Evolution of attitudes toward people with disabilities in healthcare practitioners and other occupations from 2006 to 2024: A comparative study

PurposeHealthcare practitioners have shown implicit and explicit attitudes that disfavor people with disabilities. This study aimed to describe how these attitudes evolved between 2006 and 2024 across clinicians, rehabilitation assistants, and other occupations. MethodsIn this comparative repeated cross-sectional study, data from 660,430 participants from Project Implicit were analyzed. Implicit attitudes were assessed using D-scores derived from the Disability Implicit Association Test. Explicit attitudes were assessed using a Likert scale. Generalized additive models were conducted to test the evolution of attitudes over time. ResultsExplicit attitudes toward people with disabilities became less unfavorable over time, following a linear pattern. No such effect was found for implicit attitudes. However, non-linear interactions between time, occupation group, and sex suggest a complex effect of time on attitudes that should be interpreted in the context of each specific combination of occupation group and sex, rather than assuming a uniform trend. Attitudes were less favorable toward people with physical disabilities than general disabilities. ConclusionsThe contrast between evolution of implicit and explicit attitudes suggests that implicit bias remains resistant to change despite improving explicit consideration of people with disabilities. Knowledge of these patterns may inform training programs to reduce bias in healthcare and beyond.