Mixed Race Studies

In conclusion, based on a consecutive series of patients from an urban medical center in New York City we demonstrate that a spectrum of mixed ancestry is emerging in the largest US minority groups. While consistent with previous descriptive studies, when viewed from the clinical perspective this evidence invites a re-evaluation of the relevance of racial/ethnic labels. In combination with evidence of locus heterogeneity within and between populations, this picture of extensive gene flow lends credence to the argument that the transfer of historical population labels which reflect language and other social categories onto patient samples will in many cases be unwarranted.

Tayo BO, Teil M, Tong L, Qin H, Khitrov G, et al., “Genetic Background of Patients from a University Medical Center in Manhattan: Implications for Personalized Medicine,” PLoS ONE, Volume 6, Number 5 (2011-05-04): 8-10. http://dx.doi.org/10.1371/journal.pone.0019166.

Genetic Background of Patients from a University Medical Center in Manhattan: Implications for Personalized Medicine

PLoS ONE: A peer-reviewed, open access journal
Volume 6, Number 5 (2011-05-04)
11 pages
DOI: 10.1371/journal.pone.0019166

Bamidele O. Tayo
Department of Preventive Medicine and Epidemiology
Loyola University Chicago
Stritch School of Medicine, Maywood, Illinois

Marie Teil
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Liping Tong
Department of Preventive Medicine and Epidemiology
Loyola University Chicago
Stritch School of Medicine, Maywood, Illinois

Huaizhen Qin
Department of Biostatistics and Epidemiology
Case Western University, Cleveland, Ohio

Gregory Khitrov
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Weijia Zhang
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Quinbin Song
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Omri Gottesman
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Xiaofeng Zhu
Department of Biostatistics and Epidemiology
Case Western University, Cleveland, Ohio

Alexandre C. Pereira
University of Sao Paulo Medical School, Sao Paulo, Brazil

Richard S. Cooper
Department of Preventive Medicine and Epidemiology
Loyola University Chicago
Stritch School of Medicine, Maywood, Illinois

Erwin P. Bottinger
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Background

The rapid progress currently being made in genomic science has created interest in potential clinical applications; however, formal translational research has been limited thus far. Studies of population genetics have demonstrated substantial variation in allele frequencies and haplotype structure at loci of medical relevance and the genetic background of patient cohorts may often be complex.

Methods and Findings

To describe the heterogeneity in an unselected clinical sample we used the Affymetrix 6.0 gene array chip to genotype self-identified European Americans (N = 326), African Americans (N = 324) and Hispanics (N = 327) from the medical practice of Mount Sinai Medical Center in Manhattan, NY. Additional data from US minority groups and Brazil were used for external comparison. Substantial variation in ancestral origin was observed for both African Americans and Hispanics; data from the latter group overlapped with both Mexican Americans and Brazilians in the external data sets. A pooled analysis of the African Americans and Hispanics from NY demonstrated a broad continuum of ancestral origin making classification by race/ethnicity uninformative. Selected loci harboring variants associated with medical traits and drug response confirmed substantial within- and between-group heterogeneity.

Conclusion

As a consequence of these complementary levels of heterogeneity group labels offered no guidance at the individual level. These findings demonstrate the complexity involved in clinical translation of the results from genome-wide association studies and suggest that in the genomic era conventional racial/ethnic labels are of little value.

Read the entire article here in HTML or PDF format.

Race in Contemporary Medicine

Routledge
2007
208 pages
Hardback ISBN: 978-0-415-41365-7

Edited by:

Sander L. Gilman

With the first patent being granted to “BiDil,” a combined medication that is deemed to be most effective for a specific “race,” African-Americans for a specific form of heart failure, the on-going debate about the effect of the older category of race has been renewed. What role should “race” play in the discussion of genetic alleles and populations today? The new genetics has seemed to make “race” both a category that is seen useful if not necessary, as The New York Times noted recently: “Race-based prescribing makes sense only as a temporary measure.” (Editorial, “Toward the First Racial Medicine,” November 13, 2004) Should one think about “race” as a transitional category that is of some use while we continue to explore the actual genetic makeup and relationships in populations? Or is such a transitional solution poisoning the actual research and practice.

Does “race” present both epidemiological and a historical problem for the society in which it is raised as well as for medical research and practice? Who defines “race”? The self-defined group, the government, the research funder, the researcher? What does one do with what are deemed “race” specific diseases such as “Jewish genetic diseases” that are so defined because they are often concentrated in a group but are also found beyond the group? Are we comfortable designating “Jews” or “African-Americans” as “races” given their genetic diversity? The book answers these questions from a bio-medical and social perspective.

This book was previously published as a special issue of Patterns of Prejudice.

Contents

• Introduction: On Race and Medicine in Historical Perspective. Sander L. Gilman (Emory)
• Reflections on Race and the Biologization of Difference. Katya Gibel Azoulay (Grinnell)
• Against Racial Medicine. Joseph L. Graves, Jr. (North Carolina A&T State University) & Michael R. Rose (University of California, Irvine)
• Blood and Stories: How Genomics is Rewriting Race, Medicine and Human History. Patricia Wald (Duke)
• “Why are Genetic and Medical Researchers Accepting a Category Created by Slaveholders?” A Social History of the Reification of “Race” James Downs (Princeton)
• Eugenics and the Racial Genome: Politics at the Molecular Level. Sharon Snyder and David Mitchell (University of Illinois – Chicago)
• The Risky Gene: Epidemiology and the Evolution of Race. Philip Alcabes (Hunter College School of Health Sciences)
• Folk Taxonomy, Prejudice and the Human Genome: Using Heritable Disease as a Jewish Ethnic Marker. Judith S. Neulander (Case Western Reserve University)
• The price of science without moral constraints: German and American medicine before DNA and Today. Robert E. Pollack (Columbia)
• Deadly Medicine Today: The Impossible Denials of Racial Medicine. C. Richard King (Washington State University)
• Biobanks of a “Racial Kind”: Mining for Difference in the New Genetics. Sandra Soo-Jin Lee (Stanford)

Black and Blue: The Origins and Consequences of Medical Racism by John Hoberman [Matt Wood Review]

TriQuarterly: a journal of writing, art, and cultural inquiry from Northwestern University
2013-02-04

Matt Wood, Book Review Editor

We’ve heard the statistics on black and white mortality rates in the United States. Black infants are up to three times as likely to die as babies of other races. Black patients have lower survival rates from cancer and are hospitalized twice as often as whites for preventable conditions such as high blood pressure and type 2 diabetes.

How does this happen in the twenty-first century, when a black man is the president of the United States and three of the last four surgeons general have been black? Why do whites receive more potentially lifesaving cardiac procedures than blacks? Why are black patients less likely to have cancer surgery recommended to them? Why are black patients with diabetes and circulatory problems more likely to have limbs amputated?

Racism, says John Hoberman. In his scathing book Black and Blue: The Origins and Consequences of Medical Racism, he documents how the racial prejudices of the larger American society have influenced the diagnosis and treatment of black patients over the past century, and how those practices continue today. The book is a relentless and thoroughly researched account of racial discrimination by the largely white medical establishment, composed of medical school faculty, editorial boards of scientific journals, and professional associations such as the American Medical Association that develop medical school curricula and influence decisions about research. While Hoberman offers an unsatisfying solution to these problems, the book is thorough enough to make anyone—physician, layperson, black, white—question his or her own racial prejudices and assumptions…

…Hoberman calls this “racialization,” or using pseudoscientific rationales to define racial differences in physiology. The idea that blacks are more primitive human beings than whites stemmed from the same historical racist ideas that European colonizers used to justify black African slavery. This later developed into subtler stereotyping. Conditions associated with the stresses of modern “civilized” life were labeled “white.” Whites supposedly suffered more from myopia and other vision problems caused by the strain of reading too much. White businessmen were prone to digestive problems and ulcers because they shouldered “the burdens and responsibilities of administration and management in business and politics.” Blacks, on the other hand, supposedly possessed an innate physical “hardiness” that made them less susceptible to these “white” diseases. Instead, they were allegedly prone to sexually transmitted infections, drug abuse, and alcoholism because of their “careless” and “primitive” lifestyles. Hoberman points out a classic example of endometriosis. As late as 1950, some doctors believed that it occurred only in white women, because they assumed sexually transmitted diseases were the source of any gynecological problems in black women…

Read the entire review here.

Black and Blue: The Origins and Consequences of Medical Racism

University of California Press
April 2012
304 pages
Paperback ISBN: 9780520274013
Hardcover ISBN: 9780520248908

John Hoberman

Black & Blue is the first systematic description of how American doctors think about racial differences and how this kind of thinking affects the treatment of their black patients. The standard studies of medical racism examine past medical abuses of black people and do not address the racially motivated thinking and behaviors of physicians practicing medicine today.

Black & Blue penetrates the physician’s private sphere where racial fantasies and misinformation distort diagnoses and treatments. Doctors have always absorbed the racial stereotypes and folkloric beliefs about racial differences that permeate the general population. Within the world of medicine this racial folklore has infiltrated all of the medical sub-disciplines, from cardiology to gynecology to psychiatry. Doctors have thus imposed white or black racial identities upon every organ system of the human body, along with racial interpretations of black children, the black elderly, the black athlete, black musicality, black pain thresholds, and other aspects of black minds and bodies. The American medical establishment does not readily absorb either historical or current information about medical racism. For this reason, racial enlightenment will not reach medical schools until the current race-aversive curricula include new historical and sociological perspectives.

Contents

• Acknowledgments
• 1. THE NATURE OF MEDICAL RACISM: THE ORIGINS AND CONSEQUENCES OF MEDICAL RACISM
  • Introduction
  • “Avoidance and Evasion”
  • Judging How Physicians Behave
  • Judging Physician Conduct: Privacy and the “Halo Effect”
  • The Oral Tradition
  • Physicians Share the Racial Attitudes of Their Fellow Citizens
  • The Medical Liberals
• 2. BLACK PATIENTS AND WHITE DOCTORS
  • The African American Health Calamity: The Silence
  • Medical Vulnerability and Racial Defamation
  • How Do (White) Physicians Think about Race?
  • Evidence or Medical Racism
  • Resistance to the Critique of Racial Bias in Medicine
  • Medical Liberalism and the Medical Literature
  • The Physician’s Private Sphere
  • Playing Anthropologist
  • From Racial Folklore to Racial Medicine
• 3. MEDICAL CONSEQUENCES OF RACIALIZING THE HUMAN ORGANISM
  • Racial Interpretations of Human Types and Traits
    • Introduction
    • Racial Interpretations of Black Infants and Children
    • Racial Interpretations of the Black Elderly
    • Racial Interpretations of the Black Athlete
    • Racial Interpretations of Black Musical Aptitude
    • Racial Interpretations of Losing Consciousness
    • Racial Interpretations of the Nervous System
    • Racial Interpretations of Pain Sensitivity
    • Racial Interpretations of Heart Disease
  • Racial Interpretations of Human Organs and Disorders
    • Racial Interpretations of the Eyes
    • Racial Interpretations of Black Skin
    • Racial Interpretations of Human Teeth
    • Racial Interpretations of “While” and “Black” Disorders
    • Black “Hardiness”
    • Physical Hardiness
    • Emotional Hardiness
    • Conclusion: How Human Organ Systems Acquire Racial Identities
  • Racial Folklore in Medical Specialties
    • A Century of Racial Pharmacology: From Racial Folklore to Racial Genetics
    • The Role of Racial Folklore in Obstetrics and Gynecology during the Twentieth Century
• 4. MEDICAL APARTHEID, INTERNAL COLONIALISM, AND THE TASK OF AMERICAN PSYCHIATRY
  • Introduction
  • “Africanizing” the Black Image
  • American Psychiatry as Racial Medicine
  • The Racial Primitive in American Psychiatry
  • The Task of Black Psychiatry
  • Colonial Medical Status
• 5. A MEDICAL SCHOOL SYLLABUS ON RACE
  • Introduction
  • The Doctor-Patient Relationship
  • The Problem Patient
  • Medical Authors’ Aversion to Race
  • Race and Medical Education: The Search for “Cultural Competence”
  • Two Official Versions of “Cultural Competence”
  • Physicians’ Beliefs about Racial Differences: A (Belated) Study
  • A Medical Curriculum on Race
  • Practical Advice for Physicians
  • Social Class, Misdiagnoses, and Therapeutic Fatalism
  • “Cultural Competence” as Knowledge of Stereotype Systems
  • Raceless Humanism: “Medical Humanities” and the Evasion of Difference
  • Medical Curriculum Change Is Possible: The Case of Abortion Training
• Notes
• Index

The Trend of the Race: A Study of Present Tendencies in the Biological Development of Civilized Mankind

Harcourt, Brace and Company
1921
396 pages
(Digitized by Google)

Samuel J. Holmes (1868-1964), Ph.D., Professor of Zoology
University of California, Berkeley

CONTENTS

• I. An Introductory Orientation
• II. The Hereditary Basis
• III. The Inheritance of Mental Defects and Disease
• IV. The Heritable Basis of Crime and Delinquency
• V. The Inheritance of Mental Ability
• VI. The Decline of the Birth Rate
• VII. The Causes of the Decline of the Birth Rate
• VIII. Natural Selection in Man
• IX. The Selective Influence of War
• X. Sexual Selection and Assortative Mating
• XI. Consanguineous Marriages and Miscegenation
• XII. The Possible Role of Alcohol and Disease in Causing Hereditary Defects
• XIII. The Alleged Influence of Order of Birth and Age of Parents upon Offspring
• XIV. The Racial Influence or Industrial Development
• XV. The Selective Function of Religion
• XVI. Retrospect and Prospect

PREFACE

The present volume is the outgrowth of a course of lectures on Eugenics which has been given for several years in the University of California. Its aim is to present an account of the various forces which are at present modifying the inherited qualities of civilized mankind. In dealing with so extensive and complex a subject I have doubtless committed a number of errors and have probably not altogether escaped from being misled by statistical fallacies into which I have so often accused others of having fallen. The more extensively I have delved into the varied literature on the biological evolution of man, the more I have become impressed with the necessity of employing extreme caution in drawing conclusions. Few subjects, in fact, present so many pitfalls for the unwary. It is with the conviction that it is especially important in this field to be sure one is right before going ahead that I have devoted so much effort to critical analysis at the risk of becoming tedious to the general reader.

I am indebted to my colleagues Professor F. B. Sumner and Professor F. J. Teggart for reading my original manuscript and for making a number of valuable suggestions.

The preparation of the present work has involved the compilation of an extensive bibliography which is to be published as an additional volume so that the references may be rendered avail able for other investigators.

S. J Holmes

Berkeley, Calif.
Jan. 1921.

Read the entire book here or here.

Prisoners of Abstraction? The Theory and Measure of Genetic Variation, and the Very Concept of “Race”

Biological Theory
July 2012
12 pages
DOI: 10.1007/s13752-012-0048-0

Jonathan Michael Kaplan, Associate Professor of Philosophy
Oregon State University

Rasmus Grønfeldt Winther, Assistant Professor of Philosophy
University of California, Santa Cruz

It is illegitimate to read any ontology about “race” off of biological theory or data. Indeed, the technical meaning of “genetic variation” is fluid, and there is no single theoretical agreed-upon criterion for defining and distinguishing populations given a particular set of genetic variation data. By analyzing three formal senses of “genetic variation,” viz., diversity, differentiation, and heterozygosity, we argue that the use of biological theory for making claims about race inevitably amounts to a pernicious reification. Biological theory does not force the concept of “race” upon us; our social discourse, social ontology, and social expectations do. We become prisoners of our abstractions at our own hands, and at our own expense.

Read the entire article here.

Genetic Explanations: Sense and Nonsense

Harvard University Press
February 2013
384 pages
6-1/8 x 9-1/4 inches
2 graphs, 4 tables
Hardcover ISBN: 9780674064461

Edited by

Sheldon Krimsky, Professor of Urban & Environmental Policy & Planning in the School of Arts; Sciences and Adjunct Professor of Public Health & Community Medicine in the School of Medicine
Tufts University

Jeremy Gruber, President and Executive Director
Council for Responsible Genetics

Can genes determine which fifty-year-old will succumb to Alzheimer’s, which citizen will turn out on voting day, and which child will be marked for a life of crime? Yes, according to the Internet, a few scientific studies, and some in the biotechnology industry who should know better. Sheldon Krimsky and Jeremy Gruber gather a team of genetic experts to argue that treating genes as the holy grail of our physical being is a patently unscientific endeavor. Genetic Explanations urges us to replace our faith in genetic determinism with scientific knowledge about how DNA actually contributes to human development.

The concept of the gene has been steadily revised since Watson and Crick discovered the structure of the DNA molecule in 1953. No longer viewed by scientists as the cell’s fixed set of master molecules, genes and DNA are seen as a dynamic script that is ad-libbed at each stage of development. Rather than an autonomous predictor of disease, the DNA we inherit interacts continuously with the environment and functions differently as we age. What our parents hand down to us is just the beginning. Emphasizing relatively new understandings of genetic plasticity and epigenetic inheritance, the authors put into a broad developmental context the role genes are known to play in disease, behavior, evolution, and cognition.

Rather than dismissing genetic reductionism out of hand, Krimsky and Gruber ask why it persists despite opposing scientific evidence, how it influences attitudes about human behavior, and how it figures in the politics of research funding.

Racial Medicine: Not So Fast

The Daily Beast
2008-08-19

Sharon Begley, Senior Health and Science Correspondent
Reuters

Next time you want to start a bar fight, proclaim to everyone within earshot that “race is not real; it is just a social and cultural construct and has no biological validity.” Then duck before you get punched in the face. . . . but as you’re avoiding injury try to hand your would-be assailants a new paper published online this afternoon by the journal Clinical Pharmacology & Therapeutics, which concludes that classifying people by the crude category of race—as in, of African, Asian or European ancestry—for medical purposes, as some people want to do, is really, really stupid…

…Which brings us to the new study. Scientists at the J. Craig Venter Institute got the cool idea of analyzing the genomes of two white guys who, according to the conventional racial categories, belong to the same race. The two are Venter himself and James Watson, co-discoverer of the double-helix structure of DNA. Venter led the private effort to sequence the human genome, winding up in a tie with the public project to do the same.

It happens that the genomes of both men are in the public domain. Watson agreed to have his sequenced and published last year, with Venter right behind. So what do the genomes reveal?

The two men metabolize drugs, including antidepressants, codeine, antipsychotics and the cancer drug tamoxifen, differently. Venter has two functional copies of the CYP2D6 form of the cytochrome P-450 gene, which metabolizes more than 75 percent of drugs, while Watson has two copies of the more-sluggish variant of the gene. That’s rare for Caucasians (only 3 percent of whites have the sluggish version), but common in East Asians (49 percent of whom have it). Funny, Watson doesn’t look Chinese. But if Watson’s doctor decided to use race-based medicine to predict how he would metabolize drugs, she’d say, well, we have a white guy here, and whites rarely have the sluggish version, so I’ll assume Watson doesn’t have it either. As a result, the drug would stay in Watson’s system longer, with stronger effects compared to someone in whom the drug was quickly metabolized and cleared from the body. “It is unlikely that a doctor would guess that optimal drug dosages might differ for Drs. Watson and Venter,” the scientists write.

That’s why Venter and colleagues conclude that race is too crude a proxy for what genetic group—ethnicity or, as biologists say, population—someone belongs to. It is imperative to “go beyond simplistic ethnic categorization,” they write, since that can be seriously—and perhaps fatally—misleading. (In the U.S., some 100,000 people a year die of adverse drug reactions, many caused by an inability to properly metabolize the medication because of a particular CYP2D6 variation.) “Race/ethnicity should be considered only a makeshift solution for personalized genomics because it is too approximate,” they write…

Read the entire article here.

Mixed Race Blood, Bone Marrow Donors Needed To Save Gen Y Lives

The Huffington Post-Canada
2013-01-31

Andree Lau

One of Lourdess Sumners’ most vivid memories of her childhood battle with cancer was pining for real food while hooked up to a feeding tube and watching The Food Channel on TV.

“It was horrible. I hated it,” recalls the now 14-year-old from her home in Duncan, B.C. “That would make me even more hungry. And I would draw pictures of sausages and hamburgers, whatever I felt hungry for.”

For her parents, that period was highlighted by the distressing and ultimately futile search for a bone marrow donor for their middle daughter, hampered mainly because she happens to be part of the fastest growing demographic in Canada.

Sumners, whose mother is Filipino and father is Caucasian, is among the more than 340,000 Canadian children growing up in a mixed-race family.

Only about four per cent of Canada’s couples are made up of people from different ethnic backgrounds — but they’re growing five times faster than other unions, according to data from the 2006 census.

Statistics Canada said mixed couples were most common among Canadians aged 25 to 34, followed by those aged 15 to 24 — a cohort that encompasses Generation Y, which generally refers to young adults born after 1980 (also known as millennials).

What hasn’t kept up with the growing population of mixed-race children is the registry of stem cell and marrow donors from blended ethnicities — donors that Sumners needed. She required a bone marrow transplant to fight acute myeloid leukemia, an aggressive cancer of the blood and bone marrow.

“It wasn’t even a consideration in my mind that finding bone marrow would be an issue,” says Orlando Sumners, Lourdess’ father. “There’s such a desperate need for mixed-race people on the registry … [but] most mixed-race adults wouldn’t have a clue what we’re talking about.”…

Read the entire article here.