Is systemic racism in medicine putting Black people’s lives at risk?

Across the world, medical tests are being adjusted according to patients’ skin colour – with shocking consequences. One science writer tells how she helped overturn one of the pernicious assumptions of race-based healthcare

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My younger sister is an elite 400-metre sprinter who has competed internationally for Great Britain. In early 2020, she told me about some blood test results she had recently received – her creatinine level was a bit higher than normal – a potential indicator of a kidney problem. That wasn’t particularly surprising; creatinine is a waste product produced by muscles and so athletes, who tend to be more muscular on average, commonly have higher-than-average levels of the compound in their blood without this being associated with kidney problems. She had also shared her blood test results with a sports doctor. He confirmed that creatinine is derived from muscle metabolism and that levels are proportional to muscle mass. He also gave a list of factors that he said could be responsible for raised creatinine levels. One of those listed was “Afro-Caribbean race”. “Could my race be affecting my creatinine level?” my sister asked me.

I was about to stumble on an answer to my sister’s question. I was at the beginning of an investigation into what I now refer to as “race-based medicine” – the practice of adjusting medical tests based on a person’s race or ethnicity. I had first learned about it in a 2015 Ted Talk by US academic and author Dorothy Roberts, but I had assumed it would be a thing of the past by now. I soon discovered that race-based medicine is alive and well.

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