Relationship between belief in race as a cultural phenomenon driving health disparities and physician use of race-based care
MINNEAPOLIS/ST. PAUL (02/17/2023) — Published in the American Journal of Preventive Medicine, University of Minnesota Medical School researchers found a direct relationship between belief in race as a cultural phenomenon driving health disparities and the use of race in care.
“Using race without recognizing the social, political and economic factors that contribute to racial inequity can stigmatize racially minoritized people as biologically inferior and normalize their poor health, worsening health disparities by codifying them as inevitable,” said lead investigator Ebiere Okah, MD, MS, an assistant professor at the U of M Medical School.
Based on a cross-sectional national survey of nearly 700 U.S. academic family physicians conducted in 2021, this study is the first to show a direct relationship between the belief that racially linked genetic and cultural factors drive health disparities and the use of race-based care. The Racial Attributes in Critical Evaluation (RACE) scale was used to evaluate the degree to which race is used in clinical practices. High RACE scores were associated with the belief in genetic and cultural — but not socioeconomic — causality.
The study found that family physicians at academic medical organizations who believe genetics and cultural attitudes are at the root of poor health outcomes of ethnic minority patients are likely to consider race when providing care.
Further research is suggested to identify which specific clinician behaviors are related to viewing race as cultural and how clinicians may differentially treat and counsel their patients based on racialized assumptions about their patients’ cultural values.
“The next step in this work is determining how to challenge the belief that race is related to cultural values. Part of the solution lies in advancing cultural humility as an alternative to cultural competency, acknowledging the cultural diversity that exists within racial groups, and considering the ways in which structural factors create what we perceive to be culture,” said Dr. Okah.
This research was supported by the National Research Service Award grant from the Health Resources and Services Administrations (5 T32 14001) and the National Institutes of Health’s National Center for Advancing Translational Sciences (UL1TR002494).
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