The Impact of Removing Race from Clinical Decision-Making Tools on Health Disparities

A growing number of medical institutions are removing race-based variables from clinical decision-making tools, a shift intended to address long-standing health disparities and correct for the use of race as a flawed proxy for biological difference. This transition, which has grown in the wake of the COVID-19 pandemic, aims to dismantle the application of race in diagnostic algorithms that have historically contributed to unequal treatment outcomes for patients of color, according to data from KFF.

Key Clinical Takeaways:

• Clinical calculators for kidney function, lung capacity, and heart disease risk are increasingly eliminating race-based corrections to prevent diagnostic delays.
• Research indicates that using race as a variable in medicine often lacks a biological basis and can reinforce systemic biases in pain management and disease screening.
• Ongoing efforts to remove these variables have already resulted in earlier treatment for chronic kidney disease and more equitable access to organ transplants for Black patients.

Clinical Algorithms and the Removal of Racial Variables

In 2025, researchers identified 42 risk calculators, five laboratory tests, 15 medications, and one therapy that still integrated race into their diagnostic frameworks. These tools often use demographic information to estimate organ function or disease risk without providing a clear biological mechanism to explain why race is a relevant variable. For instance, the National Cancer Institute’s Breast Cancer Risk Assessment Tool incorporates race under the premise that incidence rates differ by group. However, medical societies are increasingly moving toward models that prioritize physiological metrics over sociopolitical categorization.

The impact of this shift is measurable. Removing race-based corrections from formulas used to measure kidney function has led to earlier detection of chronic kidney disease and increased the eligibility of Black patients for life-saving kidney transplants. Similarly, reclassifying lung function equations has resulted in more Black patients being identified with severe respiratory disease, ensuring they receive necessary care.

Addressing Pseudoscientific Origins in Medical Practice

Historically, the inclusion of race in clinical guidelines was often rooted in outdated and disproven concepts, including the pseudoscientific fields of phrenology and eugenics. While modern medical consensus confirms there is no biological basis for using race as a surrogate for genetic variation, clinical medicine has struggled to separate the concept of race from disease risk. This has manifested in tangible harm, such as the persistent belief among some medical providers that Black patients possess different pain sensitivities, leading to the systemic undertreatment of pain in these populations.

The American Heart Association and the American College of Cardiology have recently removed race from heart disease risk calculators. The updated calculator’s predictive accuracy was found to be equal to or better than the previously used race-based version. This transition shows a broader movement to ensure that clinical management guidelines—ranging from diabetes screening thresholds to gout medication protocols—are based on verifiable clinical data rather than demographic assumptions.

Evaluating the Future of Disparities Research

While the elimination of race-based tools moves clinical equity forward, researchers are still debating how to account for the structural factors that race represents. Race often serves as a proxy for experiences of systemic racism and socioeconomic factors, all of which influence health outcomes. A 2023 KFF survey highlighted that Black, American Indian or Alaska Native, Hispanic, and Asian adults are more likely than White adults to report negative interactions with healthcare providers, including instances where they felt ignored or treated disrespectfully.

Continued scrutiny of clinical algorithms is required to ensure that the removal of race from calculators is matched by a decrease in systemic bias across the entire continuum of care.

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.