Joseph Wright, MD, MPH, and his team at the American Academy of Pediatrics (AAP) are in the midst of a herculean task—reviewing the AAP’s catalog of roughly 400 policies, guidelines, and algorithms to identify those that inappropriately use race as a proxy for biology and may exacerbate health disparities. The goal is to replace them with race-conscious approaches that explicitly aim to enhance equity. [JAMA Network]

“We cannot ignore the impact that race and ethnicity have on differential lived experiences and that those lived experiences contribute to differential health status and health outcomes,” Wright, chief equity officer and senior vice president of equity initiatives at the AAP, said in an interview.

While he and his team started with the 150 or so policies that explicitly involve race, they also plan to review policies with less obvious connections.

“What I’m concerned about is the more insidious embedding of bias into many clinical practice guidelines,” Wright said. “That’s what we are determined to ferret out.”

The AAP is among a growing number of medical societies that are systematically reviewing the way race is used in clinical guidelines or algorithms. Some have already replaced race with clinical factors or social determinants of health in their widely used clinical algorithms.

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