Mixed Race Studies

Education, Genetic Ancestry, and Blood Pressure in African Americans and Whites

American Journal of Public Health
August 2012, Volume 102, Number 8
pages 1559-1565
DOI: 10.2105/AJPH.2011.300448

Amy L. Non, Assistant Professor of Anthropology,
Vanderbilt University, Nashville, Tennessee

Clarence C. Gravlee, Associate Professor of Anthropology;  affiliate appointments in the Department of Behavioral Science and Community Health
University of Florida, Gainesville

Connie J. Mulligan, Professor of Anthropology; Associate Director, University of Florida Genetics Institute
University of Florida, Gainesville

• Objectives. We assessed the relative roles of education and genetic ancestry in predicting blood pressure (BP) within African Americans and explored the association between education and BP across racial groups.
• Methods. We used t tests and linear regressions to examine the associations of genetic ancestry, estimated from a genomewide set of autosomal markers, and education with BP variation among African Americans in the Family Blood Pressure Program. We also performed linear regressions in self-identified African Americans and Whites to explore the association of education with BP across racial groups.
• Results. Education, but not genetic ancestry, significantly predicted BP variation in the African American subsample (b = –0.51 mm Hg per year additional education; P = .001). Although education was inversely associated with BP in the total population, within-group analyses showed that education remained a significant predictor of BP only among the African Americans. We found a significant interaction (b = 3.20; P = .006) between education and self-identified race in predicting BP.
• Conclusions. Racial disparities in BP may be better explained by differences in education than by genetic ancestry. Future studies of ancestry and disease should include measures of the social environment. (Am J Public Health. 2012; 102:1559–1565. doi:10.2105/AJPH.2011.300448)

In recent decades, researchers have struggled to determine the causes of racial disparities in health. Many biomedical researchers have speculated that underlying genetic differences between races may contribute to these disparities. With the increasing availability of high-throughput genotyping platforms, a wealth of genomic data is now available to help address this issue. One consequence is that more researchers are estimating genetic ancestry to capture a presumed genetic basis of racial disparities in health. However, any associations found between genetic ancestry and disease could alternatively be explained by unmeasured environmental factors that are also associated with African genetic ancestry and contribute to health disparities, such as socioeconomic status (SES), neighborhood environment, and psychosocial factors including perceived stress or discrimination. Therefore, to avoid unwarranted inferences about the magnitude of genetic influences on health disparities, it is critical for any analysis of ancestry and disease to include appropriate social–environmental variables.

Social–environmental factors may be especially important when one is studying a complex disease such as hypertension. Complex diseases, by definition, involve multiple environmental and genetic causes, as well as interactions within and between them. Many studies have identified important social–environmental influences on racial inequalities in hypertension, such as SES, psychosocial stressors, and neighborhood environment, whereas other studies have begun to identify relevant genetic variants, such as those in the rennin–angiotensin–aldosterone axis and the adrenergic system. Few studies, however, have examined genetic and environmental factors simultaneously. The limited scope of this research to date has slowed progress toward explaining racial inequalities in hypertension and other complex diseases.

To address the relevance of both genetic and environmental factors in racial inequalities in hypertension, we tested associations between genetic ancestry, education, and blood pressure (BP) among Whites and African Americans in the Family Blood Pressure Program (FBPP) study. A previous analysis of this data set by Tang et al. found no evidence of a statistically significant association between African genetic ancestry and blood pressure. They concluded nonetheless that the results were “suggestive of genetic differences between Africans and non-Africans that influence blood pressure, but such effects are likely to be modest compared to environmental ones.” No environmental variables were included in their study, however. Here we reexamine the FBPP data set to test how the addition of education affects the association between ancestry and BP in African Americans. We also explored the association between education and blood pressure across racial groups. We hypothesized that education would show a greater association with BP than would African ancestry among African Americans, and that the association between education and BP may vary by racial and gender groups…

Read the entire article here.

Addressing Racial/Ethnic Health Disparities Best Practices for Clinical Care and Medical Education in the 21st Century

University of Texas, Austin
2013-09-23 through 2013-09-24

One of the primary goals of the US Department of Health and Human Services, the National Institutes of Health, and many public health programs is the reduction of health disparities in the United States. However, significant racial/ethnic disparities persist in the prevalence of disease, access to medical care, quality of care, and health outcomes for the most common causes of death (including cardiovascular and lung disease, infectious disease, cancer, diabetes, and accidents). At this conference, nationally-recognized speakers will discuss the causes of such disparities and describe new approaches in clinical care and medical education that improve care, achieve better health outcomes, and reduce racial/ethnic health disparities. We will also discuss how these best practices can be incorporated into medical training at the new Dell Medical School at The University of Texas and at other medical schools around the country. One key goal of this conference is to help design a cutting-edge curriculum that will better prepare medical students to meet the challenges and opportunities of 21st century medicine.

Conference registration is open to anyone interested in attending this event. See the Continuing Medical Education (CME) tab for information regarding continuing education for the September 23rd portion of the conference.

The second day of the conference (September 24) is open to invited participants only. Discussions and working groups on the second day will focus on developing new pedagogical approaches and innovative learning modules for the pre-clinical curriculum at the Dell Medical School, with the goal of more effectively integrating training on human genomic variation, race/ethnicity, health disparities, and social/environmental determinants of health into the medical curriculum.

Speakers

• Deborah Bolnick, PhD
• Vence Bonham, JD [Coauthor of article “Mixed Race: ”]
• Understanding Difference in the Genome Era
• Richard Garcia, MD
• Paul Godley, MD, PhD, MPP
• Ernesto Gonzalez, MD
• Clarence Gravlee, PhD [Author or article “How race becomes biology: Embodiment of social inequality”]
• Helena Hansen, MD, PhD
• John Hoberman, PhD [Author of Black and Blue: The Origins and Consequences of Medical Racism]
• Seth Holmes, MD, PhD
• Jonathan Kahn, JD, PhD [Author of Race in a Bottle: The Story of BiDil and Racialized Medicine in a Post-Genomic Age]
• Jay Kaufman, PhD [Contributor to What’s the Use of Race? Modern Governance and the Biology of Difference]
• Diane Magrane, MD
• Kyriakos Markides, PhD
• Jamie McGuire, MD
• Jonathan Metzl, MD, PhD
• Michael Montoya, PhD
• Rayna Rapp, PhD
• Dorothy Roberts, JD [Author of Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century]
• Charles Rotimi, PhD [Author of article “Are medical and nonmedical uses of large-scale genomic markers conflating genetics and ‘race’?”]
• Karen-Sue Taussig, PhD

For more information, click here.

How race becomes biology: Embodiment of social inequality

American Journal of Physical Anthropology
Special Issue: Race Reconciled: How Biological Anthropologists View Human Variation
Volume 139, Issue 1 (May 2009)
pages 47–57
DOI: 10.1002/ajpa.20983

Clarence C. Gravlee, Associate Professor of Anthropology
University of Florida, Gainesville

The current debate over racial inequalities in health is arguably the most important venue for advancing both scientific and public understanding of race, racism, and human biological variation. In the United States and elsewhere, there are well-defined inequalities between racially defined groups for a range of biological outcomes—cardiovascular disease, diabetes, stroke, certain cancers, low birth weight, preterm delivery, and others. Among biomedical researchers, these patterns are often taken as evidence of fundamental genetic differences between alleged races. However, a growing body of evidence establishes the primacy of social inequalities in the origin and persistence of racial health disparities. Here, I summarize this evidence and argue that the debate over racial inequalities in health presents an opportunity to refine the critique of race in three ways: 1) to reiterate why the race concept is inconsistent with patterns of global human genetic diversity; 2) to refocus attention on the complex, environmental influences on human biology at multiple levels of analysis and across the lifecourse; and 3) to revise the claim that race is a cultural construct and expand research on the sociocultural reality of race and racism. Drawing on recent developments in neighboring disciplines, I present a model for explaining how racial inequality becomes embodied—literally—in the biological well-being of racialized groups and individuals. This model requires a shift in the way we articulate the critique of race as bad biology.

Read the entire article here.