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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
PubMed

Insights

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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