Evolution of Attitudes Toward People with Disabilities Among Health Care Practitioners and Other Workers, 2006–2024

Purpose: Health care practitioners have shown implicit and explicit attitudes that disfavour people with disabilities. I describe how these attitudes evolved between 2006 and 2024 across clinicians, rehabilitation assistants, and individuals in other occupations. Method: I analyzed data from 660,430 participants from Project Implicit. Implicit attitudes were assessed with Disability Implicit Association Test (IAT) D-score. Explicit attitudes were assessed using a Likert scale. I conducted generalized additive models to test the evolution of attitudes over time. Results: Explicit attitudes toward people with disabilities became less unfavourable over the 19 years of the study, irrespective of occupation. This effect was not observed 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. Additionally, attitudes were more unfavourable toward people whose disability was physical. Conclusions: The contrast between the evolution of implicit attitudes and that of explicit attitudes suggests that implicit bias remains resistant to change despite improving explicit consideration of disabled people. Knowledge of these patterns may inform training programmes to reduce bias in health care and beyond.