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خرید پکیج
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Best practices for race- and ethnicity-conscious medical care

Best practices for race- and ethnicity-conscious medical care
Framework
  • Recognize that race and ethnicity are social constructs, without an innate biologic basis.
  • Most associations with health outcomes are related to social, cultural, and economic drivers of health, with wide variation within any given race or ethnic group.
Documentation of race and ethnicity
  • Ask the patient which race and ethnicity group(s) they identify with; do not make assumptions based on their appearance, language or other cultural cues.
  • Record this information with other elements of the social history; explore how a patient has experienced individual and/or structural level racism/discrimination, and how that may influence their health.
  • Do not include race and ethnicity in the chief complaint or medical history narrative; this common practice is misleading because it implies a biologic relevance.
Awareness of race-based myths and misconceptions
  • Learn about the history and ongoing manifestations of racism in medicine.
  • Recognize and correct historical and contemporary race-based myths and misconceptions.
Role of race and ethnicity information for direct clinical care
  • Appropriate uses of race and ethnicity:
    • To sensitize the clinician to a patient's disease risks.
    • To prioritize the differential diagnosis and inform the evaluation for social or genetic risk factors based on group disease risk profile.
    • To explore issues related to individual and/or structural level racism/discrimination to better inform more personalized and patient-sensitive lifestyle and health education recommendations.
  • Best practices:
    • Avoid applying group-level assumptions or stereotypes.
    • Do not use race or ethnicity to assume or exclude a diagnosis, or to make treatment decisions in the absence of clinical and laboratory data.
    • Use caution in interpreting algorithms or decision-aids that include race or ethnicity modifiers; these may be based on group-level risk differences but have little relevance for individual-level risks.
Public health and health system/allocation of resources
  • Racial and ethnic group level differences in disease prevalence or complications are useful for public health and health system purposes such as community/health system-level messaging, screening, and interventions, and allocation of resources.
This table outlines the authors' suggestions for clinicians to provide optimal race- and ethnicity-conscious health care.
Courtesy of Keith Norris MD, PhD, and Christina Harris, MD.
Graphic 143383 Version 1.0

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