Race ‘Frequently Used’ in Pediatric Medical Guidelines: Study

A new study assessing the use of race in guidance for U.S. pediatricians found race was “frequently used” in such a way that “could negatively affect health care inequities.”

The review of existing pediatric clinical practice guidelines comes in the wake of recent pushes from medical organizations calling for an end to racial bias in medicine.

The study was published Monday by JAMA Pediatrics. Researchers noted that clinical practice guidelines are used as “a common way to synthesize and disseminate best practice for some of the most common health care problems,” with more than 3,700 in existence in more than 30 countries as of 2011.

A new study published Monday said race was “frequently used” in pediatric clinical practice guidelines. Here, a nurse administers a pediatric dose of the COVID-19 vaccine at a L.A. Care Health Plan vaccination clinic in Los Angeles, California, on January 19, 2022.
ROBYN BECK/AFP via Getty Images

Clinical practice guidelines that are “appropriately” created can “lead to improvements in health care quality and outcomes,” but they “can have negative consequences on health if they are not intentionally developed to address health inequities of socially and racially marginalized communities,” the study said.

Researchers reviewed 414 pediatric clinical practice guidelines, about 30 percent of which—126 in total—included race or ethnicity terms. All of the guidelines reviewed were intended for use in dealing with patients under age 19 between the start of 2016 and the end of April 2021.

The guidelines that did include race or ethnicity terms warranted further review for the study. Researchers found that those guidelines featured 175 uses of a race term “in either background, clinical recommendations, or future directions.”

Researchers further found that “use of race with a potential negative effect occurred 87 times” in 73 of the guidelines, while mention of race with a “positive effect” was found 50 times in 45 of the guidelines.

Focusing on the instances where race terms were used to portray a negative effect in background information for the guidelines, researchers said race was “commonly suggested as a risk factor for disease pathology” and “also conflated with culture while perpetuating negative stereotypes.”

Though the majority of the pediatric clinical practice guidelines initially gathered for review did not mention race, those that did had a 57 percent rate of doing so “in a way that could exacerbate or have negative effects on inequities.”

In the study’s introduction, researchers noted that “many professional organizations” have come to terms in recent years with the ways in which they have contributed to existing inequities in the U.S. health care system. The study pointed specifically to a 2019 statement released by the American Academy of Pediatrics (AAP), in which the organization acknowledged the impact racism has on the health of children and young adults.

The AAP went on to call for the “elimination of race-based medicine” in a statement released last month. The AAP pointed Newsweek to this May 2022 statement when reached Monday for comment.

The study’s researchers encouraged organizations involved with the development of clinical guidance to continue working on addressing existing racial inequities in health care.

“In this systematic review of U.S.-based pediatric clinical guidelines, race was frequently used in ways that could negatively affect health care inequities,” researchers wrote in the study’s conclusion. “All CPG developers should adopt strategies, methods, and partnerships to address racial health inequities.”

Race ‘Frequently Used’ in Pediatric Medical Guidelines: Study
Source: Gwapo Pinoys PH

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