Introduction
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.
Methods
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.
Results
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.
Conclusions
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.
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Article info
Publication history
Published online: February 08, 2023
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
