The Right Profile? An Examination of Race-based Pharmacological Treatment of Hypertension

Abstract

Racial profiling has been increasingly cited in the clinical and social science literatures to describe race-based differences in medical diagnoses and treatment. However, the extent to which racial profiling in medicine is an empirical reality is debated—partly because the term itself is used to describe competing processes of bias. This article distinguishes between two such processes that influence race-based treatment recommendations: racial profiling and racial valuation. Through a systematic analysis of the role of race in the pharmacological treatment of hypertension, it illustrates that both mechanisms—to varying degrees—help explain race-based trends in treatment for the disease. Analyses are based on data from the Third National Health and Nutrition Examination Survey, collected during and soon after the period in which such treatment became validated and encoded in national guidelines. Findings indicate a nuanced process by which sex/gender mediates not only the effect of race on treatment recommendations but also the mechanism through which racialized treatment operates. They also suggest that over time, drugs may take on a racial character, leading to the systematic identification of certain drugs with specific races, driving treatment patterns that conflate race with legitimate medical criteria.