Since the organization was founded in June 1930, its guidelines prompted pediatricians to use race to determine diagnosis and medical protocols when treating infants with issues that ranged from urinary tract infections and jaundice. These guidelines lead to disparities in treatments, often to the detriment of the non-white infants receiving care.
In “Eliminating Race-Based Medicine,” a new policy statement pre-published in the peer-reviewed medical journal Pediatrics, the AAP says they will continue to purge outdated medical guidelines, as “race is a historically derived social construct that has no place as a biologic proxy.”
“In addition to valid measures of social determinants of health, the effects of racism require consideration in clinical decision-making tools in ways that are evidence informed and not inappropriately conflated with the limiting phenotype of race categorization,” the statement continues.
For context, phenotypic traits, or observable traits in an organism, such as skin color, were often used as justification by colonizers as they enslaved Africans, their descendants, and other people of color. This fueled even more research to support the continued colonization of the Americas, creating pseudosciences like phrenology, which measured bumps on the skull to predict personality traits and intelligence that — Surprise! — depicted white people as superior.
Naturally, these practices and discriminatory beliefs have influenced and still play a role in medicine today, which, along with the internalized racism of medical providers, makes getting good medical care harder for People of Color. For example: Black women are three times more likely to die post-childbirth because their concerns are often dismissed by their caretakers.
And apparently, the AAP was still using guidelines written in 1930 that said Black infants were less likely to get UTIs, simply because that is the way it had been for so long.
Last year, the AAP dismissed a guideline calculation based on the discriminatory belief that Black children were less likely to suffer from UTIs than their white peers. Their review found that the most prominent risk factors for UTIs were a history of prior infections and a fever lasting longer than 48 hours — which, to be clear, have absolutely nothing to do with race.
“This policy statement addresses the elimination of race-based medicine as part of a broader commitment to dismantle the structural and systemic inequities that lead to racial health disparities,” the statement continued.
In order to do this, the organization says it is committed to combing through its “entire catalog” and purging it of outdated materials, from textbooks to newsletter articles.
Later this year, the organization plans to go through its newborn jaundice guidance, which currently frames the liver condition as one more likely to be experienced by infants of “East Asian” or “Asian” ethnicity.
“We are really being much more rigorous about the ways in which we assess risk for disease and health outcomes,” Joseph Wright, lead author of the new policy and chief health equity officer at the University of Maryland’s Medical System, told NBC News. “We do have to hold ourselves accountable in that way. It’s going to require a heavy lift.”