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black or white race

Black or White race

Both terms, when describing race, should have initial capitalization, except when capitalization could be perceived as inflammatory or inappropriate (eg, "white supremacy").

race/ethnicity

race and ethnicity

There are numerous subcategories within race and ethnicity. Given that a virgule often means "and/or," which can be confusing, do not use the virgule construction in this context.

Asians, Blacks, Whites as nouns

Do not present race and ethnicity as nouns.

Use as modifiers (eg, Asian patient, Black individual, White populations) or as predicate adjectives (eg, Patients who are Asian, Black, or White).

The adjectival form may be used as a predicate adjective to modify the subject of a phrase (eg, "the patients were Asian, Black, Hispanic, and White").

White, Black, Hispanic, Asian

Asian, Black, Hispanic, White
List race and ethnicity categories in alphabetical order, not in order of proportion. "Other" and "unknown" should be listed last.

"Other" without explanation

The categories included in "other" groups should be defined and reported. Authors are advised to be as specific as possible when reporting on racial and ethnic categories (even if these categories contain small numbers).

If the numbers in some categories are so small as to potentially identify study participants, the specific numbers and percentages do not need to be reported provided this is noted.

For cases in which the group "other" is used but not defined, the author should be queried for further explanation.

African-American, Asian-American, Mexican-American, etc

African American, Asian American, and Mexican American, etc

Most combinations of proper adjectives derived from geographic entities are not hyphenated when used as noun or adjective formations; therefore, do not hyphenate these terms and similar combinations as nouns or compound modifiers (eg, African American patient).

Do not automatically add "American" to racial and ethnic categories if the context is in the US. Follow what the author provided and query if it is not clear or consistent.

Mixed race

Mixed race may carry negative connotations and should be avoided, unless it was specifically used in data collection; in that case, the term should be defined, if possible.

The terms multiracial and multiethnic may be acceptable in reports of studies if the specific categories these terms comprise are defined or if the terms were predefined in a study or database to which participants self-selected.

Abbreviations

Generally, abbreviations of categories for race and ethnicity should be avoided unless necessary because of space constraints (eg, in tables and figures). If used, any abbreviations should be clearly explained parenthetically in text, in table footnotes, or in figure legends.

Minority, minorities

Avoid use of minority and minorities as nouns as they may be inaccurate or stigmatizing. Instead, include a modifier when using the word minority and do not use the term as a stand-alone noun, for example, racial and ethnic minority groups and racial and ethnic minority individuals.

Terms such as underserved populations (eg, when referring to health disparities among groups) or underrepresented population (eg, when referring to a disproportionately low number of individuals in a workforce or educational program) may be used provided the categories of individuals included are defined at first mention.

The terms minoritized and marginalized may be acceptable as adjectives provided that the nouns that they modify are included (eg, "racial and ethnic minoritized group").

People of color

The term people of color was introduced to mean all racial and ethnic groups that are not considered White or of European ancestry and also as an indication of antiracist, multiracial solidarity.

However, there is concern that the term may be too broad, to the point that it erases differences among specific groups.

Preference is to specify the racial or ethnic categories included or intended to be addressed.

If a collective term is needed, consider racial and ethnic minority groups, racial and ethnic marginalized or minoritized groups, underserved or underrepresented groups, racial and ethnic minority individuals, and other terms noted above.

The term skin of color may be acceptable in dermatology and other skin-related clinical contexts.

Black, Indigenous, and people of color (BIPOC)

Black, Asian, and minority ethnic (BAME)

Black and minority ethnic (BME)

Criticism of these terms has noted that they disregard individuals’ identities, do not include all underrepresented groups, eliminate differences among groups, and may imply a hierarchy among them. In the case of BIPOC, the implied hierarchy is that Black and Indigenous individuals come first before any of the categories assumed under "people of color."

Preference is to provide specific racial or ethnic categories.

If a collective term is needed, consider racial and ethnic minority groups, racial and ethnic marginalized or minoritized groups, underserved or underrepresented groups, and other terms noted above.

Other national terms (eg, South African Coloureds, Canadian Visible Minority)

Ask for definitions of groups included in these collective terms, expand at first mention, and use other terms if possible (eg, "admixed African individuals"; "Canadian census categories of Arab, Black, Chinese, Filipino, Japanese, Korean, Latin American, South Asian, Southeast Asian, West Asian individuals").

Brown people

Avoid use of colors such as brown and yellow to describe individuals or groups. These terms may be less inclusive than intended or considered pejorative or a racial slur.

Spanish speaking

Hispanic, Latino or Latina, Latinx, Latine

Avoid reflexively changing Latino and Latina to Latinx or Latine or vice versa and follow author preference. Authors of research reports, in turn, should use the terms that were prespecified in their study (eg, via participant self-report or selection, investigator observed, database, electronic health record, survey instrument).

Regional descent

Description of people as being of a regional descent (eg, of African, Asian, European, or Middle Eastern or North African descent) is acceptable if those terms were used in formal research. However, it is preferable to identify a specific country or region of origin when known and pertinent to the study.

For example, describe persons of Asian ancestry according to their country or regional area of origin (eg, Cambodian, Chinese, Indian, Japanese, Korean, Sri Lankan, East Asian, Southeast Asian). Similarly, individuals from the Middle Eastern and North African region should be described using their nation of origin (eg, Egyptian, Iranian, Iraqi, Israeli, Lebanese) when possible.

For individuals of various ancestries living in the US, do not reflexively add "American." However, there are times it is appropriate. For example, individuals of Middle Eastern and North African descent who identify with Arab ancestry and reside in the US may be referred to as Arab American. Similar construction would apply for other groups such as Asian American, Indian American, etc.

Native American

American Indian or Alaska Native is generally preferred. Try to be specific; other terms include Native Hawaiian and Pacific Islander.

Indigenous or Aboriginal

Indigenous people, Indigenous peoples of Canada, Aboriginal people.

Biological explanations for health care disparities or inequities among racial and ethnic groups

There are many examples of reported associations between race or ethnicity and health outcomes, but these outcomes may also be intertwined with ancestry and heritage, social determinants of health, as well as other socioeconomic, structural, institutional, cultural, demographic, or other factors. Thus, discerning the role of these factors is difficult.

There is concern about the use of race in clinical algorithms and some health-based risk scores and databases because of inapplicability to some groups and the potential for discrimination and inappropriate clinical decisions.

Use caution in interpreting or generalizing findings from studies of risk based on populations of individuals representing specific or limited racial and ethnic categories.

Collective reference to racial and ethnic minority groups as "non-White"

If comparing racial and ethnic groups, indicate the specific groups. Researchers should generally avoid study designs and statistical comparisons of White vs "non-White" groups and should specify racial and ethnic populations included and conduct analyses comparing the specific groups.

If a comparison of "non-White" is justified, authors should explain the rationale and specify what categories are included in the "non-White" group.

Similar concerns about dichotomized comparisons of only 2 racial or ethnic groups, eg, Black compared with White patients

If such a comparison is justified, authors should explain the rationale for this focused comparison limited to only 2 groups.