score for black patients by a factor of 1.210, which the study's authors doubt the validity of. The algorithm's developers backed the results, citing that black people have higher creatinine levels, which can be a lurking variable in eGFR calculations. Vyas makes a rebuttal to this idea, stating, "Explanations that have been given for this finding include the notion that black people release more creatinine into their blood at baseline, in part because they are reportedly more muscular." In reality, this generalization may not be the case and can be harmful to minorities that encounter such correction factors. Similarly, the vaginal birth after Caesarean section (VBAC) medical calculator is used to estimate the probability that a patient will successfully complete a vaginal birth if they have already had a birth via Caesarean section. There are correction factors based on race that have been commonly used in this calculator; self-reported African American patients' results are multiplied by a factor of 0.671. The VBAC calculator is in the process of being altered by the Maternal-Fetal Medicine Units Network, as of December 2021, to omit race and ethnicity in the interest of ignoring such "socially constructed variables" that may be inaccurate. Mental health Stress can be derived from many individualistic factors or experiences, has multiple effects on health. Stress is also associated with chronic diseases. Stress that is derived from racism has specific contextual factors, which adds a daily burden to African-Americans and other demographic groups that are discriminated against. These demographic groups do not often realize that these stressors may be contributing to the state of their mental health. Groups of people are also affected in ways that may not be outward acts of racism by another person, but through education, economics, the justice system, and largely through law enforcement. It is also possible that people who hold racist ideals have mental health problems as well, such as self-centeredness, inability to empathize, and paranoia over groups of people they are discriminating against. Individuals can develop complexes about ethnic groups and races, automatically displaying emotions without learning about the people themselves, and will cut off all friendliness to them. There are many barriers that exist in the relationship for African Americans accessing mental health services. These barriers can range from family dynamics, institutional racism, socioeconomic status, and a host of other reasons. This is particularly true for African Americans in need of mental