Race-Based Medicine is a Legacy of Slavery

Photograph of woman and child at a cocoa bean plantation (believed to be taken in the late 1800s).

Racial mythology regarding biological racial differences in Black people arose as a justification for slavery; incredibly, this “race as biology” ideology continues to inform medical practice today. In keeping with the mission of The 1619 Project (to highlight the legacy of slavery in modern America), race-based medicine is a powerful example.

What is Race-Based Medicine?

Believe it or not, today (in the 21st century) doctors are using race-based algorithms to adjust the medical results of Black patients; in other words, they modify patients’ test results to make them match up with presumed biological differences. Race-based medicine isn’t just obviously discriminatory and problematic, these racially-adjusted results are used to make important clinical decisions. In the US, this often results in directing life-saving medical resources away from African-American patients.

In kidney medicine, physicians have been altering the kidney function tests of Black patients by multiplying their scores by 1.2. The pseudoscientific rationale for this alteration is the unsubstantiated belief that Black patients have genetically higher levels of a chemical waste product called creatinine than all other races. Furthermore, the use of “Black race” to estimate kidney function causes devastating delays in medical treatments such as dialysis and kidney transplants among African Americans. A 2020 study found that at one hospital, one-third of Black patients would have had their disease classified as more serious, and in turn, would have received earlier referrals for dialysis and transplants had their medical results not been racially adjusted.

The issue of race-based medicine has recently become a hot topic in the US medical community, with national kidney organizations recommending ending the practice in 2021. However, it is important to note that there are numerous other race-based algorithms that discriminate against Black patients, and these continue to be used across a whole range of medical specialties.

Medicine Needs to Move into the 21st Century

In summary, the idea of biological racial differences persists as a dominant theme in the culture and practice of modern medicine, despite having no scientific basis. This antiquated and pseudoscientific ideology contributes to devastating inequities in healthcare. Medicine needs to move into the 21st century by acknowledging that health differences between different ethnic groups are largely due to social inequality, not genetics; it’s time to focus on the social determinants of health and stop conflating biology with race.



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Clare Xanthos, PhD

Clare Xanthos, PhD

WRITER. SCHOLAR. RESEARCHER. Interests: Racial Equity, Racial Justice, Colorblind Racism. Co-Editor: Social Determinants of Health among African-American Men.