A Voice in Support of Accounting for Race and Language in Health Services

By Phyllis Griffin Epps

The role of race in medical research and practice is an area of intense debate and controversy. Increasing knowledge about the function of genes adds to evidence debunking traditional notions of race as an indicator of fundamental differences in human biology. There have been calls for the elimination of the use of racial identifiers in the context of medicine. Racial identifiers, it is argued, are more meaningless than helpful; continued use of racial identifiers in the practice of medicine causes harm by perpetuating inaccuracies about racial groups and the potential for bias on the part of the provider.

A report recently published by the Commonwealth Fund outlines a case to the contrary. The report, "Racial, Ethnic, and Primary Language Data Collection in the Health Care System: An Assessment of Federal Policies and Practices," cites the importance of collecting and reporting health-related data by race, ethnicity, and primary language across federally supported health programs as an essential step in the elimination of disparities in medical treatment and health outcomes in the United States. Uniform collection of health-related data by race, ethnicity, and primary language is necessary: (1) to develop prevention, intervention, and treatment programs as well as enforceable standards to ensure nondiscrimination; (2) to develop culturally and linguistically appropriate health care; and (3) to compare performance and quality of care in different geographic, cultural, and ethnic communities.

The report offers an interesting counter-argument to those who deny that race or ethnicity can play a legitimate role in the delivery of health care. The authors of the report encourage the use of racial and ethnic identifiers not to validate notions of physical difference but to identify and, where appropriate, resist cultural biases and preferences among providers and patients. The goal is better quality care for everyone. According to the report, the accounting of race, ethnicity, or primary language will lead to better measures for assessing the quality of health care and outcomes. The report also describes the government’s role in eliminating health disparities and the importance of institutional will and leadership.

The idea of race as a symbol of biological difference may be fading, but the concept of race as a cultural indicator or social identifier may retain some value in efforts to equalize the quality of care. Does the value outweigh the dangers of perpetuating inaccuracies about different groups? The report is a valuable contribution to the conversation.