Race Correction and Spirometry Why History Matters

In recent months, medical institutions across the United States redoubled their efforts to examine the history of race and racism in medicine, in classrooms, in research, and in clinical practice. In this essay, I explore the history of racialization of the spirometer, a widely used instrument in pulmonary medicine to diagnose respiratory diseases and to assess eligibility for compensation. Beginning with Thomas Jefferson, who first noted racial difference in what he referred to as pulmonary dysfunction, to the current moment in clinical medicine, I interrogate the history of the idea of correcting for race and how researchers explained difference. To explore how race correction became normative, initially just for people labeled black, I examine visible and invisible racialized processes in scientific practice. Over more than two centuries, as ideas of innate difference hardened, few questioned the conceptual underpinnings of race correction in medicine. At a moment when race norming is under investigation throughout medicine, it is essential to rethink race correction of spirometric measurements, whether enacted through the use of a correction factor or through the use of population-specific standards. Historical analysis is central to these efforts.

Automated summary

This essay explores the history of racialization of the spirometer in pulmonary medicine, focusing on how race correction became normative and how researchers explained differences between races. Over the past two centuries, the concept of innate racial differences has hardened, with few questioning the conceptual underpinnings of race correction in medicine.