Mixed Race Studies

What is most disturbing about the paradoxical use of race is the effect it may have on the trajectory of ongoing human genetic variation research. By making the moral argument that race-based therapeutics address injustice in health care, and at the same time maintaining that genetics research will ultimately eliminate the need for racial categories, racialization is allowed to proceed unchallenged despite its inherent contradictory claims that race is both biologically meaningful and meaningless. Rather than serving as a way station, the use of race is allowed to become more fully embedded in the production of scientific knowledge and medical practice.

Sandra Soo-Jin Lee, “Racializing Drug Design: Implications of Pharmacogenomics for Health Disparities,” American Journal of Public Health, Volume 95, Number 12 (December 2005): 2137. http://dx.doi.org/10.2105/AJPH.2005.068676.

Racializing Drug Design: Implications of Pharmacogenomics for Health Disparities

American Journal of Public Health
Volume 95, Number 12 (December 2005)
pages 2133-2138
DOI: 10.2105/AJPH.2005.068676

Sandra Soo-Jin Lee, Senior Research Scholar
Stanford Center for Biomedical Ethics
Stanford University

Current practices of using “race” in pharmacogenomics research demands consideration of the ethical and social implications for understandings of group difference and for efforts to eliminate health disparities. This discussion focuses on an “infrastructure of racialization” created by current trajectories of research on genetic differences among racially identified groups, the use of race as a proxy for risk in clinical practice, and increasing interest in new market niches by the pharmaceutical industry.

The confluence of these factors has resulted in the conflation of genes, disease, and race. I argue that public investment in pharmacogenomics requires careful consideration of current inequities in health status and social and ethical concerns over reifying race and issues of distributive justice.

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MSU scholar says medical recommendations should go beyond race

Michigan State University News
2012-10-23

Andy McGlashen, Media Communications

Sean Valles, assistant professor in Lyman Briggs College and the Department of Philosophy, says race-based medical advice is often misleading and harmful. Photo by G.L. Kohuth.

EAST LANSING, Mich. — Medical organizations that make race-based recommendations are misleading some patients about health risks while reinforcing harmful notions about race, argues a Michigan State University professor in a new paper published in the journal Preventive Medicine.
 
While some racial groups are on average more prone to certain diseases than the general population, they contain “islands” of lower risk that medical professionals should acknowledge, said Sean Valles, assistant professor in MSU’s Lyman Briggs College and the Department of Philosophy…

…By glossing over the varying degrees of health risk within a racial group, medical recommendations imply that all members of each race are biologically the same as one another and different from others – a view that promotes prejudice and discrimination, according to Valles…

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Should people’s ethnicity matter in their medical treatment?

OnCentral
Southern California Public Radio
2012-10-24

José Martinez

Chances are, medical research has found that your ethnicity makes you more likely to have certain conditions or diseases.

For Latinos, it’s diabetes. For black folks, it’s high blood pressure. For white people, it’s cystic fibrosis. For Asian women, it’s osteoporosis.

But one scholar says race-based medical recommendations to patients potentially mislead them about their health risks – and reinforce harmful notions about race at the same time.

That scholar is Sean Valles, an assistant professor of philosophy at Michigan State University in a new paper appearing in Preventive Medicine.

In his paper, Valles agrees that some racial groups are, on average, more prone to certain diseases and conditions than other ethnic groups. But, he says, within each ethnic group are what he calls “islands” of lower risk that shouldn’t go unacknowledged.

He gave a couple of examples. The government recommends that black people eat less salt than other ethnic groups, due to their predisposition for high blood pressure. But Valles notes that foreign-born black people tend to have different lifestyles, and as such have substantially lower rates of heart disease, for which high blood pressure is a risk factor…

…It can be tempting, though, for medical professionals to use any information they have to get an edge on their patients’ ailments. But still, said Dr. Felix Aguilar, the chief medical officer at South Central Family Health Center, “we have to be careful when we use race.”

Aguilar said oftentimes, when people point to ethnicity as a factor in medicine, they’re often conflating it with socioeconomic status.

“Yes, there definitely are genetics involved in a lot of these procedures, but that’s not the whole story,” he said, adding that health providers should ask themselves: “Are we using [ethnicity] for the genetic aspects or are we using it for the socioeconomic aspects?”

If the answer is the latter, said Aguilar, then ethnicity probably doesn’t need to be part of the discussion.

“Our position in society many times tells us how long we’re going to live, how healthy we’re going to be and whether we have access to clean water, clean air and good food,” he said.

“Why do Latina women have the highest rate of cervical cancer in the U.S.?” Aguilar continued. “You can say, ‘Alright, it’s genetic.’ And maybe there’s a genetic element. But most likely it’s access to care.“…

Read the entire article here.

Heterogeneity of risk within racial groups, a challenge for public health programs

Preventive Medicine
Volume 55, Issue 5, November 2012
Pages 405–408
DOI: 10.1016/j.ypmed.2012.08.022

Sean A. Valles, Assistant Professor
Lyman Briggs College, Michigan State University

Targeting high-risk populations for public health interventions is a classic tool of public health promotion programs. This practice becomes thornier when racial groups are identified as the at-risk populations. I present the particular ethical and epistemic challenges that arise when there are low-risk subpopulations within racial groups that have been identified as high-risk for a particular health concern. I focus on two examples. The black immigrant population does not have the same hypertension risk as US-born African Americans. Similarly, Finnish descendants have a far lower rate of cystic fibrosis than other Caucasians. In both cases the exceptional nature of these subpopulations has been largely ignored by the designers of important public health efforts, including the recent US government dietary recommendations. I argue that amending the publicly-disseminated risk information to acknowledge these exceptions would be desirable for several reasons. First, recognizing low-risk subpopulations would allow more efficient use of limited resources. Communicating this valuable information to the subpopulations would also promote truth-telling. Finally, presenting a more nuanced empirically-supported representation of which groups are at known risk of diseases (not focusing on mere racial categories) would combat harmful biological race essentialist views held by the public.

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Race Under the Microscope: Biological Misunderstandings of Race

Center for Genetics and Society
2012-05-24

Despite the fact that advances in genetics undermine the notion that discrete and distinct racial groups exist at the biological level, the science of genetics is inadvertently reinforcing the myth that race is a biological, rather than a social, category. In this video, produced by the Center for Genetics and Society, a group of experts discusses the history and consequences of the misuse of racial categories in medicine and science. The video is a great resource for students and educators.

Race Under the Microscope features commentary on the misuse of race from esteemed professors Jonathan Kahn (Professor of Law, Hamline University), Dorothy Roberts (Professor of Law, Northwestern University), Osagie K. Obasogie (Professor of Law, University of California Hastings Law School), and Joseph Graves (Associate Dean for Research, Joint School for Nanosciences & Nanoengineering, Greensboro, NC). The excerpts used in the video were filmed during the 2011 Tarrytown Meeting.

Heredity in Color

Hawke’s Bay Herald
New Zealand
Volume XXIII, Issue 7956
1888-01-21
Page 2
Source: Papers Past, National Library of New Zealand Te Puna Mātauranga o Aotearoa

If a white man marries a negro, their children, boys and girls alike, are all mulattos. Lot us make to ourselves no allusions or mistakes upon this score—each one is simply and solely a pure mulatto, exactly half-way in color, feature, hair, and statue, between his father’s face and his mother’s. People who have not lived in a mixed community of blacks and whites often ignore or misunderstand this fundamental fact of hereditary philosophy; they imagine that one of the children of such a marriage may be light brown, and another dark brown; one almost white, and one almost black; that the resulting strains may to a great extent be mingled indefinitely and in varying proportions. Not a bit of it. A mulatto is a mulatto, and a quadroon is a quadroon, with just one-half and one-fourth of negro blood respectively; and anyone who has once lived in an ox-slave-owning country can pick out the proportion of black or white elements in any particular brown person he meets with as much accuracy as the stud-book shows in recording the pedigree of famous racehorses. Black and white produce mulattos — all mulattos alike to a shade of identity; mulatto and white produce quadroon, and no mistake about it; mulatto and black produce sambo; quadroon and white octoroon—and so forth ad infinitum. After the third cross persistently in either direction, the strain of which less than one-eighth persists becomes at last practically indistinguishable, and the child is ” white by law ” or ” black by law,” as the case may be, without the faintest mark of its slight opposite intermixture. I speak hero of facts which I have carefully examined at firsthand; all the nonsensical talk about finger-nails and knuckles, and persistence of the negro type for ever, is pure unmitigated slave-owning prejudice. The child of an octoroon by a white man is simply white; and no acuteness on earth, no scrutiny conceivable would ever discover the one-sixteenth share of black blood by any possible test save documentary evidence. Here, then, we have a clear, physical, and almost mathematically demonstrable case, showing that, so far as regards bodily peculiarities at least, the child is on the average just equally compounded of traits derived from both its parents. Among hundreds and hundreds of mulatto and quadroon children whom I have observed, I have never known a single genuine instance to the contrary. Heredity comes out exactly true; you get just as much of each color in every case as you would naturally expect to do from a mixture of given proportions. In other words, all mulattos are recognisably different from all quadroons, and all quadroons from all octoroons or all sambos.—From “The Cause of Character,” in the Cornhill Magazine.

Regular screening mammography before the diagnosis of breast cancer reduces black:white breast cancer differences and modifies negative biological prognostic factors

Breast Cancer Research and Treatment
Volume 135, Number 2 (2012)
pages 549-553
DOI: 10.1007/s10549-012-2193-3

Paula Grabler
Feinberg College of Medicine
Northwestern University

Danielle Dupuy
Metropolitan Chicago Breast Cancer Taskforce, Chicago, Illinois

Jennifer Rai
University of Michigan College of Medicine

Sean Bernstein
Rush University Medical Center, Chicago, Illinois

David Ansell
Rush University Medical Center, Chicago, Illinois

Black women present with later stage breast cancers compared to white women, and their cancers are more likely to be larger, receptor negative, and undifferentiated. This study evaluated black:white differences in the stage and biology of breast cancer among women who had a screening mammogram at one of two Chicago academic medical centers within two years of the breast cancer diagnosis (regularly screened) and compared them to the black:white differences in the stage and biology of breast cancer in women who had not received mammographic screening within two years of a breast cancer diagnosis (irregularly screened.) There were no significant black:white differences in the proportion of early breast cancers (black = 74 %; white = 69 %, p = NS) in the regularly screened population or in the irregularly screened group (black = 60 %; white = 68 %, p = NS.) The regularly screened population received significantly more mammograms (58 % ≥4 mammograms) compared to the irregularly screened population (41 % ≥4 mammograms.) Black women in the regularly screened population were less likely than irregularly screened black women to have estrogen negative breast cancers (26 vs. 36 %, p < .05), progesterone negative breast cancers (35 vs. 46 %, p < .05), and poorly differentiated breast cancers (39 vs. 53 %, p < .05.) White women in the irregularly screened population also had worse prognostic factors than white women in the regularly screened population, though these were not statistically significant. Regular mammographic screening can contribute to the narrowing of black:white differences in presentation of breast cancer.

Read or purchase the article here.

Race in a Bottle

Scientific American
Volume 297 (January 1, 2007)
pages 40-45

Jonathan D. Kahn, Professor of Law
Hamline University, Saint Paul, Minnesota

Drugmakers are eager to develop medicines targeted at ethnic groups, but so far they have made poor choices based on unsound science. This article focuses on the drug, BiDil – a drug that combats congestive heart failure by dilating the arteries and veins of African American patients. The author expounds that there is no solid evidence that the drug should targeted towards only one ethnic group. The author includes the history of BiDil including its inception and then its reappearance with a race-based focus.

Read the entire article here.

Spirometry, Measurement, and Race in the Nineteenth Century

Journal of the History of Medicine and Allied Sciences
Volume 60, Number 2, April 2005
pages 135-169

Lundy Braun, Royce Family Professor in Teaching Excellence and Professor of Medical Science and Africana Studies
Brown University

Race correction is a common practice in contemporary pulmonary medicine that involves mathematical adjustment of lung capacity measurements in populations designated as “black” using standards derived largely from populations designated as “white.” This article traces the history of the racialization and gendering of spirometry through an examination of the ideas and practices related to lung capacity measurements that circulated between Britain and the United States in the nineteenth century. Lung capacity was first conceptualized as a discrete entity of potential use in the diagnosis of pulmonary disease and monitoring of the vitality of the armed forces and other public servants in spirometric studies conducted in mid-nineteenth-century Britain. The spirometer was then imported to the United States and used to measure the capacity of the lungs in a large study of black and white soldiers in the Union Army sponsored by the U.S. Sanitary Commission at the end of the Civil War. Despite contrary findings and contestation by leading black intellectuals, the notion of mean differences between racial groups in the capacity of the lungs became deeply entrenched in the popular and scientific imagination in the nineteenth century, leaving unexamined both the racial categories deployed to organize data and the conditions of life that shape lung function.