Use ancestry or ZIP code—not race—when considering a patient's risk factors, AMA says

The American Medical Association (AMA) is calling for collaboration to improve clinical algorithms that incorrectly adjust for race and lead to less-than-optimal care for marginalized and minoritized patients. That policy builds on a previous AMA policy addressing bias in augmented intelligence. (Getty/FatCamera)

The medical community should treat race as a social—not a biological—construct, according to two new policies approved by representatives of the American Medical Association (AMA) on Monday.

During a special meeting of the AMA's House of Delegates, physician leaders voted to approve the policies aimed at supporting anti-racist concepts that challenge the current clinical application of race, officials said.

Specifically, one of the policies calls for using factors such as ancestry, genetics, biology, ZIP codes and education to describe a patient's risk factor, rather than their race. That use of race when describing a person's risk factors "exacerbates health disparities and results in detrimental health outcomes for marginalized communities," officials said.

The second policy asks the AMA to collaborate on recommendations to improve clinical algorithms that incorrectly adjust for race and lead to less-than-optimal care for marginalized and minoritized patients. That policy builds on a previous AMA policy addressing bias in augmented intelligence healthcare tools. 

“The AMA is dedicated to dismantling racist and discriminatory policies and practices across all of health care, and that includes the way we define race in medicine,” said AMA board member Michael Suk, M.D., in a statement. 

“By acknowledging that race is a social construct and not an inherent risk factor for disease, we can truly make progress toward our goal of attaining health equity for all patients," Suk said. "The AMA will continue to strongly support policies and regulations aimed at eliminating barriers to care and protecting the health of our nation’s most vulnerable populations.” 

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Both policies direct the AMA to partner with physician organizations and other stakeholders to identify any problematic aspects of medical education that can perpetuate institutional and structural racism.

This comes less than six months after the AMA's board approved a statement formally denouncing police brutality and all forms of racially motivated violence. The AMA also said it will "actively work" to dismantle racist and discriminatory policies and practices across all of healthcare.

The AMA hired its first chief health equity officer to establish the AMA Center for Health Equity in 2019.

The policies are also particularly timely in the midst of renewed national conversations about race sparked by the death of George Floyd, an unarmed black man, in Minneapolis. It also comes as the COVID-19 crisis highlighted stark disparities in health outcomes that have cut across racial lines.

The policies come amid growing awareness and critiques around the lack of racial diversity in medical education programs and among the ranks of physicians. In a commentary published in JAMA Internal Medicine in September, Johns Hopkins radiation oncologist Curtiland Deville Jr., M.D., said the ongoing underrepresentation of Black physicians across the healthcare fields shows either "complicit exclusion or gross negligence." 

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In September, businessman and former New York Mayor Michael Bloomberg said he wanted to help increase the number of Black doctors by giving $100 million in grants to be distributed to medical schools at historically Black universities.

In July, MacKenzie Scott, who is Amazon founder Jeff Bezos' ex-wife, pledged more than $1.7 billion to several historically Black universities including Morehouse and Howard University. In June, Reed Hastings, the billionaire founder of Netflix, announced a $120 million gift to Black colleges. In May, billionaires Frank and Laura Day Baker announced a $1 million gift to Spelman College, a historically Black college in Atlanta, to cover the balances owed by nearly 50 students. 

And in 2019, Robert F. Smith—the billionaire founder of the private equity firm Vista Equity Partners—announced during the commencement speech at Morehouse that he was paying off the student loans for the entire graduating class. With nearly 400 graduates in that class, the gift is worth about $40 million.