Representation of Skin of Color in Dermatologic Media and Healthcare Trust
Enyao Zhang, Vedha Dande, Latha GantiBackground
Dermatologic educational materials and media have historically underrepresented darker skin tones. Limited representation may be associated with perceptions of inclusivity and experiences of dermatologic care.
Objective
To assess associations between perceived skin tone representation in dermatologic media and self-reported healthcare experiences and information-seeking behaviors.
Methods
We conducted a secondary analysis of an anonymous, cross-sectional U.S. web-based survey (n = 205), using descriptive statistics, chi-square tests, and age- and gender-adjusted logistic regression. Open-ended responses were examined thematically.
Results
Of 205 respondents, 118 (57.6%) perceived predominantly White/fair skin imagery online. After adjustment for age and gender, this perception was associated with higher odds of treatment dissatisfaction (adjusted odds ratio {aOR}, 2.82; 95% CI, 1.27–6.56; p = 0.011) and reliance on social media for skincare information (aOR, 4.87; 95% CI, 2.19–11.15; p < 0.0001), but not significantly with delayed care (aOR, 1.92; 95% CI, 0.81–4.48; p = 0.139). Open-ended responses addressed access, representation, and healthcare experiences.
Conclusions
Perceived predominance of White/fair imagery in dermatologic media was associated with treatment dissatisfaction and online skincare information-seeking in this cross-sectional sample. More representative educational materials warrant study, but causality and effects on healthcare trust cannot be established from these data.