; Medical education; Medical personnel; Medical schools; Medical students; mixed effects longitudinal models; Neighborhood; Neighborhoods; Neighbourhoods; Physicians; Polls & surveys; Population studies; Populations; Psychological aspects; Racial Groups; Racial socialization; residents; Residents (Medicine); Retrospective Studies; Students; Students, Medical - psychology; Surveys; Trainees
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.14191

Objective To examine the experience of interracial anxiety among health professionals and how it may affect the quality of their interactions with patients from racially marginalized populations. We explored the influence of prior interracial exposure—specifically through childhood neighborhoods, college student bodies, and friend groups—on interracial anxiety among medical students and residents. We also examined whether levels of interracial anxiety change from medical school through residency. Data Source Web‐based longitudinal survey data from the Medical Student Cognitive Habits and Growth Evaluation Study. Study Design We used a retrospective longitudinal design with four observations for each trainee. The study population consisted of non‐Black US medical trainees surveyed in their 1st and 4th years of medical school and 2nd and 3rd years of residency. Mixed effects longitudinal models were used to assess predictors of interracial anxiety and assess changes in interracial anxiety scores over time. Principal Findings In total, 3155 non‐Black medical trainees were followed for 7 years. Seventy‐eight percent grew up in predominantly White neighborhoods. Living in predominantly White neighborhoods and having less racially diverse friends were associated with higher levels of interracial anxiety among medical trainees. Trainees' interracial anxiety scores did not substantially change over time; interracial anxiety was highest in the 1st year of medical school, lowest in the 4th year, and increased slightly during residency. Conclusions Neighborhood and friend group composition had independent effects on interracial anxiety, indicating that premedical racial socialization may affect medical trainees' preparedness to interact effectively with diverse patient populations. Additionally, the lack of substantial change in interracial anxiety throughout medical training suggests the importance of providing curricular tools and structure (e.g., instituting interracial cooperative learning activities) to foster the development of healthy interracial relationships.