Like many other health conditions, patients with kidney disease can face racial health inequity. Despite no biological basis for racial distinctions, the medical and scientific community have used race to explain differences in disease prevalence and outcomes. Learn more about bias and discrimination within the healthcare field and what is being done to fix it.* 

How Did Race Measurement in Healthcare Develop?

The Western concept of race developed from European colonialization, oppression, and discrimination of non-European groups. It soon created a place in the U.S. medical curricula, clinical guidelines (algorithms and tools), and treatment, including pharmacological prescribing guidelines. 

Even today, doctors use racial or geographic terms that link diseases to specific groups or communities. For example, the COVID-19 virus was labeled as “China virus”. 

How Is Racial Discrimination Affecting Care?

Research from a survey done by the Kaiser Family Foundation (KFF) reports patients being treated unfairly because of their race/ethnicity while accessing healthcare. The study specifically found that: 

• Black and Hispanic adults are more likely than White adults to report they were personally treated unfairly because of their race and ethnicity while getting care in the past year. 
• Black adults are more likely than White adults to report negative experiences with healthcare providers, including feeling a provider did not believe they were telling the truth, being refused a test or treatment they thought they needed, and being refused pain medication.
• Black and Hispanic adults are more likely than White adults to say it is difficult to find a doctor who shares their background and experiences and treats them with dignity and respect. 

When feelings like this develop, it can lead to the collective distrust of the entire healthcare system. This can prevent people who feel ill from seeing a doctor or medical professional when they should.

What Is Being Done to Address Racial Bias in Healthcare?

There have been increasing efforts within the medical community to re-evaluate and revise practice around the use of race within clinical care and move toward racial equality in medicine. Some of these efforts include:

• In 2020, the American Medical Association (AMA) adopted new policies to recognize race as a social construct and encouraged medical education programs to recognize the harmful effects of using race as a proxy for biology curriculum. 
• In September 2020, the House Ways and Means Committee announced a Request for Information around the misuse of race in clinical care.
• In March 2021, the Agency for Healthcare Research and Quality (AHRQ) similarly announced a Request for Information on the use of clinical algorithms that have the potential to introduce racial/ethnic bias into healthcare delivery. 
• Since 2020, multiple healthcare systems, including Mass General Brigham hospital, the University of Washington, Vanderbilt University, New York City (NYC) Health and Hospitals, and UC Davis School of Medicine, have all removed race correction from kidney function estimates, also known as the estimated glomerular filtration rate (eGFR). 

For patients with kidney disease, this awakening of change, specifically how kidney function is calculated for Black patients, will help eliminate beliefs of biological differences by race and reduce racial bias and discrimination. 

*Tong, M., & Artiga, S. (2021, December 9). Use of Race in Clinical Diagnosis and Decision Making: Overview and Implications. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/use-of-race-in-clinical-diagnosis-and-decision-making-overview-and-implications/