Race-Based Medicine: Rooted in Slavery, Yet Still Endorsed in 2025
Instead of obsessing over genetic racial differences, medical scholars should be addressing the real reason for health inequities.
As someone who is the product of parents from two different so-called “races” (Black and White), the framing of race as a biological category has always made me uneasy. After all, my very existence as someone of “mixed race” indicates that race is biologically meaningless; distinct biological categories of people wouldn’t produce viable offspring.
Yet mindbogglingly, one hundred and sixty years after the abolition of slavery, myths about biological differences between races persist in medicine and science. This ideology can be observed at the highest levels of the U.S. healthcare system. For example, in 2021, Robert Francis Kennedy Jr., now serving as the United States Secretary of Health and Human Services, seemingly endorsed the idea of “race as biology” when he stated:
“We should not be giving Black people the same vaccine schedule that’s given to whites because their immune system is better than ours.”
This statement demonstrates a long history of racial mythology that continues to influence medicine today.
Racism is foundational to American medicine
Myths about biological racial differences were promoted during slavery as a justification for its brutality. Medical scholars Anderson et al., writing in Academic Medicine, note that early physicians played an important role in contributing to these harmful narratives.
In particular, the use of enslaved individuals for medical experiments demonstrates that physicians were active participants in some of the most horrifying practices of this period. The need to rationalize these acts of cruelty clearly required the dehumanization of people of African descent. In turn, this mindset played a role in the development of race science — the false notion that Black people were biologically different from other races.
These racial myths also had an impact on the public health policies of the day. During Philadelphia’s yellow fever epidemic of 1793, Black people were singled out to care for the sick based on the incorrect belief that they were immune to the disease. This led to the deaths of many Black healthcare workers who were exposed to infection.
As Anderson and colleagues emphasize, racism is foundational, rather than incidental, to American medicine. Thus, while biological racism originated centuries ago, its influence continues today in healthcare practices and medical research.
Race-based frameworks are still utilized across medical specialties
Imagine a kidney patient in desperate need of dialysis or a transplant, only to discover that their treatment was delayed due to pseudoscientific “race correction” practices. These adjustments (based on presumed biological differences) distort Black patients’ kidney function test results, making their kidneys appear healthier than they are. A 2020 study showed that one-third of Black patients at a hospital experienced delays in life-saving treatments due to this practice.
Racial bias also manifests itself in pain management. A 2016 study found that many white medical trainees believed that Black individuals had thicker skin and less sensitive nerve endings. A 2021 paper indicated that these myths still inform care decisions today, leading to inadequate pain management for Black patients.
A lesser-known example is the racialization of blood donation. Many blood services continue to be preoccupied with racial differences in their donor recruitment drives, reinforcing problematic beliefs regarding biological race.
In the 2020s, there has been some progress in the movement to end race-based medicine (e.g., the campaign to remove racialized clinical algorithms). However, challenges remain. Even in 2025, race-as-biology frameworks continue to seep into medical practice, reinforcing harmful stereotypes; leading to poor health outcomes among Black patients; and contributing to ongoing inequities.
Race medicine ideology continues to appear in scientific literature, disguised as an effort to promote health equity.
Despite clear evidence that race is a social construct, there is a reluctance among some scientists to move away from genetic explanations of racial health inequities. Race medicine ideology continues to appear in scientific literature, often disguised as an effort to promote health equity.
In a 2021 article published in The New England Journal of Medicine, the authors continue to push the harmful myth that race is a biological fact, making the case that genetic differences between racial groups are significant and that race-specific treatments should be continued. Paradoxically, at the same time, they assert that their work will advance health equity.
More recently, a 2025 paper titled Molecular Biomarkers Associated with Traumatic Brain Injury Outcome in Individuals of Black Racial Identity or African Ancestry similarly illustrates how race-as-biology thinking continues in a covert modern guise: while acknowledging that race is a social construct, the authors contradictorily focus on biological differences, subtly reinforcing the idea that race is real.
Racial health inequities are driven by systemic racism, not genetics. Yet race science continues to influence both medical practice and research. To break free from its historical shackles to slavery, medicine must stop linking race to biology. Instead of obsessing over genetic racial differences, medical scholars should be addressing the real reason for health inequities, that is, social determinants of health (racism, poverty, poor-quality care).
To reiterate, we must reject biological explanations of racial health differences and focus on the actual causes of disparities.
