Abstract 282: Race and Gender-Based Perceptions of Older Adults
Authors: Solola MD Sade , Luy Luis , Herrera- Theut BS Kathryn , Zabala BS Leanne , Torabzadehkhorasani MS Elmira , Bedrick PhD Edward , Yee BS Erica , Larsen MS Ashley , Stone PhD Jeff , McEwen PhD Marylyn , Calhoun PhD Elizabeth , Crist PhD, RN Janice D , Hebdon DNP Megan , Pool PhD Natalie , Sweitzer MD, PhD Nancy , Breathett MD, MS Khadijah 
Published: April 2019

Background:
Racial and gender bias affects decision-making in cardiovascular disease, with bias strongest particularly in older patients. Culture shifts often initiate in younger generations. With increased awareness of bias, it is unknown whether racial and gender bias of older individuals persist among the younger general public.

Methods:
From June through July 2018, we identified how an individual’s race and gender are associated with perceptions of photographed older Whites and Blacks using Amazon’s Mechanical Turk, a crowdsourcing marketplace for electronic surveys. Photos were preselected by study team to include individuals with similar facial features, age, and clothing. An international population of adult participants was randomly provided 16 out of 32 photos of White or Black women or men aged 65+ years, with or without stated heart failure. Using Likert scale 1-10, participants were asked to rate photos for health, attraction, intelligence, trustworthiness, and facial expression (happy, sad, neutral, and threatening). Mixed effect models were used to assess the interactions between participant and photo race and participant and photo gender with delta representing rating differences for White and Black photos or women and men photos.

Results:
Among 1563 participants, 63% were Non-Hispanic White, 71% US, 61% women, and average 35 years ± 12. Compared to White photos, both minority (MP) and White participants (WP) perceived Black photos as more trustworthy [Delta WP -0.59 (95%CI:-0.87,-0.32); Delta MP -0.50 (-0.78,-0.22), participant race-by-photo race interaction p=0.05] and less threatening, particularly among WP [Delta WP 0.79(0.24,1.33); Delta MP 0.60 (0.05,1.15), interaction p<0.001]. WP perceived Black photos more favorably for attraction and intelligence compared to MP who perceived no racial differences (interaction p<0.001). Both genders perceived photos of women as more trustworthy, but differences in trustworthy ratings between women and men photos were greater among women participants (WmP) [Delta WmP 0.50(0.23,0.78); Delta men Participants (MnP) 0.31(0.03,0.59); participant gender-by-photo gender interaction p<0.001]. Both genders perceived men as more threatening [Delta WmP -0.84(-1.39,-0.29), Delta MnP -0.77(-1.32,-0.22), interaction p=0.93]. Only WmP perceived women as more happy [(Delta WmP 0.80 (0.07,1.52); Delta MnP 0.42(-0.31,1.14), interaction p<0.001)]. Other ratings were not significant by race nor gender.

Conclusions:
Among a younger international generation, older Blacks were perceived more favorably than Whites, particularly by White participants. Perceptions based upon gender followed many gender norms. This suggests that explicit bias against minorities may be decreasing, but gender biases persist. Future work should investigate whether similar patterns are observed in healthcare professionals.