Skin Color Is Not the Same Thing as Race

Silver, Stephen E.

doi:10.1001/archderm.140.3.361-a

Cited by 8 publications

(11 citation statements)

References 2 publications

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“…(52) Another issue is the relation between race and skin color. (53) The relationship between skin color and ancestry has been shown to be quite variable, underscoring the need for caution when using pigmentation as a proxy of ancestry or when extrapolating the results from one admixed population to another. (54-58)…”

Section: Solutions For Health Inequitiesmentioning

confidence: 99%

Health Care Inequities: An Introduction for Dermatology Providers

Sauaia

Dellavalle

2009

Dermatologic Clinics

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When differences in health and health care are avoidable and unfair, they are labeled health inequities. In large part health inequities reflect social determinants of health, lack of access to care, and a health care system that does not allow sufficient time and resources so high-quality care may be provided to all patients. Programs aiming at reducing health disparities must include the provision of services as well as address access to care and socioeconomic barriers. This article focuses on health care disparities in dermatology, and invites providers to become agents of change.

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Section: Solutions For Health Inequitiesmentioning

confidence: 99%

Health Care Inequities: An Introduction for Dermatology Providers

Sauaia

Dellavalle

2009

Dermatologic Clinics

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“…This rapid review did not differentiate between evidence for ethnicity and skin pigmentation, which is considered inappropriate. [14]…”

Section: Discussionmentioning

confidence: 99%

“…We interpreted terms such as Black and White as describing ethnicity and only indirect indicators of skin pigmentation. [14]…”

Section: Methodsmentioning

confidence: 99%

The effects of skin pigmentation on the accuracy of pulse oximetry in measuring oxygen saturation: a systematic review and meta-analysis

Shi

Goodall

Dumville

et al. 2022

Preprint

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Background Pulse oximetry was widely used in hospitals and at home to monitor blood oxygen during the COVID-19 pandemic. There have been concerns regarding potential bias in pulse oximetry measurements for people with dark skin. We aimed to assess the effects of skin pigmentation on the accuracy of oxygen saturation measurement by pulse oximetry (SpO2) compared with the gold standard SaO2 measured by CO-oximetry. Methods We searched Ovid MEDLINE, Ovid Embase, and EBSCO CINAHL Plus (up to December 2021), as well as ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform (up to August 2021). We identified studies comparing SpO2 values in any population, in any care setting, using any type of pulse oximeter, with SaO2 by standard CO-oximetry; and measuring the impact of skin pigmentation or ethnicity on pulse oximetry accuracy. We performed meta-analyses for mean bias (the primary outcome in this review) and its standard deviations (SDs) across studies included for each subgroup of level of skin pigmentation and ethnicity. We calculated accuracy root-mean-square (Arms) and 95% limits of agreement based on pooled mean bias and pooled SDs for each subgroup. Results We included 32 studies (6505 participants); 27/32 (84.38%) in hospitals and none in people's homes. Findings of 14/32 studies (43.75%) were judged, via QUADAS-2, at high overall risk of bias. Fifteen studies measured skin pigmentation and 22 referred only to ethnicity. Compared with standard SaO2 measurement, pulse oximetry probably overestimates oxygen saturation in people with dark skin (pooled mean bias 1.11%; 95% confidence interval 0.29% to 1.93%) and people described as Black/African American (pooled mean bias 1.52%; 0.95% to 2.09%) (moderate- and low-certainty evidence). These results suggest that, for people with dark skin, pulse oximetry may overestimate blood oxygen saturation by around 1% on average compared with SaO2. The bias of pulse oximetry measurements for people with other levels of skin pigmentation, or those from the White/Caucasian group is more uncertain. The data do not suggest overestimation in people from other ethnic groups such as those described as Asian, Hispanic, or mixed ethnicity (pooled mean bias 0.31%, 0.09% to 0.54%), but this evidence is low certainty. Whilst the extent of mean bias is small or negligible for all the subgroups of population evaluated, the associated imprecision is unacceptably large (with the pooled SDs > 1%). Nevertheless, when the extents of measurement bias and precision are considered jointly in Arms, pulse oximetry measurements for all the subgroups appear acceptably accurate (with Arms < 4%). Conclusions Low-certainty evidence suggests that pulse oximetry may overestimate oxygen saturation in people with dark skin and people whose ethnicity is reported as Black/African American, compared with SaO2, although the overestimation may be quite small in hospital settings. The clinical importance of any overestimation will depend on the particular clinical circumstance. Pulse oximetry measurements appear accurate but imprecise for all levels of skin pigmentation. The evidence relates to clinician-measured oximetry in health care environments and may not be reflected in home pulse oximetry where other factors may also influence accuracy.

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“…[8][9][10] People of African descent (PAD) refers to all individuals who are African Americans, Africans and Africans with mixed ancestry. 11 Incidence rate studies of CM show an increasing incidence irrespective of race. 5,12 In a study of CM spanning over 30 years, the incidence of CM increased from 20.9% to 43.3% in Caucasians and 27.4 to 32.7% in PAD.…”

Section: Introductionmentioning

confidence: 99%

“…People of African descent (PAD) refers to all individuals who are African Americans, Africans and Africans with mixed ancestry 11 . Incidence rate studies of CM show an increasing incidence irrespective of race 5,12 .…”

Section: Introductionmentioning

confidence: 99%

Comparative study of cutaneous melanoma and its associated issues between people of African decent and Caucasians

Anaba

2021

Dermatologic Therapy

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Cutaneous melanoma is uncommon in people of African descent unlike their Caucasian counterparts. This rarity of cutaneous melanoma in people of African descent makes studies in this group difficult. In the few studies that are available, several differences exist in the incidence, disease severity, course of the disease, treatment modalities and survival rates between these two groups. Observed difference in cutaneous melanoma between people of African descent and Caucasians include; a higher incidence and better prognosis in Caucasians, a low awareness of melanoma, no definite risk factors, presentation with advanced disease, poor melanoma specific survival in people of African descent. Other differences are a better UV-induced DNA damage recovery, acral as opposed to truncal melanoma, female preponderance and lack of preventive measures in people of African descent.

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Skin Color Is Not the Same Thing as Race

Cited by 8 publications

References 2 publications

Health Care Inequities: An Introduction for Dermatology Providers

Health Care Inequities: An Introduction for Dermatology Providers

The effects of skin pigmentation on the accuracy of pulse oximetry in measuring oxygen saturation: a systematic review and meta-analysis

Comparative study of cutaneous melanoma and its associated issues between people of African decent and Caucasians

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