Does Black vs. White race affect practitioners' appraisal of Parkinson's disease?

Black patients are diagnosed with Parkinson's disease (PD) at half the rate as White patients. The reasons for this large disparity are unknown. Here, we review evidence that practitioner bias may contribute. A key sign of PD is hypomimia or decreased facial expressivity. However, practitioner bias surrounding facial expressivity in Black people versus White people may lead practitioners to appraise Black patients with hypomimia as having higher levels of facial expressivity. Furthermore, practitioner bias may cause them to characterize reduced facial expressivity as being due to negative personality traits, as opposed to a medical sign, in Black patients with hypomimia. This racial bias in the evaluation of hypomimia in Black versus White patients could profoundly impact subsequent referral decisions and rates of diagnosis of PD. Therefore, exploring these differences is expected to facilitate addressing health care disparities through earlier and more accurate detection of PD in Black patients.

Automated summary

Black patients are diagnosed with Parkinson's disease at a lower rate than White patients, and the reasons for this disparity are unknown. Practitioner bias surrounding facial expressivity in Black patients may lead to misinterpretation of hypomimia as higher levels of facial expressivity and negative personality traits. This bias in the evaluation of hypomimia could significantly impact referral decisions and diagnosis rates. Exploring these differences is crucial for addressing healthcare disparities and improving detection of Parkinson's disease in Black patients.