Racism in medicine: I thought this was an interesting article about the differences in treating respiratory illnesses in our children. The wrong or underdiagnosis of illnesses in our kids is very disturbing!
Black children are less likely to receive a prescription antibiotic
than their nonblack counterparts — even when treated by the same health
provider — according to a study published today in Pediatrics.
The findings are based on 1.3 million doctor visits with the same 222
providers, and were independent of age, gender or type of insurance.
This is not the first time research has shown racial biases among
health professionals. A smaller study at the University of Washington,
showed that unconscious racial biases affected the amount of pain
medication given to black children when they needed it. And a Johns
Hopkins study highlighted that primary physicians with unconscious
racial biases tended to dominate conversations with black patients,
ignore their social needs and exclude them from the decision-making
However, today’s study is one of the few to look at its effects on respiratory infections and antibiotic use in children.
“Our goal has always been to find ways to improve antibiotic
prescribing for children,” says study author Dr. Jeffrey S. Gerber, who
is also assistant professor of pediatrics at the University of
Pennsylvania School of Medicine’s Division of Infectious Diseases.
“These analyses [then] revealed the differences in prescribing by race.”
Although, what this study has uncovered may not be a negative. In the
age of antibiotic overprescribing and the fear that unnecessary
antibiotics later lead to “superbugs” that are too strong to treat, this
may in fact be a good thing.
“Overprescribing of antibiotics to children with [respiratory tract infections] is common,” Gerber says.
He and his team suspect that the racial discrepancy may mean that non-black children are being prescribed too
many antibiotics — not that black children are being deprived of
necessary antibiotics. However, more research is needed to prove their
The question still remains: why are black children receiving different treatments?
“The doctor-patient relationship is complex,” Gerber says.
“Differences in parental expectations (‘My child needs antibiotics’),
physician perception of parental expectations (‘This parent is going to
demand antibiotics’), or the use of shared decision-making (‘Here are
the options. Lets decide together how to proceed’) that correlate with
patient race could account for some or most of the differential
The study did not identify the races of the treating health providers.
John Hoberman, professor of Germanic Studies at The University of
Texas at Austin, examines racial biases among physicians in his book, Black & Blue: The Origins and Consequences of Medical Racism.
Last year, in a release, he explains that until medical school
curricula acknowledge historical medical racism and include new
perspectives, enlightenment about these issues won’t occur.
The problem in Gerber’s study could also exist because the providers
were missing the diagnosis altogether. Compared with nonblack children,
the healthcare providers in Gerber’s study were also significantly less
likely to diagnose an acute respiratory tract infection in their black
So, in order to at least level the field on the prescribing issue,
Gerber’s hope is that, in creating specific guidelines for physicians to
follow when prescribing antibiotics, it will leave less to
interpretation and that the discrepancies will ultimately improve.
“We are currently analyzing a study designed to do this,” he says.