How the Use of Race in Clinical Care Can Contribute to Health Care Disparities

A new KFF brief examines the use of racial classification in medical care and teaching and identifies how these practices can contribute to ongoing racial disparities in health and health care. There are growing efforts within the medical community to examine and revise the use of race in medical care and training and to acknowledge the role of racism in shaping treatment.

The overview summarizes how the medical and scientific community have used race to explain differences in health despite there being no biologic basis to race and how race continues to be used in medical diagnosis and decision-making. It explores several ways race impacts medical care and teaching:

• Provider Bias and Discrimination. There is substantial research that provider and health system bias and discrimination are drivers of disparities, contributing to racial differences in diagnoses, treatment decisions, and pain management.
• Disease Stereotyping and Nomenclature. Some medical training approaches and materials misuse race as a surrogate for genetic ancestry and socioeconomic status and some disease names use racial and geographic terms that can improperly link them to certain communities.
• Use of Race in Clinical Algorithms, Tools and Guidelines. Although race is not a reliable stand-in for genetic ancestry, some clinical estimators or algorithms assign differential risks or treatments to patients based on race, which can lead to misdiagnosis and inappropriate treatment. Diagnostic and teaching tools may also lack appropriate representation to allow for accurate diagnosis for certain groups.
• Race-based Pharmacological Prescribing Guidelines. Race plays a factor in the dosing and prescribing of certain drugs for patients and the use of race in the emerging field of personalized medical therapy is under growing scrutiny given that genetic variation within racial/ethnic groups can exceed variation across groups.

Read the issue brief, Use of Race in Clinical Diagnosis and Decision Making within Health Care: Overview and Implications, for a fuller discussion and visit the Racial Equity and Health Policy topic page for related content.