Race-Based Lung Testing and the Fight to Remove Bias from Medicine
For decades, lung function tests quietly built racial assumptions into medical practice — shaping diagnoses, treatment, and access to care for Black patients.
For years, patients walking into clinics for lung function tests, also known as spirometry, could have their results automatically adjusted based on race.
Black patients’ lung capacity scores were often reduced before any doctor interpreted the data, based on the long-standing assumption that Black bodies naturally have lower lung function than white bodies.
That adjustment was not harmless. It shaped how symptoms were read, how disease was measured, and whether patients received timely treatment at all.
These race-based corrections did not emerge from neutral science. They are tied to older medical traditions rooted in pseudoscientific ideas about racial difference.
Enslavers and early physicians once used lung capacity as supposed proof of biological inferiority, while ignoring the role of working conditions, living conditions, pollution, and unequal healthcare access.
Those assumptions did not disappear with time. They were absorbed into medical education, software, and device design, where they continued to influence care long after their racist foundations should have been rejected.
In recent years, a growing movement of physicians, researchers, and racial justice advocates has pushed for the removal of race-based corrections from lung testing.
Hospitals and professional institutions have begun revising protocols so that Black and brown patients are assessed without built-in racial reductions in their scores.
This shift is part of a broader effort to examine how medical algorithms and formulas can quietly encode structural racism while presenting themselves as objective science.
Missed Diagnoses
If a patient’s lung function is artificially lowered on paper, early signs of respiratory disease can be overlooked.
That means patients may be told they are normal even when symptoms and real risk suggest otherwise.
Delayed Treatment
When diagnosis is delayed, illnesses such as asthma, COPD, and other respiratory conditions may progress further before intervention begins.
By the time the system recognizes the severity of the problem, the patient may already be facing worse outcomes.
Occupational Harm
Workers seeking compensation for lung damage caused by exposure to toxins or hazardous environments have also been affected.
Lower baseline scores could make it harder for Black workers to meet legal or administrative thresholds for support.
Compounded Inequality
These harms do not happen in isolation. Black communities already face higher exposure to pollution, asthma triggers, and environmentally harmful living conditions.
A biased testing system only deepens the damage created by those broader inequalities.
Advocacy organizations, medical professionals, and community health groups have been pushing institutions to rewrite the standards embedded in lung testing.
That work includes pressuring hospitals, insurers, and device manufacturers to remove race variables from software and to educate patients about how these corrections have affected care.
Community-level education is especially important, because patients who understand the issue are better equipped to question results and ask whether their readings are being interpreted fairly.
The struggle over race-based spirometry is part of a larger debate inside medicine: whether race should be treated as biology or understood as a social reality shaped by environment, history, and inequality.
Time and again, race has been used in clinical formulas as if it were a fixed biological truth, even when the underlying differences reflect unequal exposures and unequal treatment rather than genetics.
Removing race corrections from lung testing is therefore about more than a single measurement. It is about challenging how medical systems have historically naturalized inequality.
The fight to end race-adjusted lung testing is ultimately part of the larger struggle for health equity.
It asks whether patients will be evaluated as individuals with real lived conditions, or filtered through assumptions that lower expectations before care even begins.
As more doctors, patients, and advocates challenge these practices, medicine is being pushed to confront the myths it carried forward for far too long.
The right to breathe freely should not be distorted by old racial myths disguised as modern science.