This is our second podcast in a two-part series about race. In this podcast, we discuss the role of race in medicine. We review the pros and cons of considering race in medicine. We also talk about the origins of some of the most common race-based medical stereotypes. Finally, beyond human interactions, we reveal how implicit biases can become engrained in the very algorithms and systems that decide our care and further increase health disparities.

Sources:

Science “Race and Medicine” – Constance Holden 2003

BMC Health Services Research “Is race medically relevant? A qualitative study of physicians’attitudes about the role of race in treatment decision-making” - Shedra Amy Snipes et al. 2011

Skin tone: https://www.washingtonpost.com/lifestyle/2020/07/22/malone-mukwende-medical-handbook/

The problem with race-based medicine:

https://www.ted.com/talks/dorothy_roberts_the_problem_with_race_based_medicine?language=en

Redheads and pain: https://www.pnas.org/content/100/8/4867

Black patients and pain:

https://www.aamc.org/news-insights/how-we-fail-black-patients-pain

https://www.pnas.org/content/113/16/4296 

Meta-analysis of disparities in pain meds:

https://pubmed.ncbi.nlm.nih.gov/22239747/

In-group bias:

http://www.psych.nyu.edu/vanbavel/lab/documents/Mende-Siedlecki.etal.2019.JEPG.pdf

Spirometers: “Breathing Race into the Machine” by Lundy Braun

Origin of myths about physiological racial differences: https://www.nytimes.com/interactive/2019/08/14/magazine/racial-differences-doctors.html

John Brown’s personal accounts:

https://docsouth.unc.edu/neh/jbrown/jbrown.html

Glomerular Filtration rates and race:

https://www.kidney.org/sites/default/files/docs/12-10-4004_abe_faqs_aboutgfrrev1b_singleb.pdf

https://pubmed.ncbi.nlm.nih.gov/9214396/

https://medicine.uw.edu/news/uw-medicine-exclude-race-calculation-egfr-measure-kidney-function#:~:text=As%20of%20June%201%2C%202020,excludes%20race%20as%20a%20variable.

https://www.kidney.org/news/establishing-task-force-to-reassess-inclusion-race-diagnosing-kidney-diseases 

Experience of Black physicians:

https://www.npr.org/sections/health-shots/2020/07/01/880373604/to-be-young-a-doctor-and-black-overcoming-racial-barriers-in-medical-training

BiDil: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60052-X/fulltext

https://www.nature.com/articles/6500489 

CYP2D6 gene: https://www.nature.com/articles/gim201680

Race and pharmacogenetics: https://www.nature.com/scitable/topicpage/pharmacogenetics-personalized-medicine-and-race-744/

Sickle cell disease: https://www.cdc.gov/ncbddd/sicklecell/features/keyfinding-trait.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2093356/

https://digitalwindow.vassar.edu/cgi/viewcontent.cgi?article=1334&context=senior_capstone

Bias in Healthcare algorithm:

Science “Dissecting racial bias in an algorithm used to manage the health of populations” Obermeyer et al. 2019

Nature “Millions affected by racial bias in health-care algorithm” Heidi Ledford 2019

https://www.washingtonpost.com/health/2019/10/24/racial-bias-medical-algorithm-favors-white-patients-over-sicker-black-patients/