Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, Minnesota.
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania; The Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
Am J Prev Med. 2023 Apr;64(4):477-482. doi: 10.1016/j.amepre.2022.10.019. Epub 2023 Feb 9.
Physicians' perspectives regarding the etiology of racial health differences may be associated with their use of race in clinical practice (race-based practice). This study evaluates whether attributing racial differences in health to genetics, culture, or social conditions is associated with race-based practice.
This is a cross-sectional analysis, conducted in 2022, of the Council of Academic Family Medicine Education Research Alliance 2021 general membership survey. Only actively practicing U.S. physicians were included. The survey included demographic questions; the Racial Attributes in Clinical Evaluation (RACE) scale (higher scores imply greater race-based practice); and 3 questions regarding beliefs that racial differences in genetics, culture (e.g., health beliefs), or social conditions (e.g., education) explained racial differences in health. Three multivariable linear regressions were used to evaluate the relationship between RACE scores and beliefs regarding the etiology of racial differences in health.
Of the 4,314 survey recipients, 949 (22%) responded, of whom 689 were actively practicing U.S. physicians. In multivariable regressions controlling for age, gender, race, ethnicity, and practice characteristics, a higher RACE score was associated with a greater belief that differences in genetics (β=3.57; 95% CI=3.19, 3.95) and culture (β=1.57; 95% CI=0.99, 2.16)-in but not social conditions-explained differences in health.
Physicians who believed that genetic or cultural differences between racial groups explained racial differences in health outcomes were more likely to use race in clinical care. Further research is needed to determine how race is differentially applied in clinical care on the basis of the belief in its genetic or cultural significance.
医生对种族健康差异病因的看法可能与其在临床实践中使用种族（基于种族的实践）有关。本研究评估将健康方面的种族差异归因于遗传、文化还是社会条件是否与基于种族的实践相关。
这是一项 2022 年进行的横断面分析，对学术家庭医学教育研究联盟 2021 年普通成员调查进行分析。仅包括活跃在美国的执业医生。该调查包括人口统计学问题；临床评估中的种族属性（RACE）量表（得分越高，基于种族的实践程度越高）；以及关于遗传、文化（如健康信念）或社会条件（如教育）方面的种族差异解释健康方面种族差异的三个问题。使用三个多变量线性回归来评估 RACE 得分与健康方面种族差异病因的信念之间的关系。
在收到的 4314 份调查中，有 949 人（22%）做出回应，其中 689 人是活跃在美国的执业医生。在多变量回归中，控制年龄、性别、种族、民族和实践特征，RACE 得分越高，越相信遗传差异（β=3.57；95%CI=3.19，3.95）和文化（β=1.57；95%CI=0.99，2.16）——但不是社会条件——解释了健康结果的差异。
认为种族群体之间存在遗传或文化差异可以解释健康结果的种族差异的医生更有可能在临床护理中使用种族。需要进一步研究如何根据对种族遗传或文化意义的信念，在临床护理中不同地应用种族。
