AMA Letter to OMB August 1, 1997

August 1, 1997

Ms. Katherine K. Wallman
Chief Statistician
Office of Information and Regulatory Affairs
Office of Management and Budget
NEOB, Room 10201
725 17th Street, NW
Washington, DC 20503

Dear Ms. Wallman:

The American Medical Association is celebrating 150 years as the nation's leading voice for physician's dedication to medical excellance and public health. This tradition is built, in large part, on the long-standing AMA commitment to serve as advocate for the care and concerns of patients in each segment of our society.

It is in this spirit that the American Medical Association offers its endorsement for the Office of Management and Budget recommendation to allow Americans to check one or more boxes when responding to the race/ethnic question on the federal census.

Permitting multiple self-designations allows health service researchers to differentiate more accurately among different subgroups of research participants. Clinical research trials and epidemiologic research will benefit from access to more detail about the racial and ethnic backgrounds of research participants. The decision to allow multiple self-designations is a superior approach to data collection, relative to simple addition of a "multiracial" category. AMA also supports consistent use of the combined racial and ethnic categories into a single checklist, rather than collecting racial and ethnic information in separate questions. Finally, AMA urges the Office of Management and Budget to encourage coding of all race/ethnicity categories checked by the respondent, rather than forming systems for coding only two or three.

AMA believes that society and patients are better served by research investigators having access to racial information. When carefully and appropriately used, having racial and ethnic information on research participants will improve our ability to help Americans who are at greater risk for diseases linked to genetic frequency, race and ethnicity (i.e. Cystic Fibrosis, Sickle Cell Anemia, Tay Sachs). Because the current federal category restrictions extend to most medical forms, the inability to more precisely define genetic, racial or ethnic backgrounds has the potential to mask serious health risks for multiracial/multiethnic people.

The alarming lack of sufficient bone marrow donors for multiracial/multiethnic cancer patients can also be linked in part, to an inability to better classify their genetic, race and ethnic backgrounds. AMA policy supports efforts to increase the number of all potential nationally registered bone marrow donors, especially minority donors to improve the odds of successful transplantation.

The AMA sees no downside to adopting the OMB recommendations as a means of giving multiracial/multiethnic people the same potential for the life-giving opportunities offered by medical treatments based on a clear understanding of one's genetic, racial and ethnic background.


Percy Wootton, MD