Race is a social construct that divides people into groups ranked as superior or inferior. It has no biological basis, but it is an important and consequential concept because societies use it to establish and justify systems of privilege, disenfranchisement, and oppression. It is also a very real part of people’s identities. Everyone is assigned a race, whether they are aware of it or not.
Historically, the Western concept of race served as a system of hierarchical human categorization to support European colonization, enslavement, and the devaluation of non-Europeans. This was the basis of racism, which is rooted in the false idea that Black and Native people are biologically inferior to Whites. This was the belief that led to medical and scientific atrocities such as forced sterilization, the use of Henrietta Lacks’ cells in research without her consent or acknowledgement, and the infamous Tuskegee syphilis study.
Today, there are many reasons to abandon the concept of race as it has no scientific validity or truth value. It is a social construct that is constantly being challenged by contemporary science which shows that there is more genetic variation within defined racial categories (intra-racially) than between different racial categories (inter-racially).
Studies consistently show that a person’s socioeconomic status — not their race – is the best predictor of health outcomes, including their risk for disease. It is time to move beyond the use of race to identify and address health disparities, replacing it with socioeconomic status as the primary indicator.
In addition, the U.S. Food and Drug Administration’s approval of the medication BiDil as a treatment for heart failure based on a limited number of studies, which were not controlled for genetic differences between people of color and Whites, is one example of how race-based medicine can be harmful.
There are growing calls to eliminate the question about race in official statistical data and for medical schools to teach students that racial classifications are flawed, misleading, and harmful. A more promising approach is to collect and report data by a combination of factors, such as socioeconomic status or ethnicity (e.g., Latino). This would enable researchers to avoid the legal impediments of using race and still provide useful information on the underlying causes of health disparities. It may also help reduce the tendency to misreport when a person is multiracial, as well as the potential for over- and underestimating risks based on inaccurate assumptions about how much genetic variation is associated with race. This is an issue that affects all communities, but the challenges are even more pronounced in low-income and minority-majority areas. Changing this pattern is crucial to reducing health disparities and improving overall population health. Fortunately, there are some encouraging signs that this trend is underway. For example, some health care organizations are instituting new policies that avoid the need for asking about a patient’s race by instead focusing on their socioeconomic status. This could be a model for other sectors to follow suit.