When Lorraine Brown got her bone density scan results earlier this year, she was shocked to find that the lab had listed her ethnicity as ‘white’ and that the results were based on norms for Caucasian women — because she is Black.
The more she dug into the issue, the angrier she became after being told that the lab machines ‘default to white’ and may skew her results.
“It erases the Asian woman, the Black woman, the Hispanic woman, the Indigenous woman. It erases us just as we’ve been erased in Canada for my entire lifetime,” Brown told CBC News.
Her family doctor referred Brown to get a bone density scan because she is over 60 years old. “The results list my name, birth date, my height, sex, age, my weight and my ethnicity. It lists my ethnicity as white, which I found shocking because I am not white.”
None of the paperwork she filled out at the private health clinic asked for her ethnicity, she said. After going back into the Well Health Diagnostic Centre on Fanshawe Park Road and speaking to numerous people, as well as calling GE Healthcare, which makes the bone density scanner that was used, she was unable to get answers about why her test results were based on those for a Caucasian woman.
Trust lost
One person at a call centre told her it’s likely that “all bone density tests default to white; it doesn’t matter what ethnicity you are,” Brown said.
“The information is inaccurate. I’m not white. How can I trust these results? It’s a problem for me. When you are telling a person of colour that something will always default to white — well, defaulting to white has never benefited me,” she said.
GE HealthCare told CBC News that prior to each patient scan, the system prompts the user to select their gender and ethnicity. Each hospital or facility can set defaults for their system, but a gender and ethnicity has to be entered each time.
The ethnicity selected doesn’t impact the scan itself, but it is used to interpret the results, the company said in a statement. The test can be re-run after putting in the correct ethnicity without having to re-scan the patient, GE HealthCare added.
Having medical tests based on baselines that are white or male is common and has led to health problems and misdiagnoses, said Chenai Kadungure, the executive director of the Black Physicians’ Association of Ontario.
“It’s a typical story. Black people in Canada are much less likely to have a family doctor and to get tests, and the machinery itself is not designed for you. It’s experiences like this that make people avoid health care because they’re just not heard and not trusted,” Kadungure said.
“This sort of inherent racism in medicine has caused a lot of problems for giving adequate care. It impacts your quality of care. The issue is more common than we think.”
Drug trials use predominantly white patients, and women’s unique physiology is also often ignored, Kadungure added. “If you’re a certain age, gender, and race, you need to find out how this impacts you. There’s a very ‘one stroke, all folks’ kind of practice that happens, and it leads to really bad health outcomes for Black and Indigenous people.”
The Black Physicians Association advised the London Health Sciences Centre on how to do culturally-appropriate community screening. The hospital declined an interview request for this story.
As for Brown, she’s looking forward to speaking to her doctor about her bone density results and seeing if she needs to do another scan. “I’m not ticked off about this; I just think we have to fix it. Like, come on,” she said. “If the ethnicity piece doesn’t matter, then eliminate it from the results page. Because right now, it tells me my T-scores and then says what normal is based on a normal Caucasian woman. I want to know, what’s normal for me?”
CBC News has reached out to Well Health Diagnostic Centres, which owns the clinic where the scan was done, and will update this story if they reply. GE HealthCare says patient safety is its top priority. “As a global healthcare company, our goal is to develop products aimed at improving outcomes for all patients,” a spokesperson said.
