Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-27T02:57:48.608Z Has data issue: false hasContentIssue false

Chapter 5 - Not Part of the Solution

Systemic Racism in Contemporary Healthcare

Published online by Cambridge University Press:  07 September 2023

Louis A. Penner ,
John F. Dovidio ,
Nao Hagiwara  and
Brian D. Smedley
Louis A. Penner
Affiliation:
Wayne State University, Michigan
John F. Dovidio
Affiliation:
Yale University, Connecticut and Diversity Science, Oregon
Nao Hagiwara
Affiliation:
University of Virginia
Brian D. Smedley
Affiliation:
Urban Institute, Washington DC
Get access

Summary

This chapter considers disparities in the quality of healthcare Black patients and White patients receive. One major cause of these disparities is that healthcare in the United States is basically a privately financed system. This makes access to necessary healthcare more difficult for Black Americans, because they are, on average, economically disadvantaged. Another factor is that American healthcare is still largely separate and unequal. Black patients are often treated at lower-quality medical facilities. Even within the same facilities, they frequently receive poorer care. Systemic racism within medicine also creates practice that contributes to racial healthcare disparities. One example of this is the widespread use of flawed diagnostic algorithms that reflect racist myths about the bodies of Black people; another is algorithms that systematically underestimate the health needs of Black patients. In addition, unique educational and financial challenges to entering medical professions faced by Black people and hostile institutional and professional climates that discourage Black trainees and practitioners have created serious shortages of Black healthcare professionals. This has numerous negative consequences for Black patients. Thus, racial healthcare inequities reflect both the nature of contemporary political, economic, and social structures in the United States and practices within medicine that seriously disadvantage Black patients.

Keywords

Affordable Care ActAmerican Association of Medical Collegesdearth of Black healthcare professionalsdiagnostic algorithmshealthcare accesshospital inequalitymedical educationracial disparities in treatmentracial concordancesafety-net hospitals
Type
Chapter
Information
Unequal Health
Anti-Black Racism and the Threat to America's Health
 , pp. 205 - 249
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Frakt, A. (2020, January 13). Bad medicine: The harm that comes from racism. New York Times. https://www.nytimes.com/2020/01/13/upshot/bad-medicine-the-harm-that-comes-from-racism.htmlGoogle Scholar
Centers for Disease Control and Prevention. (1986). Report of the Secretary’s Task Force on Black and Minority Health. National Library of Medicine. https://collections.nlm.nih.gov/catalog/nlm:nlmuid-8602912-mvsetGoogle Scholar
Smedley, B. D., Stith, A. Y., & Nelson, A. R. (Eds.) (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. National Academies Press (US) National Academy of Sciences. https://doi.org/10.17226/12875Google Scholar
Holland, B., Dozier, L., & Holland, E. (1965). It’s the Same Old Song, (song recorded by The For Tops). The Four Tops Second Album Motown Records.Google Scholar
Lopez, M., & Budiman, A. (2020, May 5). Financial and health impacts of COVID-19 vary widely by race and ethnicity. Pew Research Center. www.pewresearch.org/fact-tank/2020/05/05/financial-and-health-impacts-of-covid-19-vary-widely-by-race-and-ethnicity/Google Scholar
Mahajan, S., Caraballo, C., Lu, Y., Valero-Elizondo, J., Massey, D., Annapureddy, A. R., Roy, B., Riley, C., Murugiah, K., Onuma, O., Nunez-Smith, M., Forman, H. P., Nasir, K., Herrin, J., & Krumholz, H. M. (2021). Trends in differences in health status and health care access and affordability by race and ethnicity in the United States, 1999–2018. Journal of the American Medical Association (JAMA), 326(7), 637–648. https://doi.org/10.1001/jama.2021.9907Google Scholar
Agency for Healthcare Research and Quality. (2021). National healthcare quality and disparities report. https://www.ahrq.gov/research/findings/nhqrdr/nhqdr21/index.htmlGoogle Scholar
Agency for Healthcare Research and Quality. (2021). Healthcare quality and disparities report. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2021qdr-core-measures-disparities.pdfGoogle Scholar
Shin, P., Alvarez, C., Sharac, J., Rosenbaum, S. J., Vleet, A. V., Paradise, J., & Garfield, R. (2013). A profile of community health center patients: Implications for policy. Health Sciences Research Commons. https://hsrc.himmelfarb.gwu.edu/sphhs_policy_ggrchn/43/Google Scholar
National Association of Community Health Centers. (2020). The facts about Medicaid’s FQHC prospective payment system (PPS). www.nachc.org/focus-areas/policy-matters/pps-one-pager-noask-final/Google Scholar
Seymour, J. W., Polsky, D. E., Brown, E. J., Barbu, C. M., & Grande, D. (2017). The role of community health centers in reducing racial disparities in spatial access to primary care. Journal of Primary Care & Community Health, 8(3), 147–152. https://doi.org/10.1177/2150131917699029CrossRefGoogle ScholarPubMed
Chen, J., Vargas-Bustamante, A., Mortensen, K., & Ortega, A. N. (2016). Racial and ethnic disparities in health care access and utilization under the Affordable Care Act. Medical Care, 54(2), 140–146. https://pubmed.ncbi.nlm.nih.gov/26595227/Google Scholar
Wursten, J., & Reich, M. (2021). Racial inequality and minimum wages in frictional labor markets. Institute for Research on Labor and Employment. https://irle.berkeley.edu/files/2021/02/Racial-Inequality-and-Minimum-Wages.pdfGoogle Scholar
News Release Bureau of Labor Statistics. (2022, October 18). Usual weekly earnings of wage and salary workers third quarter 2022. www.bls.gov/news.release/pdf/wkyeng.pdfGoogle Scholar
Laws, M. B., Lee, Y., Taubin, T., Rogers, W. H., & Wilson, I. B. (2018). Factors associated with patient recall of key information in ambulatory specialty care visits: Results of an innovative methodology. PLoS ONE, 13(2), e0191940. https://doi.org/10.1371/journal.pone.0191940Google Scholar
Lewis, C. G., Getachew, Y., Abrams, M. K., & Doty, M. M. (2019, August 20). Changes at community health centers, and how patients are benefiting. The Commonwealth Fund. www.commonwealthfund.org/publications/issue-briefs/2019/aug/changes-at-community-health-centers-how-patients-are-benefitingGoogle Scholar
Schrader, C. D., & Lewis, L. M. (2013). Racial disparity in emergency department triage. Journal of Emergency Medicine, 44(2), 511–518. https://doi.org/10.1016/j.jemermed.2012.05.010CrossRefGoogle ScholarPubMed
Zhang, X., Carabello, M., Hill, T., Bell, S. A., Stephenson, R., & Mahajan, P. (2020). Trends of racial/ethnic differences in emergency department care outcomes among adults in the United States from 2005 to 2016 [Original Research]. Frontiers in Medicine, 7(300). https://doi.org/10.3389/fmed.2020.00300Google Scholar
Schnitzer, K., Merideth, F., Macias-Konstantopoulos, W., Hayden, D., Shtasel, D., & Bird, S. (2020). Disparities in care: The role of race on the utilization of physical restraints in the emergency setting. Academic Emergency Medicine, 27(10), 943–950. https://doi.org/10.1111/acem.14092CrossRefGoogle ScholarPubMed
Hsia, R. Y., Asch, S. M., Weiss, R. E., Zingmond, D., Liang, L. J., Han, W., McCreath, H., & Sun, B. C. (2011). Hospital determinants of emergency department left without being seen rates. Annals of Emergency Medicine, 58(1), 24–32.e23. https://doi.org/10.1016/j.annemergmed.2011.01.009CrossRefGoogle ScholarPubMed
Lucas, J., Batt, R. J., & Soremekun, O. A. (2014). Setting wait times to achieve targeted left-without-being-seen rates. The American Journal of Emergency Medicine, 32(4), 342–345. https://pubmed.ncbi.nlm.nih.gov/33128667/Google Scholar
Dhuyvetter, A., Cejtin, H. E., Adam, M., & Patel, A. (2021). Coronavirus Disease 2019 in pregnancy: The experience at an urban safety net hospital. Journal of Community Health, 46(2), 267–269. doi.org/10.1007/s10900–020-00940-7Google Scholar
Komaromy, M., Harris, M., Koenig, R. M., Tomanovich, M., Ruiz-Mercado, G., & Barocas, J. A. (2021). Caring for COVID’s most vulnerable victims: A safety-net hospital responds. Journal of General Internal Medicine, 36(4), 1006–1010. https://www.springermedizin.de/caring-for-covid-s-most-vulnerable-victims-a-safety-net-hospital/18779866CrossRefGoogle ScholarPubMed
Hsu, H. E., Ashe, E. M., Silverstein, M., Hofman, M., Lange, S. J., Razzaghi, H., Mishuris, R. G., Davidoff, R., Parker, E. M., Penman-Aguilar, A., Clarke, K. E. N., Goldman, A., James, T. L., Jacobson, K., Lasser, K. E., Xuan, Z., Peacock, G., Dowling, N. F., & Goodman, A. B. (2020). Race/ethnicity, underlying medical conditions, homelessness, and hospitalization status of adult patients with COVID-19 at an urban safety-net medical center – Boston, Massachusetts, 2020. Morbidity and Mortality Weekly Report, 69(27), 864–869. https://doi.org/10.15585/mmwr.mm6927a3Google Scholar
Lasser, K. E., Liu, Z., Lin, M.-Y., Paasche-Orlow, M. K., & Hanchate, A. (2021). Changes in hospitalizations at US safety-net hospitals following Medicaid expansion. JAMA Network Open, 4 (6), e2114343–e2114343. https://doi.org/10.1001/jamanetworkopen.2021.14343Google Scholar
Gangopadhyaya, A. (2021). Black patients are more likely than white patients to be in hospitals with worse patient safety conditions. Urban Institute. www.urban.org/sites/default/files/publication/103925/black-patients-are-more-likely-than-white-patients-to-be-in-hospitals-with-worse-patient-safety-conditions_0.pdfGoogle Scholar
Metersky, M. L., Hunt, D. R., Kliman, R., Wang, Y., Curry, M., Verzier, N., Lyder, C. H., & Moy, E. (2011). Racial disparities in the frequency of patient safety events: Results from the National Medicare Patient Safety Monitoring System. Medical Care, 49(5), 504–510. www.jstor.org/stable/23053809CrossRefGoogle ScholarPubMed
Advisory Board. (2021, May 20). ‘The gap is not sustainable’: Why safety-net hospitals especially struggled amid Covid-19. www.advisory.com/en/daily-briefing/2021/05/20/safety-net-hospitalsGoogle Scholar
Center for Medicare & Medicaid Services. (n. d.). Hospital-Acquired Condition Reduction Program. www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-ProgramGoogle Scholar
Rau, J. (2021, October 28). Medicare punishes 2,499 hospitals for high readmissions. Kaiser Health News. https://khn.org/news/article/hospital-readmission-rates-medicare-penalties/Google Scholar
Cunningham, P., Rudowitz, R., Young, K., Garfield, R., & Foutz, J. (2016, June 9). Understanding Medicaid hospital payments and the impact of recent policy changes. Kaiser Family Foundation. www.kff.org/report-section/understanding-medicaid-hospital-payments-and-the-impact-of-recent-policy-changes-issue-brief/Google Scholar
Westphal, Z. (n. d.). Physician fee schedules: How do they compare and what’s next? Axene Health Partners. https://axenehp.com/physician-fee-schedules-compare-whats-next/Google Scholar
Holgash, K., & Heberlein, M. (2019, April 10). Physician acceptance of new Medicaid patients: What matters and what doesn’t. Health Affairs Blog. www.healthaffairs.org/do/10.1377/forefront.20190401.678690/full/Google Scholar
Medicaid and CHIP Payment and Access Commission. (n. d.). Key findings on access to care. www.macpac.gov/subtopic/measuring-and-monitoring-access/Google Scholar
Hanchate, A. D., Paasche-Orlow, M. K., Baker, W. E., Lin, M.-Y., Banerjee, S., & Feldman, J. (2019, September 6). Association of race/ethnicity with emergency department destination of emergency medical services transport. JAMA Network Open, 2(9). https://doi.org/10.1001/jamanetworkopen.2019.10816CrossRefGoogle Scholar
Caress, B. (2020, September 16). Hospital care in black and white: How systemic racism persists. Center for New York City Affairs. www.centernyc.org/urban-matters-2/2020/9/15/hospital-care-in-black-and-white-how-systemic-racism-persists-savedGoogle Scholar
Dimick, J., Ruhter, J., Sarrazin, M. V., & Birkmeyer, J. D. (2013). Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions. Health Affairs, 32(6), 1046–1053. https://doi.org/10.1377/hlthaff.2011.1365Google Scholar
Asch, D. A., Islam, M. N., Sheils, N. E., Chen, Y., Doshi, J. A., Buresh, J., & Werner, R. M. (2021). Patient and hospital factors associated with differences in mortality rates among Black and White US Medicare beneficiaries hospitalized with COVID-19 Infection. JAMA Network Open, 4(6), e2112842–e2112842. https://doi.org/10.1001/jamanetworkopen.2021.12842Google Scholar
World Population Review. (n. d.). Countries with universal healthcare 2021. https://worldpopulationreview.com/country-rankings/countries-with-universal-healthcareGoogle Scholar
Slaybaugh, C. (n. d.). International healthcare systems: The US versus the world. Axene Health Partners. https://axenehp.com/international-healthcare-systems-us-versus-world/Google Scholar
Luke 4:23. The Bible: St. James Version.Google Scholar
Bauchner, H. (2021). Structural racism for doctors – What is it? A response from Howard Bauchner, MD. JAMA Clinical Reviews. https://jamanetwork.com/journals/jama/pages/audio-18587774Google Scholar
National Commission on Certification of Physician Assistants. (2020). 2019 statistical profile of certified physician assistants. https://prodcmsstoragesa.blob.core.windows.net/uploads/files/2019StatisticalProfileofCertifiedPhysicianAssistants.pdfGoogle Scholar
Ly, D. P. (2021). Historical trends in the representativeness and incomes of Black physicians, 1900–2018. Journal of General Internal Medicine, 37, 1310–1312. https://doi.org/10.1007/s11606–021-06745-1Google Scholar
National Science Foundation. (2015). Who earns a U.S. doctorate? www.nsf.gov/statistics/2017/nsf17306/report/who-earns-a-us-doctorate/race-and-ethnicity.cfmGoogle Scholar
Hamel, L. M., Chapman, R., Malloy, M., Eggly, S., Penner, L. A., Shields, A. F., Simon, M. S., Klamerus, J. F., Schiffer, C., & Albrecht, T. L. (2015). Critical shortage of African American medical oncologists in the United States. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 33(32), 3697–3700. https://doi.org/10.1200/JCO.2014.59.2493CrossRefGoogle ScholarPubMed
American Cancer Society. (2019). Cancer Facts & Figures for African Americans 2019–2021. www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-facts-and-figures-for-african-americans/cancer-facts-and-figures-for-african-americans-2019-2021.pdfGoogle Scholar
McFarling, U. L. (2021, April 28). After 40 years, medical schools are admitting fewer Black male or Native American students. Stat News. www.statnews.com/2021/04/28/medical-schools-admitting-fewer-black-male-or-native-american-students/Google Scholar
Association of American Medical Colleges. (2019). Diversity in medicine: Facts and Figures 2019. Figure 13. Percentage of U.S. medical school graduates by race/ethnicity (alone), academic year 2018–2019. www.aamc.org/data-reports/workforce/interactive-data/figure-13-percentage-us-medical-school-graduates-race/ethnicity-alone-academic-year-2018-2019Google Scholar
Rothstein, R. (2015). The racial achievement gap, segregated schools, and segregated neighborhoods: A Constitutional insult. Race and Social Problems, 7(1), 21–30. https://link.springer.com/article/10.1007/s12552-014-9134-1Google Scholar
Bridges, B. (2018, November 29). African Americans and college education by the numbers. United Negro College Fund. https://uncf.org/the-latest/african-americans-and-college-education-by-the-numbersGoogle Scholar
The Postsecondary National Policy Institute. (2021, February 1). Factsheets: First-generation students. https://pnpi.org/first-generation-students/Google Scholar
Nichols, A. H., & Anthony, M. Jr. (2020, March 5). Graduation rates don’t tell the full story: Racial gaps in college success are larger than we think. The Education Trust. https://edtrust.org/resource/graduation-rates-dont-tell-the-full-story-racial-gaps-in-college-success-are-larger-than-we-think/Google Scholar
Hanson, M. (2022, December, 2). Average cost of medical school. Education Data Initiative. https://educationdata.org/average-cost-of-medical-schoolGoogle Scholar
Chen, X. (2013). STEM attrition: College students’ paths into and out of STEM fields. Statistical Analysis Report. NCES 2014-001. National Center for Education Statistics. https://nces.ed.gov/pubs2014/2014001rev.pdfGoogle Scholar
Gasman, M., Smith, T., Ye, C., & Nguyen, T.-H. (2017). HBCUs and the production of doctors. AIMS Public Health, 4(6), 579–589. https://doi.org/10.3934/publichealth.2017.6.579Google Scholar
HBCU College Fair. Did You Know? www.youtube.com/watch?v=zLdYhpKgYDgGoogle Scholar
Tavernier, F. (2018, March 1). Representation is crucial. So retention of pre-med students of color is imperative. University of Michigan Health Lab. https://labblog.uofmhealth.org/med-u/representation-crucial-so-retention-of-pre-med-students-of-color-imperativeGoogle Scholar
Association of American Medical Colleges. (2020). U.S. Medical School faculty trends: Percentages. www.aamc.org/data-reports/faculty-institutions/interactive-data/us-medical-school-faculty-trends-percentagesGoogle Scholar
Association of American Medical Colleges. (2021). U.S. medical school deans by dean type and race/ethnicity (URiM vs. non-URiM). www.aamc.org/data-reports/faculty-institutions/interactive-data/us-medical-school-deans-dean-type-and-race-ethnicityGoogle Scholar
Amutah, C., Greenidge, K., Mante, A., Munyikwa, M., Surya, S. L., Higginbotham, E., Jones, D. S., Lavizzo-Mourey, R., Roberts, D., Tsai, J., & Aysola, J. (2021). Misrepresenting race: The role of medical schools in propagating physician bias. New England Journal of Medicine, 384(9), 872–878. https://doi.org/10.1056/NEJMms2025768Google Scholar
Perry, T. (2016, May 3). The racist origins of the word ‘Caucasian’. GOOD. www.good.is/articles/the-last-country-to-still-use-the-term-caucasianGoogle Scholar
Dutchen, S. (2021). Field correction. Harvard Medicine. https://hms.harvard.edu/magazine/racism-medicine/field-correctionGoogle Scholar
Souter, E. (2021, July 28). How medical schools are fighting racial disparities in health care. WebMD. www.webmd.com/a-to-z-guides/features/med-schools-fight-racismGoogle Scholar
Perry, S. P., WagesIII, J. E., Skinner‐Dorkenoo, A. L., Burke, S. E., Hardeman, R. R., & Phelan, S. M. (2021). Testing a self‐affirmation intervention for improving the psychosocial health of Black and White medical students in the United States. Journal of Social Issues, 77(3), 769–800. https://pubmed.ncbi.nlm.nih.gov/34924602/Google Scholar
Diaz, T., Navarro, J. R., & Chen, E. H. (2020). An institutional approach to fostering inclusion and addressing racial bias: Implications for diversity in academic medicine. Teaching and Learning in Medicine, 32(1), 110–116. https://doi.org/10.1080/10401334.2019.1670665Google Scholar
Hill, K. A., Samuels, E. A., Gross, C. P., Desai, M. M., Sitkin Zelin, N., Latimore, D., Huot, S. J., Cramer, L. D., Wong, A. H., & Boatright, D. (2020). Assessment of the prevalence of medical student mistreatment by sex, race/ethnicity, and sexual orientation. JAMA Internal Medicine, 180(5), 653–665. https://doi.org/10.1001/jamainternmed.2020.0030Google Scholar
Ross, D. A., Boatright, D., Nunez-Smith, M., Jordan, A., Chekroud, A., & Moore, E. Z. (2017). Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations. PLoS ONE, 12(8), e0181659. https://doi.org/10.1371/journal.pone.0181659Google Scholar
Rosenblum, K. (2020, February 7). My experience as a Black doctor in 2020. Cedars Sinai. www.cedars-sinai.org/blog/my-experience-as-a-black-doctor-in-2020.htmlGoogle Scholar
Goldberg, E. (2020, August 11). For doctors of color, microaggressions are all too familiar. New York Times. www.nytimes.com/2020/08/11/health/microaggression-medicine-doctors.htmlGoogle Scholar
Sullivan, L. W. (2005). A JBHE check-Up on Blacks in US medical schools. Journal of Blacks in Higher Education, 47, 76–81. https://www.jbhe.com/features/47_medicalschools.htmlGoogle Scholar
Ly, D. P., Seabury, S. A., & Jena, A. B. (2016). Differences in incomes of physicians in the United States by race and sex: Observational study. BMJ, 353, i2923–i2923. https://doi.org/10.1136/bmj.i2923Google Scholar
Moore, J., & Continelli, T. (2016). Racial/ethnic pay disparities among registered nurses in U.S. hospitals: An econometric regression decomposition. Health Services Research, 51(2), 511–529. https://doi.org/10.1111/1475-6773.12337Google Scholar
Boatright, D., Ross, D., O’Connor, P., Moore, E., & Nunez-Smith, M. (2017). Racial disparities in medical student membership in the Alpha Omega Alpha Honor Society. JAMA Internal Medicine, 177(5), 659–665. https://doi.org/10.1001/jamainternmed.2016.9623CrossRefGoogle ScholarPubMed
Blackstock, U. (2020, January 16). Why Black doctors like me are leaving faculty positions in academic medical centers. Stat News. www.statnews.com/2020/01/16/black-doctors-leaving-faculty-positions-academic-medical-centers/Google Scholar
Meeks, L., & Jain, N. (2019). Accessibility, inclusion, and action in medical education: Lived experiences of learners and physicians with disabilities. Association of American Medical Colleges.Google Scholar
Snyder, J. E., Upton, R. D., Hassett, T. C., Lee, H., Nouri, Z., & Dill, M. (2023). Black representation in the primary care physician workforce and its association with population life expectancy and mortality rates in the US. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2803898Google Scholar
Cooper-Patrick, L., Gallo, J. J., Gonzales, J. J., Vu, H. T., Powe, N. R., Nelson, C., & Ford, D. E. (1999). Race, gender, and partnership in the patient-physician relationship. Journal of the American Medical Association (JAMA), 282(6), 583–589. https://doi.org/10.1001/jama.282.6.583CrossRefGoogle ScholarPubMed
Traylor, A. H., Schmittdiel, J. A., Uratsu, C. S., Mangione, C. M., & Subramanian, U. (2010). Adherence to cardiovascular disease medications: Does patient-provider race/ethnicity and language concordance matter? Journal of General Internal Medicine, 25(11), 1172–1177. https://pubmed.ncbi.nlm.nih.gov/20571929/Google Scholar
Saha, S., & Beach, M. C. (2020). Impact of physician race on patient decision-making and ratings of physicians: A randomized experiment using video vignettes. Journal of General Internal Medicine, 35(4), 1084–1091. https://pubmed.ncbi.nlm.nih.gov/31965527/Google Scholar
Alsan, M., Garrick, O., & Graziani, G. (2019). Does diversity matter for health? Experimental evidence from Oakland. American Economic Review, 109(12), 4071–4111. https://www.aeaweb.org/articles?id=10.1257/aer.20181446CrossRefGoogle Scholar
Greenwood, B. N., Hardeman, R. R., Huang, L., & Sojourner, A. (2020). Physician-patient racial concordance and disparities in birthing mortality for newborns. Proceedings of the National Academy of Sciences, 117(35), 21194–21200. https://doi.org/10.1073/pnas.1913405117Google Scholar
Hill, A., Jones, D., & Woodworth, L. (2020, June 26). Physician-patient race-match reduces patient mortality. SSRN. https://dx.doi.org/10.2139/ssrn.3211276Google Scholar
James Denny, G. (1968). The pro-slavery arguments of Dr. Samuel A. Cartwright. Louisiana History: The Journal of the Louisiana Historical Association, 9(3), 209–227. www.jstor.org/stable/4231017Google Scholar
Cartwright, S. (1860). Slavery in the light of ethnology. Cotton is king and pro-slavery arguments. Digital History: ID 275. www.digitalhistory.uh.edu/disp_textbook.cfm?smtID=3&psid=275Google Scholar
Vyas, D. A., Eisenstein, L. G., & Jones, D. S. (2020). Hidden in plain sight: Reconsidering the use of race correction in clinical algorithms. New England Journal of Medicine, 383(9), 874–882. https://doi.org/10.1056/NEJMms2004740Google Scholar
Chertow, G. M., Hsu, C. Y., & Johansen, K. L. (2006). The enlarging body of evidence: Obesity and chronic kidney disease. Journal of the American Society of Nephrology, 17(6), 1501–1502. https://doi.org/10.1681/asn.2006040327Google Scholar
Uppal, P., Golden, B., Panicker, A., Kahn, O., & Burday, M. (2022). The case against race-based GFR. Delaware Journal of Public Health, 8(3), 86–89. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495470/Google Scholar
Goldstein, J. (2022, April 25). How a race-based medical formula is keeping some Black men in prison. New York Times. www.nytimes.com/2022/04/22/nyregion/prison-kidney-federal-courts-race.htmlGoogle Scholar
Fawzy, A., Tianishi, D., Wang, K., Robinson, M., Farha, J., Bradke, A., Golden, S., Yanzun, X., & Garibaldi, B. (2022). Racial and ethnic discrepancy in pulse oximetry and delayed identification of treatment eligibility among patients with COVID-19. JAMA Internal Medicine, 182(7), 730–738. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2792653Google Scholar
Tobin, M., & Jubran, A. (2022). Pulse oximetry, racial bias, and statistical bias. Annals of Intensive Care, 22(19). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723900/Google Scholar
Satel, S. (2002, May 5). I am a racially profiling doctor. New York Times. www.nytimes.com/2002/05/05/magazine/i-am-a-racially-profiling-doctor.htmlGoogle Scholar
American Medical Association. (n. d.). Trends in health care spending. www.ama-assn.org/about/research/trends-health-care-spendingGoogle Scholar
Obermeyer, Z., Powers, B., Vogeli, C., & Mullainathan, S. (2019). Dissecting racial bias in an algorithm used to manage the health of populations. Science, 366(6464), 447–453. doi: 10.1126/science.aax2342Google Scholar
Mullainathan, S., & Obermeyer, Z. (2021). On the inequity of predicting A while hoping for B. AEA Papers and Proceedings, 111, 37–42. http://ziadobermeyer.com/wp-content/uploads/2021/08/Predicting-A-While-Hoping-for-B.pdfGoogle Scholar
Ledford, H. (2019). Millions of black people affected by racial bias in health-care algorithms. Nature, 574(7780), 608–609. https://pubmed.ncbi.nlm.nih.gov/31664201/Google Scholar
Charron-Chénier, R., & Mueller, C. W. (2018). Racial disparities in medical spending: Healthcare expenditures for Black and White households (2013–2015). Race and Social Problems, 10(2). https://link.springer.com/article/10.1007/s12552-018-9226-4Google Scholar
Roy, S., Showstark, M., Tolchin, B., Kashyap, N., Bonito, J., Salazar, M. C., Herbst, J. L., Nash, K. A., Nguemeni Tiako, M. J., Jubanyik, K., Kim, N., Galusha, D., Wang, K. H., & Oladele, C. (2021). The potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system. PLoS ONE, 16(9), e0256763. https://doi.org/10.1371/journal.pone.0256763Google Scholar
Tolchin, B., Oladele, C., Galusha, D., Kashyap, N., Showstark, M., Bonito, J., Salazar, M. C., Herbst, J. L., Martino, S., & Kim, N. (2021). Racial disparities in the SOFA score among patients hospitalized with COVID-19. PLoS ONE, 16(9), e0257608. www.ncbi.nlm.nih.gov/pmc/articles/PMC8448580/Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×