Department of Family Medicine, University of North Carolina School of Medicine, 590 Manning Dr, Chapel Hill, NC, 27514, USA.
Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
J Racial Ethn Health Disparities. 2022 Oct;9(5):2019-2026. doi: 10.1007/s40615-021-01141-1. Epub 2021 Sep 7.
Colorblindness is a racial ideology that minimizes the role of systemic racism in shaping outcomes for racial minorities. Physicians who embrace colorblindness may be less likely to interrogate the role of racism in generating health disparities and less likely to challenge race-based treatment. This study evaluates the association between physician colorblindness and the use of race in medical decision-making.
This is a cross-sectional survey study, conducted in September 2019, of members of the Minnesota Academy of Family Physicians. The survey included demographic and practice questions and two measures: Color-blind Racial Attitudes Scale (CoBRAS; measuring unawareness of racial privilege, institutional discrimination, and blatant racial issues) and Racial Attributes in Clinical Evaluation (RACE; measuring the use of race in medical decision-making). Multivariable regression analyses assessed the relationship between CoBRAS and RACE.
Our response rate was 17% (267/1595). In a multivariable analysis controlling for physician demographic and practice characteristics, CoBRAS scores were positively associated with RACE (β = 0.05, p = 0.02). When CoBRAS subscales were used in place of the overall CoBRAS score, only unawareness of institutional discrimination was positively associated with RACE (β = 0.18, p = 0.01).
Physicians who adhere to a color blind racial ideology, particularly those who deny institutional racism, are more likely to use race in medical decision-making. As the use of race may be due to a colorblind racial ideology, and therefore due to a poor understanding of how systemic racism affects health, more physician education about racism as a health risk is needed.
色盲是一种种族意识形态，它最小化了系统性种族主义在塑造少数族裔结果方面的作用。接受色盲的医生可能不太可能质疑种族主义在产生健康差距方面的作用，也不太可能挑战基于种族的治疗方法。本研究评估了医生的色盲与在医学决策中使用种族之间的关联。
这是一项横断面调查研究，于 2019 年 9 月在明尼苏达州家庭医生学会的成员中进行。该调查包括人口统计学和实践问题以及两个衡量标准：色盲种族态度量表（CoBRAS；衡量对种族特权、制度歧视和明显种族问题的无知）和临床评估中的种族属性（RACE；衡量在医学决策中使用种族）。多变量回归分析评估了 CoBRAS 与 RACE 之间的关系。
我们的回复率为 17%（267/1595）。在控制医生人口统计学和实践特征的多变量分析中，CoBRAS 分数与 RACE 呈正相关（β=0.05，p=0.02）。当 CoBRAS 子量表代替总体 CoBRAS 分数使用时，只有对制度歧视的无知与 RACE 呈正相关（β=0.18，p=0.01）。
坚持色盲种族意识形态的医生，尤其是那些否认制度种族主义的医生，更有可能在医学决策中使用种族。由于种族的使用可能是由于色盲的种族意识形态，因此由于对系统性种族主义如何影响健康的理解较差，需要对医生进行更多关于种族主义作为健康风险的教育。
