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“First do no harm”: Clinical practice guidelines, mesolevel structural racism, and medicine's epistemological reckoning

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  • Rondini, Ashley C.
  • Kowalsky, Rachel H.

Abstract

This paper presents a critique of clinical practice guidelines (CPGs) that standardize the use of race as a proxy for biological difference in medical settings. Drawing on the illustrative example of a pediatric UTI testing guideline, we contend that when CPGs necessitate that Black patients meet a higher threshold of illness severity or duration than their non-Black counterparts to receive comparable medical testing or other medical care, they function as mesolevel sites of race-racism reification processes (see Sewell, 2016) that contribute to the reproduction of racial health disparities. We describe broader implications and make recommendations for the conceptualization and implementation of future research in the sociological study of race, health, and medicine.

Suggested Citation

  • Rondini, Ashley C. & Kowalsky, Rachel H., 2021. "“First do no harm”: Clinical practice guidelines, mesolevel structural racism, and medicine's epistemological reckoning," Social Science & Medicine, Elsevier, vol. 279(C).
    • Handle: RePEc:eee:socmed:v:279:y:2021:i:c:s0277953621003002
    DOI: 10.1016/j.socscimed.2021.113968
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    1. Sandro Serpa & Carlos Miguel Ferreira, 2019. "Micro, Meso and Macro Levels of Social Analysis," International Journal of Social Science Studies, Redfame publishing, vol. 7(3), pages 120-124, May.
    2. Stern, A.M., 2005. "Sterilized in the name of public health: Race, immigration, and reproductive control in modern California," American Journal of Public Health, American Public Health Association, vol. 95(7), pages 1128-1138.
    3. Lee, Catherine, 2009. ""Race" and "ethnicity" in biomedical research: How do scientists construct and explain differences in health?," Social Science & Medicine, Elsevier, vol. 68(6), pages 1183-1190, March.
    4. Ford, Chandra L. & Airhihenbuwa, Collins O., 2010. "The public health critical race methodology: Praxis for antiracism research," Social Science & Medicine, Elsevier, vol. 71(8), pages 1390-1398, October.
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    Cited by:

    1. Jeffrey Anvari-Clark & Theda Rose, 2023. "Financial Behavioral Health and Investment Risk Willingness: Implications for the Racial Wealth Gap," IJERPH, MDPI, vol. 20(10), pages 1-29, May.

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