The Race Equation

In medical school, Aaron Baugh learned a fact that was commonly taught to most doctors in training. He was told that Black people have smaller lungs than white people. This belief stemmed from evolution and body proportions, according to his professors.

The spirometer, a device used to measure lung capacity, played a significant role in diagnosing and treating lung diseases. However, this device came with a so-called "race equation" built into it. When a patient breathed into the machine, their lung capacity was compared to what was considered normal for their age, gender, and race. For Black patients, this normal range was 10 to 15 percent lower than for white patients.

Doctors had believed that this race "correction" made the test more accurate for years. However, Aaron Baugh, who later became a pulmonary and critical care physician, discovered that the historical assumptions embedded in the spirometer were not only incorrect but were based on racist science. This science could be traced back to the era of American slavery.

Baugh's discovery revealed that these assumptions were leading to misdiagnoses in thousands of Black patients, including military veterans. He emphasized that this wasn't a minor test. The spirometer was used in diagnosis of lung disease, job hiring, disability assignments, and various medical treatments. If the test was done incorrectly, it could have a profound impact on patients' lives.

The Race Equation, a podcast series from the New England Journal of Medicine, partnered with Reveal to investigate this standard medical test with a dark history. This investigation aims to shed light on how this test is harming Black patients and continues to be used in hospitals across the country.