The Shocking Way Your Race Affects Your Health Without You Knowing It
Experts say that racial stereotypes are baked into the health calculators used by doctors every day.
Racial inequity when it comes to healthcare is a multi-faceted issue. Not only are Black Americans more likely to live in "food deserts"–areas in which fresh and healthy food is not readily available–and to be uninsured than white people, there are also issues of implicit bias among medical professionals. Studies and surveys have proven that a significant portion of doctors and other healthcare workers believe that Black people experience less pain, which can lead to misdiagnoses or a lack of proper treatment. And new research published in The New England Journal of Medicine posits that there's even racial bias in some of the tools and calculators doctors use to diagnose their patients every day—bias those doctors may not even be aware is there.
The article explains that some "diagnostic algorithms and practice guidelines … adjust or 'correct' their outputs on the basis of a patient's race or ethnicity." According to the article, these tools are used by doctors to produce information that helps to guide treatment, including calculating an admitted patient's risk of dying from heart failure, estimating kidney function, and evaluating labor risks for pregnant patients who've had cesarean sections.
But is race actually a factor in determining those things? The researchers looked into the logic behind inputting race into these algorithms and found that they're built on some shaky science.
"Some algorithm developers offer no explanation of why racial or ethnic differences might exist," the study reads. "Others offer rationales, but when these are traced to their origins, they lead to outdated, suspect racial science or to biased data."
The research cites a 2019 study published in Women's Health Issues, which shows that Black and Hispanic women receive higher scores on the widely used labor risk calculator because of outdated medical assumptions that white women are better suited to give birth. Because of this, Black and Hispanic women are disproportionately pushed into cesarean surgeries as opposed to vaginal births, which are often safer. In 2018, 14.7 white women out of every 100,000 died of pregnancy-related deaths, per NBC News, while for Black women, the rate was 37.1 out of 100,000.
In its coverage of The New England Journal of Medicine research, The New York Times notes that there is an adjustment for race in the kidney function calculator, based on decades-old studies that may not have accurately incorporated the effect of race on kidney function, if there even is any. The Times reports that "labs routinely use a kidney function calculator that adjusts filtration rates for black patients. With the adjustment, black patients end up with slightly better rates than whites, which can be enough to make those with borderline rates ineligible to be on a kidney transplant list."
The authors hope that their research spawns a reevaluation of the tools that may be incorrectly reflecting or incorporating race so that doctors can offer their patients better care. "If doctors and clinical educators rigorously analyze algorithms that include race correction, they can judge, with fresh eyes, whether the use of race or ethnicity is appropriate," the study reads. And for vital information on taking care of yourself, here's The One Health Appointment You Definitely Shouldn't Skip This Year.