Methylation clocks fail to generalize across genetically admixed individuals.

Drug overdose deaths are a leading cause of mortality in the United States. There were nearly 108,000 drug overdose-related deaths in 2022, according to the National Institutes of Health. In 2023 the U.S. Centers for Disease Control and Prevention’s State Unintentional Drug Overdose Reporting System reported victim demographics as follows: most were male (71.6%); 23% were Black, 61.3% were White; and 25.9% were 35–44 years of age. Of note, in recent years overdose death rates have increased disproportionately among non-Hispanic Black and non-Hispanic American Indian/Alaska Natives. Demographics describe the social milieu that helps inform how society constructs stereotypes of groups more likely to experience substance use. Evidence is limited regarding the ways in which bias based on skin color affects clinical decision-making. Previous investigations of explicit and implicit bias in clinical practice were based on clinical case vignettes, rather than on actual human behavior in clinical scenarios (in situ or simulation-based). In those vignettes it was noted that participants tended to spend similar amounts of time on cases and create similar differential diagnoses regardless of patient presentation and/or background. We began this study at a time when racial inequities were discussed more frequently and race-based medical guidelines were being questioned and in flux. We believe that medical students have become more aware of and are more likely to consider the intersection between race and health outcomes and that their perceptions would influence their clinical practice. (Philips and Soltis describe this as the conceptual framework of knowledge construction and schemas.)