From race-based to race-conscious medicine: how anti-racist uprisings call us to act

Elsevier, The Lancet, Volume 396, Issue 10257, 2020, Pages 1125-1128, ISSN 0140-6736
Jessica P Cerdeña, mPhil, Marie V Plaisime, MPH, and Jennifer Tsai, MD

The brutalisation of Jacob Blake and murders of George Floyd, Breonna Taylor, Ahmaud Arbery, Tony McDade, and countless others—coupled with horrifying statistics about the disproportionate burden of COVID-19 on Black and Brown communities—have forced the USA and the world to reckon with how structural racism conditions survival. Although clinicians often imagine themselves as beneficent caregivers, it is increasingly clear that medicine is not a stand-alone institution immune to racial inequities, but rather is an institution of structural racism. A pervasive example of this participation is race-based medicine, the system by which research characterising race as an essential, biological variable, translates into clinical practice, leading to inequitable care. The authors discuss examples of race-based medicine, how it is learned, and how it perpetuates health-care disparities. They introduce race-conscious medicine as an alternative approach that emphasises racism, rather than race, as a key determinant of illness and health, encouraging providers to focus only on the most relevant data to mitigate health inequities.