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|Title: ||The BIAS FREE Framework. A practical tool for identifying and eliminating social biases in health research|
|Authors: ||Burke, Mary Anne|
|Keywords: ||health research, sexist biases, racist biases, ableist biases|
hierarchy, pathologization, objectification, victim-blaming, appropriation, decontextualization, overgeneralization, universalization, assumed homogeneity, double standards, denying agency, stereotyping, exaggerating differences, hidden double standards, underrepresentation, exclusion
|Issue Date: ||2006|
|Publisher: ||Global Forum for Health Research|
|Citation: ||Burke, Mary Anne and Eichler, Margrit. The BIAS FREE Framework. A practical tool for identifying and elininating social biases in health research. Geneva: Global Forum for Health Research, 2006|
|Abstract: ||This book presents the BIAS FREE Framework — a tool for identifying and avoiding biases in health research that derive from any social hierarchy. BIAS FREE stands for Building an Integrative Analytical System for Recognizing and Eliminating InEquities. The acronym is the statement of a goal, not an achievement. The BIAS FREE Framework suggests a pathway towards this destination. In this book we concentrate on biases deriving from three social hierarchies only: those based on gender, race and ability, and on the application of the Framework to health research, although in principle it is applicable to all types of research that involve human beings.
The Framework is “integrative” in that it aims to combine, co-ordinate and consolidate the various analytical lenses that have emerged from these various fields of study into a unified whole. It is also “integrative” in that it recognizes that health research is a global public good and that as such, all people have an equal claim to the health research process and its benefits, regardless of their gender, ability, race or other social characteristics, and works towards this end.
It is therefore premised on a rights-based understanding of health, which in turn rests on the following three basic relationships:
1. Health policies, programmes and practices have an impact on human rights.
2. Violations or lack of fulfilment of human rights have negative effects on health (physical, mental, social and spiritual well-being)
3. Health and human rights act in synergy. Promoting and protecting health requires explicit and concrete efforts to promote and protect human rights and dignity; greater fulfillment of human rights necessitates sound attention to health and its societal determinants. Paying attention to the inter-relationship between health and human rights may help to re-orient thinking about major global challenges to health and to broaden human rights thinking and practices.
While the BIAS FREE Framework is applicable not just to research but also to legislation, policies, programmes and practices, in this book the focus is on its application to health research in particular.
The following underlying criteria were used in developing the approach: that it be
• systematic and comprehensive;
• theoretically grounded;
• capable of providing a common terminology describing the various problems;
• applicable to biases deriving from any social hierarchy;
• free from privileging biases deriving from one type of hierarchy (e.g. gender) over those generating from another one (e.g. ability or race);
• capable of identifying intersections and compounding layers of biases deriving from different social hierarchies;
• applicable to research, legislation, policies, programmes, services and practices;
• applicable to any sector, e.g. health, education, justice, industry, transportation communication;
• applicable to all types of research, including one's own or that of others; and
• usable at all stages of the research process.
The framework is open-ended, and defines concepts that have variable meanings in the relevant literatures by operationalizing them through a set of questions that alert the reader to the presence or absence of a bias that derives from a social hierarchy. The existence of social hierarchies gives rise to a tripartite set of problems that may play out in research. Efforts aimed at maintaining a hierarchy, give rise to the first of a tripartite set of problems identified in research. These are clustered in the BIAS FREE Framework under the heading of the Main Problem Type: Maintaining a Hierarchy. The second set of problems arises when one’s position on a given social hierarchy is not examined for its relevance, and ensuing differences are not accommodated. This set of problems is clustered under the Main Problem Type: Failing to Examine Differences. The final set of problems emerges when different groups are treated differently because of their position within a social hierarchy. This set of problems is clustered under the Main Problem Type: Using Double Standards. To identify all three types of problems, we have formulated a set of abstract questions with yes-no answers (see the Framework at the back of the book). Each of the questions has its own solution.
Failing to Examine Differences (the F-Problem) and Using Double Standards (the D-Problem) are two sides of the same coin. The solution to the F-Problem consists of recognizing and accommodating existing differences by treating people differently, while the solution to the D-Problem consists of recognizing and eliminating unwarranted differential treatment. The F- and D-Problems are therefore mutually limiting. The touchstone that lets us decide which type of problem we are dealing with is whether different or same treatment reduces or reinforces an existing hierarchy.
Each of the questions comes with a set of sub-questions and the answers. The various bias problems (which are operationalized in the questions) are:
H – Maintaining an existing hierarchy
H 1 Denial of hierarchy
H 2 Maintenance of hierarchy
H 3 Dominant perspective
H 4 Pathologization
H 5 Objectification
H 6 Victim-blaming
H 7 Appropriation
F - Failing to examine differences
F 1 Insensitivity to difference
F 2 Decontextualization
F 3 Over-generalization or universalization
F 4 Assumed homogeneity
D – Using Double Standards
D 1 Overt double standard
D 2 Under representation or exclusion
D 3 Exceptional under-representation or exclusion
D 4 Denying agency
D 5 Treating dominant opinions as fact
D 6 Stereotyping
D 7 Exaggerating differences
D 8 Hidden double standard
The framework is based on a three-dimensional matrix consisting of the type of hierarchy examined (gender, race, ability, age, class, caste, religion, sexual orientation, etc.), the component of the research process relevant at any particular point of time (research proposal, literature review, research question and design, concepts, theoretical framework, research methods, data analysis and interpretation, conclusions) and the particular type of bias problem.
Extensive examples of all types of biases in all components of the research process are provided. Since no one is a member of only one hierarchy (i.e. a person may be a woman, black, and highly educated living in a high-income country with a good job, or may be a white man, disabled, living in a low-income country) the analytical process is iterative. Different ways of using the framework are discussed.|
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