Power of Story
Send a Tweet        
- Advertisement -

Share on Google Plus Share on Twitter Share on Facebook 4 Share on LinkedIn Share on PInterest Share on Fark! Share on Reddit Share on StumbleUpon 2 Tell A Friend 1 (7 Shares)  

Printer Friendly Page Save As Favorite View Favorites (# of views)   7 comments
OpEdNews Op Eds

Racism Alive and Well in New Medical Guidelines

By   Follow Me on Twitter     Message Jess Guh, MD     Permalink
      (Page 1 of 2 pages)
Related Topic(s): ; ; ; ; ; ; ; ; ; ; (more...) ; ; ; ; ; ; , Add Tags  (less...) Add to My Group(s)

Must Read 1   Well Said 1   Supported 1  
View Ratings | Rate It

opednews.com Headlined to H4 12/16/15

Author 504255
Become a Fan
  (3 fans)


(Image by ThisCantBeHappening!)   Permission   Details   DMCA
- Advertisement -

Going to the doctor is like going to the car mechanic. It falls right between "trip to DMV" and "post office during the holidays" on the list of errands that we all hate doing. Just like the car mechanic, it can be expensive and even if they don't fix the problem, you still have to pay. When they do find something wrong, you have to take their word for it and assume that whatever course of treatment they suggest is best. If you try to go against their recommendation they give a condescending stare and then ominously warn, "OK, it's your life do whatever you want, but it really isn't safe."

But at least some people know something about cars that can give some advice. We all have a friend who spends the weekend with their buddies fixing cars. I don't know anyone who sits around on a Sunday with friends working on each other's hypertension.

Whether it's your health or your transportation, it's disconcerting to have such critical parts of your life in a black box of decision making. You don't know how physicians are making their decisions. Surely they are thinking about what will make the best health impact, but what else are they considering? Cost? Pharmaceutical advertisements? Convenience? What about race?

- Advertisement -

In a time where white supremacy is no longer acceptable, a far more insidious form of racism is at play: unconscious bias. Implicit bias and microaggressions are difficult to describe and almost uniformly unintentional, but their impact is tremendous. Because medical decision-making is far more ambiguous than most people realize and involves the evaluation of subjective and incomplete data, it's particularly prone to unconscious bias.

The CDC estimates that two thirds of adult Americans have either hypertension or pre-hypertension. Deciding the best way to treat this disease impacts over 70 million people. So when the Joint National Committee, a panel of experts on hypertension, released their updated guidelines at the end of 2014, it caused quite a controversy. While the guidelines included a plethora of recommendations, the debate has largely surrounded their recommendation that patients over the age of 60 have a more relaxed blood pressure goal of 150/90 instead of 140/90.

It's been over a year since the new guidelines were released, but the debate continues. What's so baffling to me is not that we keep discussing the 150/90 thing, I agree it is important, but that in all this time the most controversial part of the guidelines hasn't been mentioned in public debate or the media: that physicians should treat black patients and non-black patients differently.

- Advertisement -

From flickr.com/photos/23307937@N04/5517839272/: pop life
pop life
(Image by frankieleon)
  Permission   Details   DMCA

In a nutshell, the new guidelines recommend that certain blood pressure medications, ACE inhibitor medications (ACEs) and angiotensin receptor blockers (ARBs), which are recommended for non-black people as treatment for lowering blood pressure, should not be initially prescribed to black people. Given that, as a society we have accepted race as a social construct as opposed to a biological one, the implications of this recommendation are disturbing.

Guidelines based on shaky research

Guidelines are recommendations that are so strongly supported by research and expert opinion, that everyone should be doing them. This guideline was based solely on one study only (ALLHAT). Even from its conception that study failed to make consistent scientific sense: it did not define what it means to be biologically black.

In the study the researchers relied upon each patient's racial self-identification -- a social, not biological definition. Many people who are white and only black still identify as black because their skin color is still darker and/or they are treated as such by the people around them. But if they are white, does that make them biologically "more white?" Furthermore, the researchers categorized the groups into black versus white, Asian, other and Native American. How can you on one hand claim there is a biological basis to race and then at the same time decide that Asian, other, and Native American patients are similar enough to belong in the non-black category?

- Advertisement -

Confirmation bias

So how did such shaky research make the cut? It's simple. Physicians and researchers are subject to the same racial biases as the rest of our society. It doesn't matter how enlightened or non-racist you want to be, a racist society influences all its members. Couple unconscious bias with confirmation bias -- the tendency to over-weight facts that support beliefs we already have -- and it's easy to see how this concept made it into the guidelines. We inherently believe that races are different, so we are willing to take any evidence, no matter how flawed, as proof.

Rather than go through the trouble of sorting out cause from correlation, a white-dominated profession finds it much more comfortable to assume that racial differences in health outcomes are due to biology instead of the truth, which is that race is a complex issue that cannot be reduced to one variable. By incorporating such stereotypes into guidelines we cross the line from unconscious bias on an individual level to racism, because now we are implanting that bias systematically.

All of this echoes eerily back to old anthropological "research" that proved white superiority through the measurement of skull size between white and black people. Of course, I'm not saying that these modern researchers are white supremacists; their intentions are certainly nobler. But the same racist pitfall is at play: over attributing observations to race.

Next Page  1  |  2

 

- Advertisement -

Must Read 1   Well Said 1   Supported 1  
View Ratings | Rate It

Jess Guh hails from a home just outside of Philadelphia where two Taiwanese immigrants were delightfully surprised to have raised a queer, outspoken radical. She attended Stanford University where she officially majored in film and unofficially (more...)
 

Share on Google Plus Submit to Twitter Add this Page to Facebook! Share on LinkedIn Pin It! Add this Page to Fark! Submit to Reddit Submit to Stumble Upon



Go To Commenting
/* The Petition Site */
The views expressed in this article are the sole responsibility of the author and do not necessarily reflect those of this website or its editors.

Follow Me on Twitter

Contact AuthorContact Author Contact EditorContact Editor Author PageView Authors' Articles
- Advertisement -

Most Popular Articles by this Author:     (View All Most Popular Articles by this Author)

TrumpCare is an Entitlement Program for the Rich and Powerful

Seattle's 'Liberals' Get Chance to Finally Start Addressing Police Brutality

Neurology Study Reveals What We Already Know: People of Color Get Worse Healthcare

Racism Alive and Well in New Medical Guidelines

Even with treatment for Hepatitis C, Abu-Jamal's health not guaranteed

Dakota Access Pipeline Prophecy for Worse to Come: Treaty Rights as Grim Lesson