The American Academy of Pediatrics is attempting to ban race-based medical guidance to which the organization attributes longstanding inequities in healthcare.
In a statement on Monday, the AAP said: “Race is a historically-derived social construct that has no place as a biologic proxy. Over the years, the medical field has inaccurately applied race correction or race adjustment factors in its work, resulting in differential approaches to disease management and disparate clinical outcomes.
“Although it will continue to be important to collect clinical data disaggregated by race and ethnicity to help characterize the differential lived experiences of our patients, unwinding the roots of race-based medicine, debunking the fallacy of race as a biologic proxy, and replacing this flawed science with legitimate measures of the impact of racism and social determinants on health outcomes is necessary and long overdue,” the academy added.
A re-examination of AAP treatment recommendations that began before George Floyd’s 2020 murder by police in Minneapolis, and intensified after it and the resulting nationwide protests, has doctors concerned that Black youngsters have been undertreated and overlooked, said Joseph Wright, lead author of the new policy and chief health equity officer at the University of Maryland medical system, a network of hospitals.
According to Wright, the academy has begun to scrutinize its “entire catalog”, including guidelines, educational materials, textbooks and newsletter articles.
“We are really being much more rigorous about the ways in which we assess risk for disease and health outcomes,” Wright said. “We do have to hold ourselves accountable in that way. It’s going to require a heavy lift.”
The academy went on to recommend a series of policies to medical societies, institutions and pediatricians. “All professional organizations and medical specialty societies should advocate for the elimination of race-based medicine in any form,” it said.
It urged institutions to collaborate with learner-facing organizations such as the Accreditation Council on Continuing Medical Education to expose more people to health equity content with a “specific focus on the elimination of race-based medicine”.
The academy also called on pediatricians to incorporate content regarding the elimination of race-based medicine for professionals as a “component of lifelong learning and maintenance of certificate”.
Monday’s announcement by the AAP follows in the footsteps of other major health organizations including the American Heart Association and the American Medical Association which have also released strategic plans to dismantle structural racism affecting their organizations and policy.
In 2020, the American Heart Association declared that structural racism is a driver of health disparities. It pledged to “look to assure its medical journals use processes that assure antiracism and diversity considerations” and focus its future medical statements on structural racism in a “meaningful way”.
Similarly, in 2021, the American Medical Association released a strategic plan that seeks to embed racial justice within its organization.
The approaches cited include building alliances with marginalized physicians and other stakeholders, fostering pathways for racial healing and reconciliation, and empowering physicians with tools for dismantling structural and social drivers of health inequities.