Home Forums Discussions Problems Race on demographics

It does not give enough options when putting in race. It also list American indian and Alaskan native. I am american indian but not an alaskan native, so this needs to be corrected also. Thanks

And as a Jew who knows we are not seen or viewed as all other WHITE People nor do we have the same Genes either... I would love to finally see this get made separate as I'm sure so would most people of various Arab backgrounds and heritages... They are not black or what one thinks of as african american even if in actuality many of them honestly are from the northern part of Africa, nor are they plain old wonder bread white either.... Just watch the news to know I'm right here. It's a tough designation ethicity to own right now in America to say the least and my heart goes out to such folks who are probably suffering much abuse at the hands of some very closed minded and negative people...

Just ask my GI who recently Dx'ed me with Ulcerative Colitis if my 100% Jewish ethnicity and genetics is or is NOT significant to my condition. It is almost certainly my genes that played a huge role in my developing this disease... Right????Celiac too as I have been told runs harder in Jewish lines.

Just as Blacks, African Americans are more prone to BP and Diabetes in a different forms with different needs and prognosis than most white people as well...

IN the end, I don't care about the Gov'ts lack of specificity and over generalization. This is medicine and we here all know better than this... and we need to be able to properly document and track it as such.... When my GI's all too vauge new horrible EMR's questionaire asked me this same exact question, I entered OTHER and on the line next to it, I said "Jewish" which is the most honest and most accurate answer, especially in my case and with my condition.... Time for us to stop using politically determined designations and to make sure we use the ones that medicine and science dictate we use so as to best track, document and treat folks so we can take the best care of them if and when such things are valid and relavent....

Paul

Unfortunately the government mandates the categories as listed.

Aaaaaahhhh Yes, there goes that all too "Meaningful" (Or was that Meaningless????) Use thing again.... I forget so easily sometimes...

Paul

As far as I can tell, this is the latest official information from the Office of Management and Budget, which manages the Census. [not sure why the link function didn't work in HTML, but the URL is right, so you can copy and paste in your browser]

url=http://www.census.gov/population/www/socdemo/race/Ombdir15.html

Everything is going to be bases on the census, and the racial distinctions are sociopolitical, no longer genetic or medically-based in any way. If you think certain groups need to be kept track of, write your congressperson.

From a medical ethics point of view, there is clearly emerging data suggesting that different treatments or approaches might be optimal for those with different genetic ancestries. These distinctions are unlikely to overlap much with meaningless Census distinctions, such as 'Hispanic' (which, after years of debate, has apparently been changed to 'Hispanic or Latino.' The 'Asian or Pacific Islander' category will be separated into two categories -- "Asian" and "Native Hawaiian or Other Pacific Islander." Hey, at least the islanders live on islands for pete's sake. My Korean and Chinese families don't want to be grouped with Japanese. My family with 4 Chinese grandparents who just immigrated here from Brazil--what are they? Are they Latino because Portuguese is a Romance Language? Hispanic because they are from South America? I think this is an ethics discussion because even with demonstrable medical distinctions, how does the working doctor categorize the folks sitting in the exam room, and their variegated offspring? Do we wing it on skin pigment (I have dark kids and light kids from curiously mixed parents).

My personal opinion is that the idea of race is a sad vestigial construct without helpful meaning. Here's what I need to know: have any of the child's relatives had sickle-cell disease? Cystic Fibrosis? Hemophilia? You just can't judge a book by its cover. It wouldn't help me to have a place on the chart for 'ethnicity.' But in the Social History section of AC, which is generally retained for some notes, I will note if a child is adopted and from where. I will note there if there are medically-relevant familial risk factors. Here in California, every baby is screened for sickle-cell at birth (since 1990).

Because I don't think racial labels are generally helpful, I also believe that they are a potential problem. I wouldn't want my calling a patient 'white' when they are 1/16 Native American to interfere with their self-description. This may have legal implications, perhaps for Federal contracts or programs. Will it help them or hurt them in gaining a scholarship to define their race in a certain way, especially if whatever institution looks to their physician or medical record for verification?

So far as I can tell, the "race" box in AC is only useful for "meaningful use". It certainly has no medical significance as things stand now.

If we really want useful genetic data, we will have to do our own genetic histories -- not rely on the color of someone's face, or his/her surname.

Why not just put "white" or "black", depending on the preference of the receptionist, on everyone? Who is going to audit this?

Ahhh...it's just not so easy. I personally have been labeled everything from Asian to Swedish to East Indian to Puerto Rican (all incorrectly). Of course, there is no one right answer and I personally detest being told to "check one".

The danger in this is that these labels stick, correctly or incorrectly. So if someone labeled me as Swedish, incorrectly, would you as the provider be looking for sickle cell? Likely not...and that is the problem...at least it has been historically (and personally).

If we are going to have to collect the data, at least ask the patients their preference and note it. Just don't assign one.

Barbara
a multi-box checker

I agree with Barbara - try to be accurate and just do it. I am reminded of a sunday school song - red, brown, yellow, black and white, we are precious in his sight.......

Anyway, I digress. At least for now if you want to do meaningful use you must collect this data and for those that do not want to then don't do it. It does no good to lecture anyone on the dangers of MU or why we should not do it as many people need the money to expand their use of AC or to add/replace equipment, or just to make ends meet - if they do then AC's role and any help we can give is to help them with that.

Thanks all. I didn't mean to be arbitrary, but someone has to decide the undecidable. I suppose the best is to ask the patient, but they can take offense at the question. The receptionists have enough problems with cranky patients and lists of foolish questions they are required to ask -- and yet another one is just a little over the top. Sometimes the receptionist will just have to decide rather than argue.

Maybe post a little note:

The Federal Government requires us to record your race. Please do not take offense, but choose one of the following categories. There is no "other" choice, and it doesn't matter if it makes no sense. Please contact the Bureau of the Census if you have concerns:

American Indian and Alaska Native
Asian
Black or African American
Black Hispanic or Latino
Native Hawaiian and other Pacific Islander
White
White Hispanic or Latino