| Abstract [eng] |
Background. Unconscious bias is a pervasive phenomenon that compromises health outcomes and perpetuates societal disparities. Despite its critical impact, the foundational mechanisms driving unconscious biases—specifically their evolutionary and cognitive origins—remain contested in contemporary literature, complicating efforts to mitigate them. Aim. To review unconscious bias by defining its theoretical foundations, examining its impact on health and healthcare, and evaluating its possible evolutionary origins. Objectives. 1) To establish a conceptual framework for unconscious bias, including its definition, related terminology, and a typology of its forms. 2) To detail the impact of unconscious bias on health and healthcare. 3) To critically evaluate evolutionary perspectives of unconscious bias by synthesizing findings from neuroscience, cognitive science, evolutionary psychology, and philosophy of science. Methods. A narrative literature review was conducted using PubMed, PsycINFO, PhilPapers and Google Scholar, supplemented by the Stanford Encyclopedia of Philosophy and StatPearls. Search included combinations of keywords related to evolutionary theory, cognitive architecture, unconscious bias, and social cognition. In total 129 articles were included in the review. Results. Unconscious biases are automatic associations that happen without conscious awareness. They influence how people see the world and how they behave, and they often lead to discrimination. Because biases are common and hard to change, some researchers think they may have evolved as part of human psychology. There are two main ways to explain the origins of unconscious biases. The first, domain-specific approaches, suggest that these biases are evolved adaptations. In the past, they may have helped people deal with recurring problems such as avoiding disease, detecting danger, or protecting resources. The second, domain-general perspective, argues that unconscious biases are by-products of basic mental processes like learning from experience, grouping things into categories, and making predictions. These processes can lead to biased thinking, especially in environments where social biases already exist. Conclusions. This literature review examined the concept of unconscious bias and its evolutionary explanations. The findings indicate that the concept is theorized inconsistently throughout the literature. Moreover, unconscious bias remains a pervasive phenomenon that poses significant public health challenges. Finally, existing evolutionary accounts lack sufficient theoretical and empirical validity, and a domain-general perspective provides a plausible explanation for the origins of unconscious bias. |
