Race, Ethnicity and Their Implication on Bias in Large Language Models

Large language models (LLMs) increasingly operate in high-stakes settings including healthcare and medicine, where demographic attributes such as race and ethnicity may be explicitly stated or implicitly inferred from text. However, existing studies primarily document outcome-level disparities, offering limited insight into internal mechanisms underlying these effects. We present a mechanistic study of how race and ethnicity are represented and operationalized within LLMs. Using two publicly available datasets spanning toxicity-related generation and clinical narrative understanding tasks, we analyze three open-source models with a reproducible interpretability pipeline combining probing, neuron-level attribution, and targeted intervention. We find that demographic information is distributed across internal units with substantial cross-model variation. Although some units encode sensitive or stereotype-related associations from pretraining, identical demographic cues can induce qualitatively different behaviors. Interventions suppressing such neurons reduce bias but leave substantial residual effects, suggesting behavioral rather than representational change and motivating more systematic mitigation.

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Journal
medRxiv
Published
2026-01-05
DOI
https://doi.org/10.64898/2026.01.04.26343415
Primary Topic
Artificial Intelligence in Healthcare and Education
Type
article
Field-Weighted Citation Impact
0.00

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article

Race, Ethnicity and Their Implication on Bias in Large Language Models

Ruizhe Li, Yanjun Gao, Shiyue Hu
medRxiv
Artificial Intelligence in Healthcare and Education
article

Race, Ethnicity and Their Implication on Bias in Large Language Models

Ruizhe Li, Yanjun Gao, Shiyue Hu
article en

Abstract

Large language models (LLMs) increasingly operate in high-stakes settings including healthcare and medicine, where demographic attributes such as race and ethnicity may be explicitly stated or implicitly inferred from text. However, existing studies primarily document outcome-level disparities, offering limited insight into internal mechanisms underlying these effects. We present a mechanistic study of how race and ethnicity are represented and operationalized within LLMs. Using two publicly available datasets spanning toxicity-related generation and clinical narrative understanding tasks, we analyze three open-source models with a reproducible interpretability pipeline combining probing, neuron-level attribution, and targeted intervention. We find that demographic information is distributed across internal units with substantial cross-model variation. Although some units encode sensitive or stereotype-related associations from pretraining, identical demographic cues can induce qualitatively different behaviors. Interventions suppressing such neurons reduce bias but leave substantial residual effects, suggesting behavioral rather than representational change and motivating more systematic mitigation.

medRxiv
University of Colorado Boulder (US), University of Aberdeen (GB), University of Colorado System (US), University of Colorado Anschutz Medical Campus (US)
National Institutes of Health, U.S. National Library of Medicine
Openalex Percentile: Top 95%
Artificial Intelligence in Healthcare and Education
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Race, Ethnicity and Their Implication on Bias in Large Language Models — Ruizhe Li, Yanjun Gao, et al. · medRxiv (2026) | TGRS Research Map | TGRS