How should hospitals isolate meaningful racial data while honoring the complete person
I don’t know what it was about this past Fall, but it seemed as if every other week, my son was injuring himself. He suffered a bad fall while playing soccer on an unpaved parking lot. He suffered a black eye and cuts to his face after being hit by a bat-wielding 3 year old.
By far, the scariest incident was when he cut his eye. While entertaining cousins in his room, he yelled out in a shriek that could lead any parent to imagine the most horrific scene ever. Blood, oozing guts, we wondered what we’d see once we reached his room.
As it turned out, my son had managed to shoot himself in the eye with a Nerf gun. Leave it to an 8 year old boy to attempt to clear a jammed Nerf gun by pulling the trigger while looking down the barrel.
At the advice of the on-call pediatrician, we made a trip to the emergency room. As I handed in the completed intake forms, the ER registration coordinator asked me what my son’s race was. Haphazardly, I shrugged off a quick response – “Multiracial”. In an apologetic tone, she asked me to clarify. “Which one would you say he is. Is he White, Black, Asian, Native American…?” Before she could finish, trying not to sound as impatient as I was becoming, I broke in and said “he’s Multiracial, that’s all. Please indicate this.”
As an employee of a hospital, I am more than familiar with the government’s ethnic and racial classification system required for hospitals and other public agencies to keep track of. In the research setting I work in, Multiracial and Unknown are current (as of December 2010) categories one can select. However, in some clinical settings (i.e. where people are being treated), these categories are not always available. Are clinical settings just out of date/sync or are the racial options kept purposefully narrow?
If the state and federal governments are to set effective public policy, they require meaningful data. If a hospital is tracking race-based health care disparities or the relation of ailments to certain population groups, identifying racial classification may be useful. Thus, my answer of “Multiracial” may provide little, if any, useful data.
Moreover, Multiracial is not a racial classification. A person who is part German and part Chinese is very different from a person who is part Puerto Rican and part Haitian. Cultural habits may be different and the way the world interacts with these individuals may be different. Therefore, if governments want to abstract usable information for public policy sake, racial groups are separated out.
Plus as we know, most all Americans have a checkered racial heritage. Allowing people to honor and recognize their full and/or most proximate racial heritage may cause ALL of the race boxes to be checked, leading to data that is nearly impossible to extrapolate from. However, forcing individuals to constrain their self-identity to one “primary” race also leads to somewhat inconsequential data.
So my question to you – what is a government to do?
By the way, I explained to the ER staff that my son is ½ Black, ¼ Mexican and ¼ European. I asked her how she would classify him. She said she didn’t know. I responded “well then I don’t know either.”
(The US 2010 Census included an expanded section on race. Some ethnic groups that would have in the past been lumped together as “Asian” were broken out into individual categories, i.e. Japanese, Chinese, Korean etc., and respondents were allowed to check ALL of the applicable race boxes. When this change will be pushed out to all hospitals, schools and other public agencies remains to be seen.)