Year: 2024
Type: article
Abstract: Teaching and learning patient advocacy in academic health centers requires critical engagement with social, political, and cultural conceptions of racial difference.This article considers understandings of race and racism typically drawn upon in health care and suggests which historical and social science-based approaches should be used in health professions teaching and learning.Navigating Complex Terrain Racial categories, often derived from US census categories, have been used in studies of risk factors for illness and disease as well as in diagnostic and clinical algorithms that adjust for the imputed race of a health care seeker.1,2,3 Discussion of these uses of race or ethnicity as "markers of an intrinsic health difference between human populations" 4 has produced widespread debate over how to reckon with ongoing systemic inequalities that contribute to racial inequalities in health and the use of race as a proxy for genetic differences in supposedly hereditable traits.5 Responding to lingering perceptions that racial categories constitute a biologically salient and observable basis of difference, Dorothy Roberts argues in her book, Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-First Century, that an assumed biological basis of race was preceded by the employment of racial difference for the purposes of political and social classification, exploitation, and separation.6 Indeed, scientific racism or biological explanations of racial difference and ordering developed in tandem with European colonial expansion and the trans-Atlantic slave trade.While it was established decades ago that race has no underlying biological basis, 7 the biological effects of racism on health are easily demonstrable in health disparities and disparities in care due to clinician bias, to name 2 examples.Importantly, the ongoing effects of the use of race in medicine are the subject of contemporary debates in medical education.Race in Health Care While the hereditary basis of racially and ethnically associated disease categories, such as sickle cell disease and Tay-Sachs disease, are well known, race-based thinking in medicine exists across many different areas of practice and training.In 2021, the American College of Obstetricians and Gynecologists shifted its stance about using race as risk factor in the vaginal birth after cesarian calculator 8 after articles critiquing the
Source: The AMA Journal of Ethic
Authors: Alexandre White, Jeremy A. Greene
Institution: Johns Hopkins University
Language: English
Topic: Race, Genetics, and Society
Subfield: Genetics
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4390632620