Misrepresenting Race — The Role of Medical Schools in Propagating Physician Bias

Amutah, Christina; Greenidge, Kaliya; Mante, Adjoa; Munyikwa, Michelle; Surya, Sanjna; Higginbotham, Eve J.; Jones, David S.; Lavizzo‐Mourey, Risa; Roberts, Dorothy E.; Tsai, Jennifer; Aysola, Jaya

doi:10.1056/nejmms2025768

Cited by 252 publications

(218 citation statements)

References 48 publications

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“…14 Genetic variations are more likely by geographical ancestry than by racial categorization. 15 Even if assuming any biological difference, given the mixture of racial identities, particularly as people of different races come together to procreate, a clear distinction is often impossible. Being a social construct, racial identity can differ, depending on placefor example, a person considered Black in the US (bi-racial, having one Black parent) may be considered White in West Africa.…”

Section: Race: a Social Constructmentioning

confidence: 99%

Examining the Inclusion of Race and Ethnicity in Patient Cases

Okoro

Arya

Gaither

et al. 2021

American Journal of Pharmaceutical Education

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Health disparities continue to exist in the United States, with the most significant differences occurring between racial groups. Racial health disparities are largely a result of the strong association between race and structural inequities -the systematic differential in the distribution of power, resources, opportunities, and exposures across racial populations. The use of case-based learning is common practice in pharmacy education, with race often included out of convention. In some cases, race is included to inform treatment based on guidelines developed from epidemiological and clinical studies that link race to disease by conferring biological significance to race categories. This continuing use of race/ethnicity to guide treatment contributes to racial health disparities, and may further perpetuate existing provider implicit bias. This paper discusses the pedagogical approach of using patient cases; convention, propriety, and implications of including race in patient cases; and guides pharmacy educators on how to utilize information on race.

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Section: Race: a Social Constructmentioning

confidence: 99%

Examining the Inclusion of Race and Ethnicity in Patient Cases

Okoro

Arya

Gaither

et al. 2021

American Journal of Pharmaceutical Education

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“…Historically, the understanding of 'race' as a biological construct is a remnant of a discredited theory of racial classification developed in the eighteenth century by Johann Blumenbach, a German physician anthropologist, who invoked the false idea that races are biological and that there are ranked subdivisions of the human species with 'Caucasians' (White) placed as the superior race or at the top of the racial classification or hierarchy [93][94][95]. Indeed, there are renewed calls for medical schools to stop promoting 'race' as biology and offering specific recommendations for improvements [96] including an anti-racist approach [97].…”

Section: Clustermentioning

confidence: 99%

Experiences of everyday racism in Toronto’s health care system: a concept mapping study

Mahabir

O’Campo²,

Lofters

et al. 2021

Int J Equity Health

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Background In Canada, there is longstanding evidence of health inequities for racialized groups. The purpose of this study is to understand the effect of current health care policies and practices on racial/ethnic groups and in particular racialized groups at the level of the individual in Toronto’s health care system. Methods This study used a semi-qualitative study design: concept mapping. A purposive sampling strategy was used to recruit participants. Health care users and health care providers from Toronto and the Greater Toronto Area participated in all four concept mapping activities. The sample sizes varied according to the activity. For the rating activity, 41 racialized health care users, 23 non-racialized health care users and 11 health care providers completed this activity. The data analysis was completed using the concept systems software. Results Participants generated 35 unique statements of ways in which patients feel disrespect or mistreatment when receiving health care. These statements were grouped into five clusters: ‘Racial/ethnic and class discrimination’, ‘Dehumanizing the patient’, ‘Negligent communication’, ‘Professional misconduct’, and ‘Unequal access to health and health services’. Two distinct conceptual regions were identified: ‘Viewed as inferior’ and ‘Unequal medical access’. From the rating activity, racialized health care users reported ‘race’/ethnic based discrimination or everyday racism as largely contributing to the challenges experienced when receiving health care; statements rated high for action/change include ‘when the health care provider does not complete a proper assessment’, ‘when the patient’s symptoms are ignored or not taken seriously’, ‘and ‘when the health care provider belittles or talks down to the patient’. Conclusions Our study identifies how racialized health care users experience everyday racism when receiving health care and this is important to consider in the development of future research and interventions aimed at addressing institutional racism in the health care setting. To support the elimination of institutional racism, anti-racist policies are needed to move beyond cultural competence polices and towards addressing the centrality of unequal power social relations and everyday racism in the health care system.

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“…One recent study showed that a substantial number of White laypeople, medical students, and residents hold false beliefs about biological differences between Black and White people and demonstrated that these false beliefs predict racial bias in pain perception and treatment recommendation accuracy (34). This is in part because race is misrepresented in preclinical curricula (35), as well as that over the last 30 years, the world's top medical journals have rarely published scientific articles about the impact of racism on health (36). There are also limits to classroom education on public health and primary care.…”

Section: Historical Roots Of Racism Stem From Medicine and Research Sciencementioning

confidence: 99%

The Case for Health Reparations

Soled

Chatterjee

Ölveczky

et al. 2021

Front. Public Health

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The disproportionate impact of COVID-19 on racially marginalized communities has again raised the issue of what justice in healthcare looks like. Indeed, it is impossible to analyze the meaning of the word justice in the medical context without first discussing the central role of racism in the American scientific and healthcare systems. In summary, we argue that physicians and scientists were the architects and imagination of the racial taxonomy and oppressive machinations upon which this country was founded. This oppressive racial taxonomy reinforced and outlined the myth of biological superiority, which laid the foundation for the political, economic, and systemic power of Whiteness. Therefore, in order to achieve universal racial justice, the nation must first address science and medicine's historical role in scaffolding the structure of racism we bear witness of today. To achieve this objective, one of the first steps, we believe, is for there to be health reparations. More specifically, health reparations should be a central part of establishing racial justice in the United States and not relegated to a secondary status. While other scholars have focused on ways to alleviate healthcare inequities, few have addressed the need for health reparations and the forms they might take. This piece offers the ethical grounds for health reparations and various justice-focused solutions.

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Misrepresenting Race — The Role of Medical Schools in Propagating Physician Bias

Cited by 252 publications

References 48 publications

Examining the Inclusion of Race and Ethnicity in Patient Cases

Examining the Inclusion of Race and Ethnicity in Patient Cases

Experiences of everyday racism in Toronto’s health care system: a concept mapping study

The Case for Health Reparations

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