I have a condition. Actually, I don’t and that’s the problem. Let me explain.
I have a new doctor because of new insurance. I’ll skip the annoyance about insurance practices. The doctor did a new baseline blood test and discovered my white blood cell count is consistently low. Chronic leukopenia it is called. It may be nothing. But just to be safe, she sends me to a specialist in hematology and oncology, i.e. blood and cancer.
He confirms it is likely nothing. I answer no to all his questions meant to suss out possible conditions. He orders a next level blood test and an abdominal ultrasound to be sure. He also says he expects nothing to come of it. Why? People of African descent often present with chronic leukopenia because the reference group used to create baseline values was white. Moreover, the phenomenon has not one name but two: Benign Ethnic Neutropenia and, more recently Duffy-Null Associated Neutrophil Count (DANC).
According to Cincinnati Children’s Hospital these terms describe a normal variation outside the range used by the laboratory. The American Society of Hematology confirms a misdiagnosis can result in “unnecessary, expensive, and invasive testing, delayed or discontinued chemotherapy or other critical medications, exclusion from clinical trials, and other negative consequences”. And a study published in 2023 by the same organization found two-thirds of its sample of people of African ancestry in the US had values in the lower range while 80-100% of people in Sub-Saharan Africa do, compared to nearly zero for Asian or white.
Anything with a name has existed for a while. It is known. In this case, the cause is also known. There is NOTHING wrong with people of African descent except as measured by standards derived by looking at white people only, with known negative consequences and remedies. From the same study, “Laboratory reference intervals should be critically examined to ensure all healthy individuals are accurately represented”. Yet rather than fix the problem, i.e. the measuring stick, practice is to send me and countless others to specialists for unnecessary appointments and tests. We bear the stress of contemplating something dire, finding space in our schedules and money for co-pays. Our insurance rates reflect undue usage. Our health is mischaracterized.
Difference is misconstrued as deficient again. This single tale from the medical world parallels work life. What is acceptable hair or appropriate clothing designed to fit other bodies, times, and climes?
- What “neutral” standards do you or your organization use that exclude others?
- What do “neutral” standards cost the organization?
- What do those standards cost the people who do and don’t meet them?