MGH only recognizes a limited number of ethnicities

I was quite pleased to see that MGH has a new policy of asking patients to provide race and ethnicity data. I've always thought that the census categories for race were stupid and arbitrary, and never saw what purpose they served in patient care.

In order to be sensitive to someone's cultural ties, we need to know a lot more than which census color is closest to who they are. It also doesn't make sense in terms of compiling stats or being aware of hereditary medical conditions; I once told a medical records person, when asked for my race (with only the census options to choose from), that I declined to answer. She told me it was required, because many diseases run in certain racial groups and not in others. I told her that, yes, I realize this, and I belong to a couple ethnic/racial groups with characteristic diseases, but that the option of "white" wasn't really going to serve this purpose. She didn't get it.

So, I thought MGH's practice was a great idea, until I saw that their "ethnicity" field in the computer wasn't anywhere near comprehensive. It had maybe 30 options (hopefully someone who works at MGH can correct this), and it seemed to focus on mostly Asian and Caribbean ethnicities, with a few others. It didn't seem to be based on anything logical, like ethnic groups that are well-represented in Boston, ethnic groups for whom there are notable hereditary diseases, or ethnic groups for whom sensitivity to traditional medicine practices is particularly important. It didn't list any Jewish groups, and I don't believe there were any European ethnicities other than "European" listed.

It's great that they're wanting to know these things about patients, but why not just have a blank field instead of limiting the choices of valid ethnicities?


3 comments:

Suldog said...

I'm normally not one in favor of categorizing folks based on color or ethnicity, but you cite one of the instances where it is extremely important. I couldn't agree more. Leave a blank space and let folks fill in every little bit they wish. What could it hurt?

Ron Newman said...

When I see a form like this, I often check off "Other" and fill in "Jewish" or "Jewish-American".

Anonymous said...

a blank field might be helpful for making a patient feel better, and possibly for patient care (like identifying a disease more common in that group)- liek specifying within white or european, as you pointed out. if there are only limited choices, they should definitely be focused on groups with certain high rates of disease, as you also pointed out.

however, this data is also collected to understand the demographic make-up of mgh, and to identify more disparities in certain groups, and for reseach purposes. people have hypothesized that if people could fill in whatever they want, they would have so many different race/ethnicities that nothing would be statistically significant or help us identify someone as being in a group with a high risk for something.

pros and cons either way, i suppose... maybe coming up with a standard (across MA, across the US) set of choices, and then letting people fill-in-the-blank to specify beyond these options IN ADDITION is what we need???