Cited by 6Race, Genetics, and SocietyRacial and Ethnic Identity ResearchMedical History and Research

Challenging Race-Based Medicine Through Historical Education About the Social Construction of Race

Open access
Skinner-Dorkenoo, Allison L., Rogbeer, Kasheena G., Sarmal, Apoorva, Ware, Cynthia, Zhu, Jennifer·2023·Health Equity

Abstract

Background: Scientifically, there is little genetic variation among humans and race has no biological basis. However, medical school preclinical curricula tend to misrepresent race and reify biologically essentialist explanations for disease. The social construct of race is, therefore, used to inform health care providers' treatment decisions. Use of race-based medicine has been identified as a contributor to racial health disparities, spurring a growing movement to challenge race essentialism and race-based medicine. The current research tested an intervention that educates college students about the historical construction of racial categories in the United States. Methods: Participants who were randomly assigned to the intervention condition read an article highlighting the history of the sociopolitical construction of race. They were then prompted to discuss in dyads how racial categories were created and changed over history, and-in light of all this-the appropriateness of race-based medicine. Those assigned to the control condition advanced directly to the outcome measures. Results: Participants in the intervention condition reported less race essentialism, less support for race-based medicine, and greater belief that race-based medicine contributes to racial health disparities. Findings were not moderated by premed status. Discussion: Our data provide initial evidence that our interactive intervention could effectively reduce biological essentialism and support for race-based medicine in both premed and non-premed students. Health Equity Implications: This intervention has the potential to shape the way health care providers in-training understand race, their internalization of biologically essentialist explanations for disease, and willingness to adopt race-based treatment plans.

AI snapshot

Written from the paper’s full text.

TL;DR

This study tested a brief interactive educational intervention about the historical sociopolitical construction of race among U.S. undergraduates and found reduced race essentialism and less support for race-based medicine. Effects did not differ by premed status, though the authors frame this as initial proof-of-concept evidence.

Key findings

  • Intervention participants reported lower biological essentialism than controls (M=2.87 vs. 3.61; t=5.25, p<0.001) and lower general race essentialism (M=3.71 vs. 4.22; t=6.77, p<0.001).
  • Intervention participants reported less general support for race-based medicine (M=4.06 vs. 4.88; t=7.52, p<0.001), less agreement with specific race-based medical decisions (M=2.91 vs. 3.76; t=7.31, p<0.001), and less trust in those decisions (M=2.79 vs. 3.48; t=6.45, p<0.001).
  • Intervention participants more strongly agreed that race-based medicine contributes to racial health disparities (M=5.53 vs. 5.04; t=2.92, p=0.004).
  • Premed status did not moderate intervention effects (ps>0.10), but premed students were more likely than non-premed students to agree with physicians’ race-based decisions (M=3.56 vs. 3.21; F(1,349)=7.79, p=0.006) and to trust those decisions (M=3.37 vs. 3.02; F(1,349)=10.08, p=0.002).

Methods

  • Undergraduate students (N=356) were recruited from a psychology department participant pool at a large public university in the Southeastern United States and completed the study on Zoom; conditions were control (n=161) and intervention (n=195).
  • Intervention participants read a ~500-word article on the historical social construction of race, discussed it in dyads, read a ~500-word article about a biracial teenage boy harmed by race correction, and discussed race-based medicine; control participants went directly to outcome measures.
  • Outcomes were assessed with 7-point Likert-type measures of biological and general race essentialism, support for race-based medicine, agreement with and trust in specific race-based medical decisions, and belief that race-based medicine contributes to racial health disparities; analyses used t-tests and ANOVAs.

Limitations

  • The paper states that pre-intervention attitudes were not assessed, limiting confirmation that individual differences were evenly distributed across conditions.
  • The paper states that the study was not longitudinal, so durability of attitude changes is unknown.
  • The text makes evident that the sample was undergraduates at one Southeastern public university rather than medical students, and outcomes were self-reported; the authors describe this as an initial proof-of-concept test.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1089/heq.2023.0036

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

8 of 26 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Race corrections in clinical algorithms often have the effect of requiring patients of color to be sicker before they qualify for the same level of care as a White patient.

    “Such “corrections” are used in a variety of areas of medicine, from endocrinology and nephrology to oncology and obstetrics, which often have the effect of requiring patients of color to be sicker before they qualify for the same level of care as a White patient.24–26”
    Quote in the paperSubstantial claim3 of 3 sources checked
    • cites [24] source

      The section on racial disparities in kidney disease says the eGFR race coefficient can delay transplant waitlist priority for Black patients. The section on implications of race-adjusted equations also describes a heart-failure calculator that assigns Black patients lower mortality risk, potentially withholding recommended therapy. These examples support the claimed effect, but the paper does not establish that it occurs often across all the named specialties, particularly oncology and obstetrics. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [25] source

      The passage on UNOS waiting-time reinstatement (section and page unavailable) describes a Black transplant recipient who, at the same creatinine level as another recipient, would not regain waiting time. This supports the claim for a kidney-transplant eligibility decision, but the paper does not establish the broader claim across the other areas of medicine named in the citing sentence. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [26] source

      The introduction says many race-adjusted algorithms may direct more resources to White patients, and the Nephrology section says race-corrected kidney estimates might delay Black patients’ referral for specialist care or transplantation. Table 1 likewise says a heart-failure score may raise the threshold for clinical resources for Black patients. These passages support the concern behind the paraphrase, but describe potential effects rather than establishing that patients of color often must be sicker to receive the same care. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    Removing race corrections in the treatment of kidney disease would result in a third of Black kidney disease patients in the United States receiving an elevated level of care.

    “a recent analysis of the impact of removing race corrections in the treatment of kidney disease indicated that a third of Black kidney disease patients in the United States would receive an elevated level of care if the race corrections were dropped.27”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [27] source

      The Results report that 743 of 2,225 African-American patients (33.4%) in one healthcare system would be reclassified to a more severe CKD stage if the race multiplier were removed. The paper discusses potential care implications, but it does not establish that one-third of Black kidney disease patients across the United States would actually receive an elevated level of care. The Abstract also cautions that the single-system sample may limit generalizability; page numbers were not supplied. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
  • Premisecitation

    Race-based medicine has been identified as a contributor to racial health disparities in the United States.

    “race-based medicine has been identified as a contributor to racial health disparities in the United States 29”
    Quote in the paperSubstantial claim1 of 1 sources checked
  • Premisecitation

    Active learning activities facilitate long-term changes in attitudes.

    “Beyond facilitating deep learning, active learning activities also seem to facilitate long-term changes in attitudes.46–48”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [46] source
    • cites [47] source
    • cites [48] source

      The Materials and procedure and primary analysis sections report that participants expecting to transmit a persuasive message retained their attitudes four weeks later, while those expecting to receive more information showed weakening attitudes. This supports persistence after a specific participatory task, but the study did not test active learning activities generally or show that those activities themselves produced the initial attitude change. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Premisecitation

    A substantial minority of medical students and residents report false beliefs about biological differences between racial groups.

    “a substantial minority of medical students and residents report false beliefs about biological differences between racial groups—such as Black people having thicker skin than White people.23”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [23] source

      Study 2 reports that about 50% of its medical-student and resident participants considered at least one false belief possibly, probably, or definitely true. The paper describes this as a sample of white medical students and residents, so the citing sentence omits a population qualifier. The paper also gives the thicker-skin belief as an example. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • May combine two claims. 4
  • Classified as probably not a substantial claim. 9
  • May combine two claims.

    Interpretationown data

    The interactive intervention could effectively reduce biological essentialism and support for race-based medicine in both premed and non-premed students.

    “Our data provide initial evidence that our interactive intervention could effectively reduce biological essentialism and support for race-based medicine in both premed and non-premed students.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The trust in specific race-based medical decisions measure had an internal consistency reliability of α=0.81.

    “trust in (α=0.81)”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    By including critical historical education about the sociopolitical construction of race in medical school curricula, interventions of this kind have the potential to help reduce persistent racial health disparities.

    “By including critical historical education about the sociopolitical construction of race in medical school curricula, interventions of this kind have the potential to help reduce persistent racial health disparities that impact the lives of millions of people of color in the United States, creating a more equitable health care system.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Reducing essentialist attitudes and support for race-based medicine among students will lead to reduced use of race-based medicine in clinical practice and thereby reduce racial health disparities.
    • Rests on an assumption: The effects of the intervention on undergraduate students will generalize to medical students and future physicians.
  • May combine two claims.

    Interpretationown data

    Our intervention may be one avenue for changing how medical education is structured, as it shows potential to reduce racial essentialism and support for race-based medical practices among the next generation of medical practitioners.

    “Our intervention may be one such avenue for changing how medical education is structured, as it shows the potential to reduce racial essentialism and support for race-based medical practices among the next generation of medical practitioners.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Study design and conductreasoning

    The study was not longitudinal, so it cannot draw conclusions about the durability of the attitude changes.

    “Since this was not a longitudinal study, we are also unable to draw conclusions about the durability of the attitude changes observed in our study.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The general race essentialism measure had an internal consistency reliability of α=0.84.

    “General race essentialism was assessed using the Race Conceptions Scale55 (α=0.84)”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The biological race essentialism measure had an internal consistency reliability of α=0.86.

    “Biological race essentialism (α=0.86)54”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The support for race-based medicine measure had an internal consistency reliability of α=0.90.

    “We assessed support for race-based medicine in general (α=0.90)”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Interactive, Constructive, Active, and Passive framework identifies interactive learning as the strategy that results in the most learning.

    “Our intervention approach was developed using the Interactive, Constructive, Active, and Passive framework to facilitate interactive learning among students, which has been identified by education scholars as the strategy that results in the most learning.52”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52] source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The agreement with specific race-based medical decisions measure had an internal consistency reliability of α=0.78.

    “agreement with (α=0.78) specific race-based medical decisions”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    When only a single participant was present, they were placed in the control condition regardless of their originally planned condition assignment.

    “Two participants were required to administer the experimental condition; therefore, when only a single participant was present to participate in the session, they were placed in the control condition regardless of their originally planned condition assignment.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    There is little genetic variation among humans, and much more genetic variation within racial groups than there are between them.

    “Despite advanced genomic research confirming that there is little genetic variation among humans, and much more genetic variation within racial groups than there are between them,19”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] source
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    The intervention has the potential to shape the way health care providers in-training understand race, their internalization of biologically essentialist explanations for disease, and willingness to adopt race-based treatment plans.

    “This intervention has the potential to shape the way health care providers in-training understand race, their internalization of biologically essentialist explanations for disease, and willingness to adopt race-based treatment plans.”
    Quote in the paperNot a substantial claim
13 of 13
  • The paper relies on this without support.

    Reducing essentialist attitudes and support for race-based medicine among students will lead to reduced use of race-based medicine in clinical practice and thereby reduce racial health disparities.

    “This intervention has the potential to shape the way health care providers in-training understand race, their internalization of biologically essentialist explanations for disease, and willingness to adopt race-based treatment plans.”
    “By including critical historical education about the sociopolitical construction of race in medical school curricula, interventions of this kind have the potential to help reduce persistent racial health disparities that impact the lives of millions of people of color in the United States, creating a more equitable health care system.”
  • The paper relies on this without support.

    The effects of the intervention on undergraduate students will generalize to medical students and future physicians.

    “Testing our interactive educational intervention in this population allowed us to do an initial assessment of its potential effectiveness (proof of concept) before attempting a much more costly and logistically challenging intervention with medical students.”
  • The paper relies on this without support.

    The historical information presented in the intervention accurately represents the sociopolitical construction of race.

    “Those who were assigned to the intervention condition each read a different article (∼500 words) highlighting the historical social construction of race (see the Open Science Framework for full articles, materials, and data)”
3 of 3

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • ConsistentF(1, 349) = 7.79reported p = .006 · recomputed p = .006

    “F(1, 349)=7.79, p = .006”

  • ConsistentF(1, 349) = 10.08reported p = .002 · recomputed p = .002

    “F(1, 349)=10.08, p = .002”

2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. 38. Mills CW. The Racial Contract. Cornell University Press: Ithaca, New York; 1997.

Cited by

Sorted by citations

Authors
Skinner-Dorkenoo, A. L., Rogbeer, K. G., Sarmal, A., Ware, C., & Zhu, J.
Affiliations
  • Department of Psychology, University of Georgia, Athans, Georgia, USA.
  • University of California, Los Angeles (US)
  • University of Georgia (US)
Venue
Health Equity
Published
2023-11-01
Volume
7
Issue
1
Pages
764-772
ISSN
2473-1242 (ISSN-L)
OpenAlex
W4389168380
Cited by
6
References
56
Citations by year
2025: 3 · 2024: 3
FWCI
0.88
Type
journal article
Language
en
Open access
Locations
  • Health Equity (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • PsyArXiv (OSF Preprints) (submittedVersion)
  • PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
Funders
University of Georgia
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Race, Genetics, and Society
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Social Sciences › Arts and Humanities › History › Medical History and Research
Keywords
race-based medicine, social construction of race, medical education, racial disparities in health, biological essentialism

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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