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Editor's Note
December 2017

Race/Ethnicity–Based Outcomes in Cardiovascular Medicine

Author Affiliations
  • 1Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Department of Cardiology, Columbia University Medical Center and the Cardiovascular Research Foundation, New York
  • 3Deputy Editor, JAMA Cardiology
  • 4Associate Editor, JAMA Cardiology
JAMA Cardiol. 2017;2(12):1313-1314. doi:10.1001/jamacardio.2017.3826

During the past several decades, recurring observations derived from randomized clinical trials, longitudinal cohort studies, and registries have emphasized differences that are seemingly associated with race (eg, black or self-described African American or not) or ethnicity (eg, Hispanic/Latino in origin or not). The observed differences across categories of race/ethnicity have, on occasion, been problematic because of residual confounding in observational comparisons, limited or as yet undiscovered biological (including genetic) explanations, and uncertain clinical directives. Race especially is not a biological model but a social construct that exists in a space with shared experiences, similar heritage, and intermarriage.1 It is a poor proxy for genetics and a flawed surrogate marked by significant within-group heterogeneity. When observed race/ethnicity–based differences supersede known biological explanations or accepted indications for care, it is assumed that an evident disparity has been identified. The ensuing call for health equity has been heard by many, but gaps in care still remain.

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