Medical school activists are sounding the alarm over the EDUCATE Act, a bill that aims to remove Diversity, Equity, and Inclusion curricula and ban race-based admission mandates at medical schools.

NAOMI TWEYO NKINSI; naomi.nkinsi@gmail.com 
    Nkinsi is a family medicine resident physician at MultiCare Tacoma Family Medicine in Tacoma, Washington.

Backers of the EDUCATE Act are in favor of continuing the use of race-based testing for kidney function. Nkinsi spoke to the Institute for Public Accuracy about the problems with race-based kidney function algorithms. “In medicine, there are a variety of shortcuts that physicians use to get a better picture of someone’s health, called algorithms. These are pathways that help standardize [care] across clinics, hospitals, and specialties. We have known for a long time now that a large number of algorithms include race [as a factor]––specifically Black vs. non-Black. The algorithms don’t consider other groups, and just single out ‘Black.’ They give a different lab value or next [clinical] step if the patient is Black, which alters what the physician does down the line. 

“For kidney function, [physicians] use a test to calculate eGFR that used to include race; if a patient were Black, the eGFR [value] was increased. This value works as a cutoff for transplants, medications, referrals to specialists, insurance coverage––so for Black patients to be viewed as sick as their non-Black counterparts, they had to be sicker to get the same eFGR, because their [value] was artificially bumped.”

In 2020, Nkinsi and other medical school students led a successful campaign to remove the race-based value from eGFR, leading to changes in national guidelines. But there has been a backlash among conservatives “who argue there are biological differences” between racial groups; these groups are upset over the algorithms that have been changed to remove race.

These conservatives argue that the removal of race-based eGFR is part of a larger push by DEI to “bastardize medicine and make it less scientific.” But the “people who are pushing for the removal of DEI measures [in medical schools] are pushing for further inequity that will lead to even greater morbidity and mortality in the Black population,” Nkinsi said. “They’re actively pushing for more Black people to face harm in healthcare.”

“Race-based medicine,” Nkinsi said, assumes that “Black people are biologically different and specifically biologically inferior, because it makes the assumption that Black people’s organs don’t function as well as their counterparts.”