Erased in Code: Uncovering Cultural Gaps in Clinical Terminologies

SNOMED CT, the most comprehensive multilingual clinical terminology, is essential for structuring global health data but reveals notable racial, ethnic, and cultural exclusions. Using the Diversity Minimal Item Set (DiMIS) framework, we examined whether socially and culturally relevant concepts-such as values and beliefs, geographical and environmental influences and social practices-are represented within the system. A structured search showed that many of these terms are either absent or insufficiently defined, impeding context-aware diagnostics and inclusive healthcare practices. For instance, while generic items like "scarf" exist, culturally specific terms like "hijab" are missing, and concepts such as consanguinity distinctions, or African Traditional Medicine remain unrepresented. These omissions reflect structural invisibilities that perpetuate healthcare inequities and limit the potential of data-driven, personalized medicine. Addressing these gaps requires inclusive, collaborative revisions of medical terminologies to ensure more equitable and socially responsive health systems.