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Race-adjusted medical test scores harm Black patients. Why do we still use them?

A nurse checks the vitals of a 33-year-old woman in Shreveport, La., on Oct. 9, 2021. (Rebecca Blackwell/AP)
Rebecca Blackwell/AP
A nurse checks the vitals of a 33-year-old woman in Shreveport, La., on Oct. 9, 2021. (Rebecca Blackwell/AP)

For decades, the medical standard of care included race-based medical tests — or giving different scores to Black and white patients with identical test results — to determine how sick a patient might be. It’s most prominently used for kidney and lung function.

The result is that Black patients appear less sick, and therefore have been getting less aggressive treatment, lower-to-no priority for transplants, and difficulty collecting benefits for chronic, life-altering disease. The score adjustments are based on antiquated pseudo-science claiming that Black people, or those who doctors identify as Black, are physiologically different; that they have more muscle mass, or that their lung capacity is inferior to that of white people.

Some of the fake science goes all the way back to Thomas Jefferson and the plantation doctors who claimed beating enslaved people could actually help them by causing them to gasp, thereby improving their lung capacity.

Veteran medical reporter Rachel Gotbaum takes a deep dive into the so-called “Race Equation,” how it came to be, who it’s affecting, and what’s been done to change the thinking and establish the new race-neutral testing that’s changing the lives of tens of thousands of Black patients. Her podcast series is “The Race Equation,” part of the New England Journal of Medicine’s “Intention to Treat” show. She joins host Robin Young to discuss her series.

This article was originally published on WBUR.org.

Copyright 2026 WBUR

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