Medical Racism

Spirometers are medical devices that are "race corrected." 

Do I just measure lung capacity or do I do more...

In 1864, a study administered by Benjamin Apthorp Gould found that soldiers classified as "white" had a higher lung capacity that those labeled "full blacks" or "mulattoes." These results were found using a spirometer that measures a person's lung capacity. Even in the past, plantation physicians would use them to show that black slaves had weaker lungs than whites. These studies were used as another reason to justify slavery and other discriminations. Gould's results were so phenomenal that by the 19th century, lung capacity difference between whites and blacks had become so rooted that there is a consensus in scientific literature that "virtually everyone in the world has lower lung capacity than people classified as white" (Lundy Braun). For black patients, the normal reading is reduced by 13%.

Several issues associated with race correction 

• Device apples population standards to individual patients--not every patient has the same physique and health
• Manufacturers program race into the machine, so doctors using it cannot know for sure how the functions are adjusted
• Medical textbooks teach doctors that different races have different lung capacities and functions.

Although there have been many critics about the device, the device is still used today and still "race corrected." Race corrected sounds as if the device is physically "correcting" or changing a race, but in reality the term has more to do with the ability of doctor's to select a patient's race and then run the device. This brings in the question of are the patient's race assigned to them or are they self-selected.

Lundy Braun, professor of Africana Studies and pathology and laboratory medicine at Brown University, is the author of Breathing Race into the Machine, which explores the history of the spirometer. When she interviewed doctors about the spirometer, she reported that many were aware of the "race correction" ordeal, however they did not know if they were causing this "correction factor" by adding the patient's race in. Some doctors argued that they do not race correct. When Braun looked at the data sheet from the machine, there was actually a correction factor built into the machine. Braun said that many doctors make their own judgements about a patient's perceived race and never asks the person specifically about his or her race. There are some that ask patients to self-identify, but can get awkward because patients wonder why race is even questioned when they are checking out their lungs. 

Low-income, minorities residents live the closest to areas with high pollution
(Bay Area, California)

Braun also touches upon the idea that minorities having lower lung capacities is linked to their environmental and socioeconomic status. There have been studies that show residents living in highly polluted neighborhoods have lower lung capacity. She also points out that there is so much more research on genomics than on social determinants of health. 

Some questions to think further about:

• Why are people so interested in race as a biological concept rather than a social or historical one?
• Why do people still rely on physical attributes to classify a race? 
• Are continual usage of devices such as the spirometer ignoring the implications they can have on the progression of understanding race?

References

Shaban, Hamza. "How Racism Creeps Into Medicine." The Atlantic. Atlantic Media Company, 29 Aug. 2014. Web. 20 Nov. 2014. <http://www.theatlantic.com/health/archive/2014/08/how-racism-creeps-into-medicine/378618/?single_page=true>.