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Bridging the Gap: Implementing Race-Conscious Clinical Guidance in Pediatrics
Robert H Rosen1,2, Joseph L Wright3,4, Courtney A Gilliam5
1Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York University Langone Health, New York, New York.
Pediatrics
|June 17, 2026
Summary
Pediatric race-based medicine is being replaced by race-conscious medicine, which uses neutral tools to address health disparities. Progress is being made, but barriers remain in implementation across healthcare systems and education.
Area of Science:
- Pediatric Health Equity
- Medical Ethics
- Health Disparities Research
Background:
- Traditional pediatric clinical guidelines often use race as a proxy for socioeconomic status and genetic ancestry, a practice termed 'race-based medicine'.
- The American Academy of Pediatrics advocates for eliminating race-based medicine in favor of 'race-conscious medicine'.
- Race-conscious medicine prioritizes race-neutral tools and addresses systemic health barriers causing racial disparities.
Purpose of the Study:
- To evaluate recent advancements in implementing race-conscious medicine within pediatrics.
- To identify persistent obstacles hindering the adoption of race-conscious medical practices.
- To explore strategies for transitioning from race-based to race-conscious approaches in pediatric care.
Main Methods:
- Reviewing the contributions of medical societies and researchers in developing race-conscious alternatives.
- Analyzing the implementation of race-conscious guidance by healthcare organizations, considering various facilitating and impeding factors.
- Examining the role of medical education bodies in integrating these principles.
- Assessing the influence of third-party platforms, device manufacturers, policy, and patient engagement.
Main Results:
- While race-conscious alternatives are emerging, many pediatric tools still incorporate race, potentially undermining equity.
- Implementation varies across healthcare organizations due to organizational, cultural, technical, and financial challenges.
- Medical education, third-party platforms, policy, and patient engagement are critical factors influencing progress.
Conclusions:
- Transitioning to race-conscious medicine in pediatrics requires a multi-faceted approach involving all stakeholders.
- Addressing structural barriers and promoting equitable tools are essential for reducing racial health disparities.
- Continued efforts are needed to integrate race-conscious principles throughout medical practice, education, and policy.
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