Race is a social and power construct whose meaning has shifted over time. Racist beliefs in medicine fostered the continuation of these notions. In this commentary, we review race-based medicine versus race-conscious medicine. Race-conscious medicine emphasizes racism as a key determinant of illness and health. Racism in obstetrics and gynecology has deep roots in its history. The use of race in clinical decision-making tools, such as those that predict successful vaginal birth after cesarean delivery, should be eliminated. Research that explores the complexities of health disparities and their effects on clinical outcomes are pivotal to race-conscious approaches in medicine.
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http://dx.doi.org/10.1097/GRF.0000000000000756 | DOI Listing |
Milbank Q
December 2024
Milken Institute School of Public Health, George Washington University.
Policy Points In a recently commissioned report on solutions for eliminating racial and ethnic health care inequities entitled Ending Unequal Treatment, the National Academies of Sciences, Engineering, and Medicine found a health workforce that is representative of the communities it serves is essential for health care equity. The Supreme Court decision to ban race-conscious admission constraints pathways toward health workforce representativeness and equity. This paper draws on the National Academies report's findings that health care workforce representativeness improves care quality, population health, and equity to discuss policy and programmatic options for various participants to promote health workforce representativeness in the context of race-conscious admissions bans.
View Article and Find Full Text PDFJ Gen Intern Med
November 2024
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
Background: Medical mistrust among Black patients has been used to explain the existence of well-documented racial inequities at the end of life that negatively impact this group. However, there are few studies that describe patient perspectives around the impact of racism and discriminatory experiences on mistrust within the context of serious illness.
Objective: To better characterize experiences of racism and discrimination among patients with serious illness and its association with medical mistrust.
Ann Surg
August 2024
Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI.
JAMA Cardiol
October 2024
Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia.
J Gen Intern Med
October 2024
Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, The City University of New York, New York, NY, USA.
Emerging consensus in the medical and public health spheres encourages removing race and ethnicity from algorithms used in clinical decision-making. Although clinical algorithms remain appealing given their promise to lighten the cognitive load of medical practice and save time for providers, they risk exacerbating existing health disparities. Race is a strong risk marker of health outcomes, yet it is not a risk factor.
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