Ending the Practice of “Race Correction” in Lung Function Testing (PFT)

Li Ka Shing, Clinical and Population Research Rounds, 2022

Ending the Practice of “Race Correction” in Health Care speaker series as part of the Li Ka Shing, Clinical and Population Research Rounds, 2022

Presented by Dr. Patricia O’Campo, Executive Director of the Li Ka Shing Knowledge Institute at Unity Health Toronto, in partnership with the Canada-US Coalition to End Race Correction in Health Care and Knowledge Translation at the MAP Centre for Urban Health Solutions.

Date and time of this virtual talk:  Nov 18, 2022 from 12 pm – 1:30 pm EST

Register on Eventbrite: https://www.eventbrite.ca/e/ending-the-practice-of-race-correction-in-lung-function-testing-pft-tickets-450702271627

About this talk: Lung function tests (i.e. pulmonary function tests) are used to assess lung-related conditions such as asthma or chronic obstructive pulmonary disease. Around the world, health care systems apply a “race correction” based on the false and racist assumption that Black people have lower lung function at baseline, for a variety of reasons. These false and racist ideas about Black people and lung function can be traced directly back to slave owners who used these ideas to advance white supremacy (Braun, 2014).

Race corrections are unscientific and done without the patient’s consent. As a result of the race correction applied to lung function tests, physicians are less likely to correctly diagnose Black patients with lung disease, and less likely to offer appropriate treatment. An examination of lung function tests performed at the University of Pennsylvania Health System between 2010 and 2020 discovered that, without race correction, diagnoses of lung disease in Black patients would have increased by 20 per cent (Moffett, Eneanya, Halpern & Weissman, 2021). The race correction applied to lung function tests also means that clinicians are less likely to refer Black people to necessary follow-up services, such as pulmonary therapy.

Dr. Lundy Braun, author of “Breathing race into the machine: the surprising career of the spirometer from plantation to genetics” (2014) will address the history of how pulmonary function tests became so deeply racialized from the late 18th century to the present. Dr. Braun will emphasize the processes by which racism persists in race correction across health care systems.

What is “race correction”? Health care providers often use tests to assess a patient’s health. In many cases, health care providers calculate test results differently for Black patients than they do for everyone else. Overall, “race correction” means that Black people are diagnosed late, or never diagnosed at all, for serious conditions from heart, kidney and lung diseases to cognitive impairment. It also means that Black people are systematically excluded from timely access to life-saving treatments like organ transplants and other surgeries. “Race correction” has no scientific basis because “race” is not biological. It is a social construct that is applied differently in different times and in different places. In fact, scientists have shown us that people have more in common genetically across “racial” groups than within them.

Speaker bios:

Lundy Braun, PhD

Author, Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics

Professor of Pathology and Laboratory Medicine and Africana Studies, Brown University

Lundy Braun is a Professor of Africana Studies and Pathology and Laboratory Medicine/Alpert Medical School of Brown University and a member of the Science, Technology, and Society (STS) Program. Professor Braun received her Ph.D. from the Johns Hopkins Bloomberg School of Public Health. Her research analyzes the historical role of science in the production of racialized knowledge and racial hierarchies. She has participated in national and international workshops on race, imperialism, genetics, and health and in 2016 organized an ongoing interdisciplinary Research Cluster on Race, Medicine, and Social Justice at the Center for the Study of Slavery and Justice at Brown. Her award-winning book Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics addresses the history of how racialized knowledge, particularly algorithms, got baked into biomedical research over time.

Chris Simpson, MD, FRCPC, FACC, FHRS, FCCS, FCAHS

Executive Vice-President, Medical, Ontario Health

Professor of Cardiology, Queen’s University School of Medicine

Dr. Chris Simpson is the Executive Vice President (Medical) and Chief Medical Officer at Ontario Health – the provincial agency overseeing Ontario’s health care system. He works clinically as a cardiologist at Kingston Health Sciences Centre and is also an Affiliate Scientist with the Institute for Clinical Evaluative Sciences at Queen’s University. From 2016-2021, he served as the Vice-Dean (Clinical) of the Queen’s University Faculty of Health Sciences and Medical Director of the Southeastern Ontario Academic Medical Organization (SEAMO), stepping in as Acting Dean of the Faculty and Acting CEO of SEAMO for 6 months in 2019. An active clinician, educator and researcher, Dr. Simpson has authored or co-authored over 350 peer reviewed papers and abstracts and has won numerous teaching awards. His clinical and research interests include access to care and medical wait times, medical fitness to drive, atrial fibrillation, sudden death in the young, catheter ablation and cardiac resynchronization therapy.

Kim Connelly, MD, PhD, FRACP, MBBS, FSCMR, FCCS

Division Head, Cardiology St Michael’s Hospital

Executive Director, Keenan Research Centre for Biomedical Science

Associate Professor of Medicine, University of Toronto

Dr. Kim Connelly is a Cardiologist and Scientist who is both nationally recognized as an expert in echocardiography, cardiovascular MRI and the impact of diabetes upon cardiac function and ventricular remodeling. His work has been recognized evident by winning the “Young Investigator of the Year Award” by the Canadian Cardiovascular Society, an Early Researcher Award in 2014, and a CIHR New Investigator award in 2014. Dr. Connelly runs a basic research laboratory at the Keenan Research Centre at St. Michael’s Hospital where he focuses upon basic mechanisms of disease – primarily around the role of pathological extracellular matrix accumulation and the pro-sclerotic cytokine transforming growth factor beta, with a focus upon translating discoveries into therapies in humans.

For any questions please contact LKSKIResearch@unityhealth.to

Below please find important background materials: