- The Washington Times - Thursday, October 21, 2021

When the NFL introduced a revised testing plan for its $1 billion settlement of concussion claims Wednesday, the league did so to eliminate the use of “race norming” — a controversial medical practice that assumes Black players have lower cognition function than other races.  

The adjustment to the settlement was in the work for months. The league announced in June that it would stop using the practice, following a public outcry that race norming was discriminatory for Black players suffering from dementia — costing them hundreds of thousands of dollars.

But why was race norming used in the first place? The Washington Times asked multiple medical experts to find out more information.

Dr. Katherine Possin, an associate professor at the University of California San Francisco who specializes in neuropsychology, said when neuropsychologists administer a cognitive test for dementia, race norming causes the formula that determines whether that person is impaired to be adjusted for a person’s race.

“In other words, the benchmark for whether the person is impaired enough to qualify for an award or to meet a diagnosis is lower for Blacks than for Whites,” Possin said. “The underlying assumption is that the Blacks started at a lower cognitive baseline and therefore need to score even lower than the Whites to meet the same benchmark to qualify for a (financial) award in this case.”

The NFL has denied using race norming to discriminate. But the issue was brought into the public eye when former NFL players Kevin Henry and Najeh Davenport, who are Black, accused the NFL in an August 2020 lawsuit of using the practice to deny medical claims for Black players. That lawsuit was initially dismissed, but the NFL agreed to eliminate the method following public pressure.

According to The Associated Press, the use of race norming in dementia testing was developed by neurologists in the 1990s as a way to factor in a patient’s socioeconomic background. Dr. Possin told The Washington Times that the practice was implemented as a “Band-Aid solution” to account for “all the social disadvantages that Blacks experience more than Whites” and prevent overdiagnosis.

“But the thing is, having Black skin does not cause lower scores, right?” she said. “We need to be measuring the factors that actually cause variation in performance and adjusting for those.”

As part of Wednesday’s settlement, Black retirees from the pool of 20,000 players in the concussion settlement will now have the chance to have their tests rescored or seek a new round of cognitive testing, in some cases.

The vast majority of the league’s players are Black, with 70% of active players and more than 60% of living retirees.

Of the 20,000 retirees who registered for the concussion settlement program, more than 2,000 sought financial awards for early or advanced dementia. Only 30% have been rewarded — with an average of $715,000 awarded for those with advanced dementia and $523,000 for those with early dementia.

The fund has paid $821 million out for five types of brain injuries.

A federal judge must still approve the proposal.

“No race norms or race demographic estimates — whether Black or White — shall be used in the settlement program going forward,” the proposal said.

The controversy of race norming hasn’t just applied to neuropsychology.

For example, Dr. Benjamin Tolchin, a neurologist who is an assistant professor at Yale, pointed to the testing of kidney function. Historically, he said, the formula used to measure whether a person’s kidney functioned properly adjusted for race.

Specifically, there was a higher threshold for Black people to determine whether their kidney was considered to be impaired than White people, Dr. Tolchin said. This was due to the difference in creatinine levels —molecules that help filter waste from the kidneys to the body — between the races.

Dr. Tolchin said most medical systems are now moving away from the practice.

“There’s a lot of concern within the medical community and within research communities that having race-specific criteria or race-specific comparisons can, in some cases, systematically disadvantage members of particular races,” he said.

This article is based on wire service reports. 

• Matthew Paras can be reached at mparas@washingtontimes.com.

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