Icahn School of Medicine at Mount Sinai, New York, NY.
Icahn School of Medicine at Mount Sinai, New York, NY; Department of Medicine, Division of Nephrology, Mount Sinai Hospital, New York, NY.
Adv Chronic Kidney Dis. 2022 Nov;29(6):493-500. doi: 10.1053/j.ackd.2022.08.003.
Addressing persistent racial health disparities in cases of kidney disease will first require significant investment in examining how structural racism has influenced our clinical practice and medical education. Improving how we understand and articulate race is critical for achieving this goal. This work begins with ensuring that race's mention within nephrology literature and curricular materials for medical trainees is thoroughly rooted in evidence-based rationale-not to serve as a proxy for polygenic contributions, social determinants of health, or systemic health care barriers. While many institutions are increasingly recognizing the importance of instituting such changes on behalf of the systematically marginalized patient populations who are most affected by these disparities, there is a paucity of guidance on how to critically appraise and revise decades of pathophysiological and epidemiological findings through an antiracist lens. In this article, we propose an inquiry-based framework with case-study examples to help readers recognize improper use of race within nephrology, assess personal and institutional readiness to introduce changes to said content, and generate materials that center evidence-based findings and reject harmful misinterpretations of race.
解决肾脏疾病病例中持续存在的种族健康差异，首先需要大量投资研究结构性种族主义如何影响我们的临床实践和医学教育。改善我们对种族的理解和表达至关重要，以实现这一目标。这项工作首先要确保在肾脏病学文献和医学生的课程材料中提到种族时，其基础是有充分证据支持的理论，而不是作为多基因贡献、健康的社会决定因素或系统性医疗保健障碍的替代物。虽然许多机构越来越认识到必须为受这些差异影响最大的系统性边缘化患者群体进行此类变革，但关于如何通过反种族主义视角批判性地评估和修改数十年来的病理生理学和流行病学发现，几乎没有指导。在本文中，我们提出了一个基于探究的框架，并提供了案例研究示例，以帮助读者识别肾脏病学中种族的不当使用，评估个人和机构准备好对相关内容进行修改，以及生成以基于证据的发现为中心并摒弃对种族的有害误解的材料。
