The US pediatricians group is moving to abandon race-based guidance

For years, pediatricians have followed erroneous guidelines that link breed to risks of UTIs and neonatal jaundice. In a new policy announced Monday, the American Academy of Pediatrics said it is scrutinizing all of its guidelines to eliminate “race-based” medicine and the health disparities that result from it.

A re-examination of AAP treatment recommendations, which began before George Floyd’s death in 2020 and intensified after doctors were concerned that black youth were being undertreated and overlooked, said Dr. Joseph Wright, lead author of the new guideline and chief health equity officer at the The University of Maryland Medical System.

The influential academy has started deleting outdated advice. It commits to reviewing its “entire catalog,” including policies, instructional materials, textbooks and newsletter articles, Wright said.

“We’re really much more rigorous in the way we assess risk for disease and health outcomes,” Wright said. “We have to hold ourselves accountable in this way. It will require hard work.”

dr Brittani James, a primary care physician and medical director at a Chicago health center, said the academy is taking a critical step.

“What makes this so monumental is the fact that this is a medical facility and it’s not just words. They play,” James said.

In recent years, other major medical associations, including the American Medical Association, have made similar commitments. They are driven in part by civil rights and social justice movements, but also by science showing the powerful role that social conditions, genetics and other biological factors play in determining health.

Last year, the Academy withdrew a guideline calculation based on the unproven idea that black children are at lower risk of UTIs than white children. A review had shown that the strongest risk factors were previous UTIs and fever lasting more than 48 hours, not race, Wright said.

A revision of the guidelines for newborn jaundice – which currently suggest certain breeds have higher and lower risks – is planned for this summer, Wright said.

dr Nia Heard-Garris, director of an academy group on minority health and justice and a pediatrician at Lurie Children’s Hospital in Chicago, noted that the new policy includes a brief history of “how some of our commonly used clinical tools came about — about pseudoscience and racism.” .”

Whatever the intent, these tools have harmed patients, she said.

“This is against our oath as physicians – to do no harm – and therefore should not be used,” Heard-Garris said.

dr Valerie Walker, a specialist in neonatal care and health equity at Nationwide Children’s Hospital in Columbus, Ohio, called the new policy “a critical step” in reducing racial health disparities.

The Academy calls on other medical institutions and professional groups to take a similar approach to eradicating racism in medicine.

“We can’t just plug a leak in a punctured pipe and expect it to be fixed,” Heard-Garris said. “This statement sheds light on pediatricians and other healthcare providers to find and patch these holes.”

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Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.

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