SECTION 3
Race-Based Medicine in Diagnosis and Treatment "In multiple medical textbooks (such as Robbins and Cotran) and popular health reference websites (such as Medscape, WebMD, UpToDate), I have seen race as a risk factor in disease and pathology, particularly among Black and Hispanic/Latinx communities. Whether it’s hypertension, kidney failure, interstitial lung disease, asthma, diabetes, and more…the medical community has cemented one’s race as a biological destiny and of inherent biological danger. This framing misses the point: Racism, not race, is a risk factor."
TH I R D -Y E A R M ED I CA L ST U D ENT
THE CONCEPT OF RACE has no biological basis. Racism, not race, has been and continues to be a key determinant of health outcomes, especially in the United States. Research that falsely biologizes race dates back to colonialization and slavery, and contemporarily translates to poor clinical guidelines. And yet, medicine continues to uphold the idea of biological race—and, thus, racism—in diagnosis and treatment schema. What does this look like in context? Clinicians will use a patient’s skin color and ethnicity as heuristics to determine their diagnosis and treatment plan. In fact, race serves as a shortcut for clinical thinking from the onset of training, as evidenced in the United States Medical Licensing Examination. A study question tweeted by the American College of Obstetricians and Gynecologist (@ACOGAction) reads, A 33-year-old married African American woman comes to your office and admits to thoughts of suicide for the last month. She was previ-
ously diagnosed with bipolar disorder, but has never attempted suicide before. Which of the following characteristics is associated with an elevated epidemiological risk for suicide? The listed options are A. Age < 35, B. Bipolar disorder, C. Lower socioeconomic status, D. Being married, and E. Black race.”68 Although the correct answer, according to the ACOG, is B. Bipolar disorder, question writers likely included “Black race” as an option because they thought test takers would rely on the pervasive, yet false, assumption that race is an epidemiological risk factor for various pathologies. Another test prep resource offers the following on sickle cell anemia: Sickle cell disease (SCD) is a multisystem disorder and the most common genetic disease in the United States, affecting 1 in 500 African Americans.69
Toward the Abolition of Biological Race in Medicine
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