Race-Based Medicine Quiz

Race-Based Medicine

• Involves using race as a biological determinant in clinical practice
• Relies on the assumption that racial groups have distinct genetic and physiological traits
• Influences diagnoses, treatments, and medical education
• Example: Adjusting Black patients' renal function based on presumed higher muscle mass
• Example: Screening Asian patients for diabetes at lower BMI thresholds
• Example: Different hypertension treatment guidelines for Black patients based on presumed ACE inhibitor efficacy

Flaws in Race-Based Medicine

• Race is a social construct, not a biological category
• Genetic variation is continuous, not aligned with racial classifications
• Implicit bias perpetuates stereotypes and systemic inequalities
• Inaccuracy of using race as a proxy, oversimplifying complex factors like genetic ancestry, environment, and socioeconomic conditions
• Misinforms care and leads to delayed diagnoses, inappropriate treatments, and exacerbates health disparities.

Race-Conscious Approach

• Acknowledges racism as a determinant of health, instead of using race as a biological marker
• Aims to address racism and promote equity and precision in care
• Avoidance of race-based adjustments (e.g., use cystatin C instead of race-based eGFR for kidney function)
• Education on structural racism, focusing on socioeconomic and environmental factors
• Critical research practices, avoiding race as a proxy for biology
• Inclusive policymaking ensuring diverse representation in guideline creation and decisions

COVID-19 Related Racism and Mental Health

• Study examines the experiences of Chinese American parents and children
• Focuses on COVID-19 related racism and racial discrimination
• Explores online and in-person direct and vicarious discrimination
• Examines perceptions of Sinophobia related to health and media portrayals
• High rates of COVID-19 racial discrimination were reported by parents and youth, both online and in-person
• Vicarious racial discrimination online and in person was reported in high percentages
• Many perceive health related Sinophobia
• The study found negative association between psychological well-being and perceptions of discrimination and Sinophobia
• Anxiety and depressive symptoms increased with exposure to discrimination and Sinophobia
• Psychological well-being declined due to online and in-person discrimination, health-related Sinophobia, and media Sinophobia

Racialization of Disease

• The association of specific diseases with specific racial or ethnic groups
• Stigmatization and systemic bias
• COVID-19 examples: Chinese Americans unfairly blamed and viewed as carriers of the virus
• Reinforces xenophobia and tangible mental health consequences

Lecture Concepts (Socioeconomic Status and Health)

• Misconception: Biology solely defines health
• Health develops and changes over time
• Socioeconomic status is strongly correlated with health status
• Higher-class individuals have better health
• Excess death in lower-income populations
• Wealth concentration and its impact on health disparities

Racial Health Disparities

• African Americans and Hispanics have higher rates of hospitalizations for COVID-19 compared to whites
• High blood pressure is more common in African Americans
• Higher rates of diabetes and heart disease in certain racial groups
• Life expectancy varies significantly among racial groups, with disparities related to socio economic conditions
• Some states have larger life expectancy gaps than others
• Pregnancy related mortality rate is higher for some racial groups

Models of Racial Health Disparities

• Racial genetic model (little empirical support)
• Health behavior model (little empirical support)
• Socioeconomic disparities model (explains some but not all of the gap)
• Psychosocial stress model (well supported)
• Structural-constructivist model (well supported)

Income and Life Expectancy

• High-income Americans are more likely to live longer than low-income Americans
• Wider discrepancies in life expectancy between high and low-income groups throughout history
• Relationships between socioeconomic status and racial health disparities have grown stronger over time
• Minority Poverty and Diminishing Returns hypotheses

Childhood Trauma, Racism, and Public Health

• Childhood trauma increases the risk of mental health issues (anxiety, depression, PTSD)
• Racism is a public health crisis
• Racism contributes to physical and mental health problems
• Racism in access to COVID-19 vaccines
• Some minority groups are more likely to face inadequate health infrastructure.

Symbolic Violence and Racial Survival

• A term describing subtle ways that dominant groups maintain their power over marginalized groups
• Racial survival strategies used by marginalized groups, including code-switching, masking, and racial tolerance testing
• Ways in which marginalized groups feel out members of other groups to determine their tolerance niveles.

Test your knowledge on the implications and flaws of race-based medicine in clinical practice. This quiz explores how racial assumptions can affect diagnoses and treatments while highlighting the issues surrounding race as a biological determinant in healthcare. Learn about the consequences of relying on race in medical education and practice.