Mixed Race Studies

On Race and Medicine: Insider Perspectives

Rowman & Littefield
April 2015
178 pages
6 1/2 x 9 1/4
Hardback ISBN: 978-1-4422-4835-9
eBook ISBN: 978-1-4422-4836-6

Edited by:

Richard Garcia, M.D.

Health disparities exist between races in America. These inequalities are cataloged in numerous studies, reports, conferences, articles, seminars, and keynote speeches. Various studies include reports on income, health insurance, cultural differences between patients and their physicians, language barriers, and biological “racial” differences in the discourse of health disparities.

On Race and Medicine: Insider Perspectives is a collection of enlightening personal essays written by an interdisciplinary group of scholars, physicians, and medical school deans. They invite readers to evaluate disparities differently when considering race in American healthcare. They address the very real, everyday circumstances of healthcare differences where race is concerned, and shine light on the realities of race itself, inequalities in healthcare, and on the very way these American complexities can be discussed and considered.

This is not another chronicle of studies cataloging differences in health care based on race. The essays are narrated from practical and personal stances examining disparate health between the races. Decreasing inequalities in health for racial minorities, who are sicker in so many areas—diabetes, heart disease, stage of cancer, etc.—is financially good for everyone. But understanding health inequalities in race is of even greater human importance. How race intersects with medicine is striking given the existence of racial issues throughout the rest of American history. These authors attempt to explain and explore the truth about health disparities, which is necessary before we can turn our national attention toward eliminating differences in health based on race.

Inconsistency within Expressed and Observed Racial Identifications: Implications for Mental Health Status

Sociological Perspectives
Volume 59, Number 3 (September 2016)
pages 582-603
DOI: 10.1177/0731121415602133

Whitney N. Laster Pirtle, Assistant Professor of Sociology
University of California, Merced

Tony N. Brown, Associate Professor of Sociology
Vanderbilt University, Nashville, Tennessee

The present study extends previous work on distress that arises from discrepancy between self and interviewer racial identifications. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health) data, we examine mental health consequences of inconsistency over time within expressed (self) and observed (interviewer) racial identifications among American Indians. Given that phenotype signals race, we also contribute to prior research by examining whether skin color moderates inconsistency’s mental health consequences. Analyses show that observed racial inconsistency increased American Indians’ depressive symptoms and suicidal ideation. That is, when interviewers labeled a respondent “American Indian” at one wave of data but not another, there were deleterious implications for mental health status. In addition, an interaction between observed inconsistency and skin color demonstrated that observed inconsistency tended to be harmful when respondents were observed as having light skin. We argue observed inconsistency captures the distressing experience of being not readily classifiable.

Read or purchase the article here.

Genetics against race: Science, politics and affirmative action in Brazil

Social Studies of Science
Volume 45, Number 6 (December 2015)
pages 816-838
DOI: 10.1177/0306312715610217

Peter Wade, Professor of Social Anthropology
University of Manchester

Michael Kent, Honorary Research Fellow in Social Anthropology
School of Social Sciences
University of Manchester

This article analyses interrelations between genetic ancestry research, political conflict and social identity. It focuses on the debate on race-based affirmative action policies, which have been implemented in Brazil since the turn of the century. Genetic evidence of high levels of admixture in the Brazilian population has become a key element of arguments that question the validity of the category of race for the development of public policies. In response, members of Brazil’s black movement have dismissed the relevance of genetics by arguing, first, that in Brazil race functions as a social – rather than a biological – category, and, second, that racial classification and discrimination in this country are based on appearance, rather than on genotype. This article highlights the importance of power relations and political interests in shaping public engagements with genetic research and their social consequences.

Read the entire article here.

Biohistorical Narratives of Racial Difference in the American Negro: Notes toward a Nuanced History of American Physical Anthropology

Current Anthropology
Volume 53, Number S5 (April 1, 2012) (Volume Supplement)
pages S196-S209
DOI: 10.1086/662416

Rachel J. Watkins, Associate Professor of Anthropology
American University, Washington, D.C.

This paper examines the scientific construction of racial differences through the lens of early twentieth-century bioanthropological studies of American Negro skeletal and living population samples. These studies, as well as the scientists who conducted them, are generally distinguished from one another based on their adherence to quantitative and/or qualitative measures of racial difference. However, these binary distinctions tend to obscure the rather complex processes of racial formation in which scientists and research subjects were engaged. Both racialist and nonracialist scholarship positioned American Negroes as products of white, African, and, sometimes, Indian admixture. As the singular label used in these studies connotes, “the American Negro” was also classified as a distinct racial type based on elements of skeletal and physical morphology. Studies reveal that multiple definitions and meanings of race were operating and being generated in the process of situating American Negroes in these seemingly opposed positions. Finally, I consider the implications of this discussion for developing critical histories of American physical anthropology and engaging contemporary public and academic discourse around race, health, and biological diversity.

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‘We Are All the Same, We All Are Mestizos’: Imagined Populations and Nations in Genetics Research in Colombia

Science as Culture
Volume 23, Issue 2, 2014
pages 226-252
DOI: 10.1080/09505431.2013.838214

María Fernanda Olarte Sierra, Assistant Professor
Department of Design
University of the Andes, Bogotá, Colombia

Adriana Díaz Del Castillo Hernández, Independent Researcher
Consultoría en Estudios Sociales Sobre Educación, Salud, Ciencia y Tecnología, Bogotá, Colombia

In Colombia, as in other Latin American countries, current population genetics research is based on the understanding that Colombians constitute a mestizo nation, given the admixture process that took place between Africans, Amerindians, and Europeans during colonial times. The mestizo is a pervasive category used by geneticists to conduct, organise, and publish research studies that deal with the continent’s peopling process and the genetic makeup of its contemporary population(s). It is also the dominant imaginary for the Colombian population and a key nation-building ideology. By tracing how this category moves and is used across four Colombian genetics laboratories, it is possible to discern that despite its apparently clear-cut boundaries, the mestizo is contingent, contested, and flexible, allowing for multiple understandings and usages. This flexibility and multiplicity are visible in the quantification of genetic ancestry, the divisions of geographical location, and the understanding of gender. Such understandings allow one to think about a homogeneous nation (inclusive) that is simultaneously heterogeneous (exclusive); they provide multiple but not necessarily contradictory possibilities of being mestizo, allowing the coexistence of images of the nation that could otherwise seem contradictory; and they permit navigation around contested terms such as race, while simultaneously thinking of mixed races or racialised individuals. Finally, these flexible and multiple constructions of the mestizo (re)produce various subjects as ‘other’, whether they are women, the Indigenous, the black/dark, or the poor.

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Nation and the Absent Presence of Race in Latin American Genomics

Current Anthropology
Volume 55, Number 5 (October 2014)
pages 497-522
DOI: 10.1086/677945

Peter Wade, Professor of Social Anthropology
University of Manchester

Vivette García Deister, Associate Professor
Social Studies of Science Laboratory
National Autonomous University of Mexico

Michael Kent, Honorary Research Fellow in Social Anthropology
School of Social Sciences
University of Manchester

María Fernanda Olarte Sierra, Assistant Professor
Department of Design
University of the Andes, Bogotá, Colombia

Adriana Díaz del Castillo Hernández, Independent Researcher
Consultoría en Estudios Sociales Sobre Educación, Salud, Ciencia y Tecnología, Bogotá, Colombia

Recent work on genomics and race makes the argument that concepts and categories of race are subtly reproduced in the practice of genomic science, despite the explicit rejection of race as meaningful biological reality by many geneticists. Our argument in this paper is that racialized meanings in genomics, rather than standing alone, are very often wrapped up in ideas about nation. This seems to us a rather neglected aspect in the literature about genomics and race. More specifically, we characterize race as an absent presence in Latin America and argue that genomics in the region finds a particular expression of race through concepts of nation, because this vehicle suits the deep-rooted ambiguity of race in the region. To make this argument we use data from an ethnographic project with genetics labs in Brazil, Colombia, and Mexico.

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Towards a Biopolitics of Beauty: Eugenics, Aesthetic Hierarchies and Plastic Surgery in Brazil

Journal of Latin American Cultural Studies: Travesia
Volume 24, Issue 4, 2015
Special Issue: Visual Culture and Violence in Contemporary Mexico
DOI: 10.1080/13569325.2015.1091296

Alvaro Jarrín, Assistant Professor
Department of Sociology and Anthropology
College of the Holy Cross, Worcester, Massachusetts

This article provides a historical and ethnographic perspective to explain the saliency of beauty within the reproduction of racial inequalities in Brazil. I argue that Brazil’s neo-Lamarckian eugenics movement was the first to craft beauty as an index of racial improvement within the nation, and this eugenic legacy undergirds many of the contemporary discourses of beautification. Plastic surgery, in particular, inherited the biopolitical aim to produce a homogeneous body politic through beautification, an aim that was easily adapted to the contemporary context of neoliberal self-improvement. Today, beauty is a technology of biopower, one which ranks the population within an aesthetic hierarchy that produces non-white facial characteristics as undesirable, and interpellates patients as responsible for their own surgical corrections, albeit with state support in the case of the poor. Thus, this article contributes to the literature that understands science and medicine as key within the history of racialization in Latin America, making explicit how biopolitics has fashioned race and beauty as inextricable and intertwined elements of social inclusion and exclusion.

Read or purchase the article here.

What Scientists Mean When They Say ‘Race’ Is Not Genetic

The Huffington Post
2016-02-09

Jacqueline Howard, Senior Science Editor

A new paper explains why it can be dangerous to think otherwise.

If a team of scientists in Philadelphia and New York have their way, using race to categorize groups of people in biological and genetic research will be forever discontinued.

The concept of race in such research is “problematic at best and harmful at worst,” the researchers argued in a new paper published in the journal Science on Friday.

However, they also said that social scientists should continue to study race as a social construct to better understand the impact of racism on health.

So what does all this mean? HuffPost Science recently posed that question and others to the paper’s co-author, Michael Yudell, who is associate professor and chair of community health and prevention at the Dornsife School of Public Health at Drexel University in Philadelphia…

Read the entire article here.

In First for Sitting President, Obama Publishes a Scholarly Article

Fortune
2016-07-11

Jeff John Roberts

Call him scholar-in-chief

An author named “Barack Obama, JD” published an article on Monday in a scholarly journal. No prizes for guessing the topic: It’s an assessment of the Affordable Care Act as well as policy recommendations for the next president to improve the U.S. health care system.

The article, titled “United States Health Care Reform: Progress to Date and Next Steps,” was published by the Journal of the American Medical Association.

The piece, which contains 68 footnotes to academic journals and government publications, claims to present evidence showing that the number of Americans without health insurance has dropped dramatically, and resulted in lower hospital readmission rates. Obama also used the article to recommend the introduction of a “public option” plan in parts of the U.S. and for the federal government to push down drug prices…

Read the entire article here.

Is there a racial ‘care gap’ in medical treatment?

PBS News Hour
2016-04-05

A new survey has found implicit biases in medical students that may explain why black patients are sometimes undertreated for pain, with some students believing that black people feel less pain and have thicker skin than white people. For more on the perplexing discovery, Gwen Ifill talks to Dr. David Satin of the University of Minnesota and Dorothy Roberts of the University of Pennsylvania.

GWEN IFILL: A new study finds African-American patients are often treated differently when it comes to medicine and care. The survey of more than 500 people, 400 of them medical students, found implicit bias exists that may help explain why black people are sometimes undertreated for pain.

Among its findings: Medical students believed that African-Americans felt less pain than white patients, and even thought their skin was thicker.

For more on this perplexing discovery, we turn to Dr. David Satin of the University of Minnesota Medical Center, and Dorothy Roberts of the university of Pennsylvania.

Thank you both for joining us.

Dr. Satin, try to describe this disparity for me. Why does this exist? And is it new?

DR. DAVID SATIN, University of Minnesota Medical Center: So, Gwen, we have known that this has been an issue for at least a couple decades.

And every now and then, a study comes out that underscores the need for the field of medicine, and in particular medical education, to do some work and get it right.

So, this is a problem, and it’s been a problem, and hopefully this study will spur on more activity.

GWEN IFILL: Dorothy Roberts, is this a medical problem or a sociological problem?

DOROTHY ROBERTS, University of Pennsylvania: It’s both.

I think what’s really important and fascinating about the study is that it, for the first time, links what we have long known as undertreatment of pain for black patients with doctors, or at least medical students’ false beliefs about biological differences based on race.

And those beliefs, as the study has shown, are widely held by laypeople as well. They’re deeply embedded, longstanding myths about racial difference, especially biological differences between races, which goes back to the very concept that race is a biological difference that is widespread in U.S. society. So it’s sociological, as well as medical…

Read the entire transcript here. Watch the interview here.