+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Hematocrit levels and race: an argument against the adoption of separate standards in screening for anemia

Hematocrit levels and race: an argument against the adoption of separate standards in screening for anemia

Journal of the National Medical Association 71(10): 945-954

The average hematocrit levels of black children have been widely reported to be about two to three percent lower than those of white children. Until recently, the relative contributions of economic, nutritional, and genetic factors to these differences have been unspecified. Based on new evidence and reanalysis of past data, however, some investigators now argue that genetic differences exist which transcend economic status. Separate screening standards are thus recommended for black children-standards which would define fewer as anemic. The present paper discusses methodological inadequacies in the evidence supporting the separate standards argument, focusing on the skewed economic distributions by race which suggest economic disparities within the racial subgroups compared. Findings are presented from a study of children in Washington, DC, to illustrate the role of particular risk factors known to be differentially distributed by income (eg, multiparity, birthweight, source of medical care). These factors are associated with varying hematocrit levels, even among blacks, and they also appear to account for a large part of the black-white hematocrit differentials. Study findings cast doubt on conclusions about the genetic basis of hematocrit differences and suggest that, without better evidence, it would be inappropriate to adopt lower standards for blacks in screening for anemia.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 040260742

Download citation: RISBibTeXText

PMID: 537117

Related references

The micro hematocrit as a screening test for sickle cell anemia. Southern Medical Journal 62(12): 1546, 1969

Screening hematocrit and the sources of anemia at birth in a tertiary care facility. Journal of Investigative Medicine 48(5): 250A, 2000

Anemia screening via non-invasive transcutaneous measurement of hematocrit in hemodialysis and pre-ESRD patients. Journal of the American Society of Nephrology 13(Program and Abstracts Issue): 220A, 2002

Separate hemoglobin standards for blacks and whites a critical review of the case for separate and unequal hemoglobin standards. Medical Hypotheses 32(3): 181-190, 1990

Early changes in hemoglobin and hematocrit levels after packed red cell transfusion in patients with acute anemia. Transfusion (bethesda). 37(6): 573-576, 1997

Race/Ethnicity and Adoption of a Population Health Management Approach to Colorectal Cancer Screening in a Community-Based Healthcare System. Journal of General Internal Medicine 31(11): 1323-1330, 2016

Hematocrit levels in breast-fed American babies. A preliminary study suggesting that nutritional anemia may not develop. Clinical Pediatrics 16(7): 649-651, 1977

Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels. Journal of General Internal Medicine 20(6): 520-524, 2005

Adoption and race: implementing the Multiethnic Placement Act and the Interethnic Adoption Provisions. Social Work 44(2): 167-178, 1999

Hemoglobin concentration in white, black, and Oriental children: is there a need for separate criteria in screening for anemia?. American Journal of Clinical Nutrition 31(3): 377-380, 1978

Gender- and race-based standards of competence: lower minimum standards but higher ability standards for devalued groups. Journal of Personality and Social Psychology 72(3): 544-557, 1997

Screening and evaluation of blood donors with upper-limit hematocrit levels. Transfusion 27(6): 485-487, 1987

Crystal Structure of Plant Legumain Reveals a Unique Two-Chain State with pH-Dependent Activity Regulation. Plant Cell 30(3): 686-699, 2018

Hemodynamic effects of staged hematocrit reduction in patients with stable cor pulmonale and severely elevated hematocrit levels. American Journal of Medicine 58(1): 92-98, 1975

An outcome-based approach for the creation of fetal growth standards: do singletons and twins need separate standards?. American Journal of Epidemiology 169(5): 616-624, 2009