How Not To Talk About Race And Genetics

Posted in Articles, Health/Medicine/Genetics, Letters, Media Archive on 2018-03-31 02:37Z by Steven

How Not To Talk About Race And Genetics

BuzzFeed
2018-03-30


Micah Baldwin / Via Flickr: micahb37

Race has long been a potent way of defining differences between human beings. But science and the categories it constructs do not operate in a political vacuum.

This open letter was produced by a group of 68 scientists and researchers. The full list of signatories can be found below.

In his newly published book Who We Are and How We Got Here, geneticist David Reich engages with the complex and often fraught intersections of genetics with our understandings of human differences — most prominently, race.

He admirably challenges misrepresentations about race and genetics made by the likes of former New York Times science writer Nicholas Wade and Nobel Laureate James Watson. As an eminent scientist, Reich clearly has experience with the genetics side of this relationship. But his skillfulness with ancient and contemporary DNA should not be confused with a mastery of the cultural, political, and biological meanings of human groups.

As a group of 68 scholars from disciplines ranging across the natural sciences, medical and population health sciences, social sciences, law, and humanities, we would like to make it clear that Reich’s understanding of “race” — most recently in a Times column warning that “it is simply no longer possible to ignore average genetic differences among ‘races’” — is seriously flawed…

Read the entire letter here.

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Building a Face, and a Case, on DNA

Posted in Articles, Health/Medicine/Genetics, Law, Media Archive, United States on 2015-02-24 02:39Z by Steven

Building a Face, and a Case, on DNA

The New York Times
2015-02-23

Andrew Pollack


The police in Columbia, S.C.,  released this sketch of a possible suspect based on DNA left at the crime scene. Parabon NanoLabs, which made the image, has begun offering DNA phenotyping services to law enforcement agencies.

There were no known eyewitnesses to the murder of a young woman and her 3-year-old daughter four years ago. No security cameras caught a figure coming or going.

Nonetheless, the police in Columbia, S.C., last month released a sketch of a possible suspect. Rather than an artist’s rendering based on witness descriptions, the face was generated by a computer relying solely on DNA found at the scene of the crime.

It may be the first time a suspect’s face has been put before the public in this way, but it will not be the last. Investigators are increasingly able to determine the physical characteristics of crime suspects from the DNA they leave behind, providing what could become a powerful new tool for law enforcement.

Already genetic sleuths can determine a suspect’s eye and hair color fairly accurately. It is also possible, or might soon be, to predict skin color, freckling, baldness, hair curliness, tooth shape and age.

Computers may eventually be able to match faces generated from DNA to those in a database of mug shots. Even if it does not immediately find the culprit, the genetic witness, so to speak, can be useful, researchers say…

…Law enforcement authorities say that information about physical traits derived from DNA is not permitted in court because the science is not well established. Still, the prospect of widespread DNA phenotyping has unnerved some experts.

Duana Fullwiley, an associate professor of anthropology at Stanford, said that she worried that use of such images could contribute to racial profiling. She noted that Dr. Shriver developed his system by analyzing the DNA and faces of people with mixed West African and European ancestry.

“This leads to a technology that is better able to make faces that are African-American,” she said. The image produced in the South Carolina case, Dr. Fullwiley added, “was of a generic young black man.”

Dr. Shriver said he initially studied people of mixed European and African ancestry, many of them from Brazil, because that made the analysis easier. His more recent research has involved people of many different ethnicities, he said…

Read the entire article here.

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The Biologistical Construction of Race: ‘Admixture’ Technology and the New Genetic Medicine

Posted in Anthropology, Articles, Health/Medicine/Genetics, Media Archive, Politics/Public Policy, Social Science on 2012-06-03 15:22Z by Steven

The Biologistical Construction of Race: ‘Admixture’ Technology and the New Genetic Medicine

Social Studies of Science
Volume 38, Number 5 (2008)
pages 695-735
DOI: 10.1177/0306312708090796

Duana Fullwiley, Associate Professor of African and African American Studies and of Medical Anthropology
Harvard University

This paper presents an ethnographic case study of the use of race in two interconnected laboratories of medical genetics. Specifically, it examines how researchers committed to reducing health disparities in Latinos with asthma advance hypotheses and structure research to show that relative frequencies of genetic markers characterize commonly understood groupings of race. They do this first by unapologetically advancing the idea that peoples whom they take to be of the `Old World’, or `Africans’, `Europeans’, `East Asians’, and `Native Americans’, can serve as putatively pure reference populations against which genetic risk for common diseases such as asthma can be calculated for those in the `New World’. Technologically, they deploy a tool called ancestry informative markers (AIMs), which are a collection of genetic sequence variants said to differ in present-day West Africans, East Asians, Europeans, and (ideally Pre-Columbian) Native Americans. I argue that this technology, compelling as it may be to a range of actors who span the political spectrum, is, at base, designed to bring about a correspondence of familiar ideas of race and supposed socially neutral DNA. This correspondence happens, in part, as the scientists in question often bracket the environment while privileging racialized genetic variance as the primary source of health disparities for common disease, in this case between Mexicans and Puerto Ricans with asthma. With their various collaborators, these scientists represent a growing movement within medical genetics to re-consider race and `racial admixture’ as biogenetically valid points of departure. Furthermore, many actors at the center of this ethnography focus on race as a function of their personal identity politics as scientists of color. This to say, they are driven not by racist notions of human difference, but by a commitment to reduce health disparities and to include `their’ communities in what they describe as the `genetic revolution’.

The very word ‘race’ applies to a hypothetical past, or to a problematical future, not to the actual present … the only way to measure the genetic relationship of ethnic groups would be by ascertaining the quantitative values of their coefficients of common ancestry, which would be based entirely upon the statistical methods of probability theory. (We Europeans [Julian Huxley and Alfred Court Haddon, 1939: 114])

To me, the refusal to use race in medicine is political correctness gone awry. It’s a lot of white researchers gone political. (Esteban Gonzàles Burchard, asthma geneticist at the University of California, San Francisco Lung Biology Center; field notes 2003)

The Molecularization of ‘Admixture’: A History of the Present

In 1949, the year before the first United Nations Educational Scientific and Cultural Organization (UNESCO) statement rallying against the race concept, Linus Pauling characterized sickle cell anemia as the first ‘molecular disease’ (Pauling et al., 1949). At the time, most experts and lay people considered sickle cell a ‘black-race disorder’. Despite global good will and contrition for the violence perpetuated in the name of racial purification in Germany and elsewhere a few short years before, some North American scientists called the UNESCO statement an ‘incautious affirmation’ and claimed that sickle cell anemia in American blacks (who by definition, it was assumed, had white ancestry) was a perfect example of how ‘race mixture can be disadvantageous in its racial effects’ (Gates, 1952: 896). The then ‘odd’ observation that ‘hybrids’ (black Americans) seemed to have more sickle cell disease than their ‘pure’ (African) counterparts who had more sickle cell trait (which was actually mistaken for a milder form of the disease in many cases) gave immediate rise to theories that ‘racial admixture’ could affect disease risk and/or severity (Gates, 1952). With Pauling’s Nobel-winning observations came the first intellectual opening for the molecularization of race. Immediately with it came the idea that racialized ancestral mixing, or ‘admixture’, constituted increased risk of disease pathology. In what follows, I examine a present-day resurgence of the concept of human biological admixture as a factor in disease risk in some quarters of contemporary American medical genetics…

…Over the past few years, social scientists studying genetics and race have urged their colleagues to ‘go to the very sites’ of scientific production and ‘document how [racial] categories are being constructed’ anew (Reardon, 2005: 18; Duster, 2006a: 12). Following from this, it is as imperative that ethnographers also attempt to understand better scientists’ motives for wanting to resuscitate such troubled categories. To this end, it is important for me to note how my informants’ social experiences shape the tautological product of genetic racial admixture they use on a daily basis. In particular, one challenge these scientists have posed for themselves is to ‘care’ for their own disproportionately sick communities of ‘racially admixed subjects’ by recruiting and enrolling them in genetic research. A crucial aspect of their effort to reduce health disparities is a search for the biological component of these communities’ mixed racial heritage. For several of my informants, this heritage is a point of biological difference that may contain clues about present-day health differences. Here it is many ‘drops of blood’ – rather than one – that now constitute the brown bodies in question. Today, Mexicans and Puerto Ricans in the US are assumed to be differentially constituted from African-Americans and Native Americans, based on their varying amounts of African, European, and Native (pre-Columbian) genetic ancestral contributions. Yet, contrary to earlier American norms of hypo-descent, these mixed groups must remain conceptually separate, ‘ethnically’ and ‘politically’, from the referent groups that make them up. Today, Mexicans’ and Puerto Ricans’ African ancestries are deemed important for reasons that will become clear below, but they are rarely collapsed into a category of ‘blackness’. In fact, as one of the main researchers featured in this ethnography reminded himself and his team time and again, as of the 2000 census, Latinos surpassed African-Americans as the largest minority group in the US. Over the course of my fieldwork in his lab, I heard this feat by numbers repeated, as if to say that this researcher’s ‘community’ needed and deserved the same kind of attention, political courtship, and scientific resources as one of the most historically ‘important’ and visible American minority groups…

Read the entire artcle here.

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The Enculturated Gene: Sickle Cell Health Politics and Biological Difference in West Africa

Posted in Africa, Anthropology, Books, Health/Medicine/Genetics, Media Archive, Monographs, Social Science on 2011-11-20 22:29Z by Steven

The Enculturated Gene: Sickle Cell Health Politics and Biological Difference in West Africa

Princeton University Press
2011
368 pages
6 x 9; 7 halftones. 1 line illus. 4 maps
Paper ISBN: 9780691123172
Cloth ISBN: 9780691123165
eBook ISBN: 9781400840410

Duana Fullwiley, Associate Professor of African and African American studies and of Medical Anthropology
Harvard University

In the 1980s, a research team led by Parisian scientists identified several unique DNA sequences, or haplotypes, linked to sickle cell anemia in African populations. After casual observations of how patients managed this painful blood disorder, the researchers in question postulated that the Senegalese type was less severe. The Enculturated Gene traces how this genetic discourse has blotted from view the roles that Senegalese patients and doctors have played in making sickle cell “mild” in a social setting where public health priorities and economic austerity programs have forced people to improvise informal strategies of care.

Duana Fullwiley shows how geneticists, who were fixated on population differences, never investigated the various modalities of self-care that people developed in this context of biomedical scarcity, and how local doctors, confronted with dire cuts in Senegal’s health sector, wittingly accepted the genetic prognosis of better-than-expected health outcomes. Unlike most genetic determinisms that highlight the absoluteness of disease, DNA haplotypes for sickle cell in Senegal did the opposite. As Fullwiley demonstrates, they allowed the condition to remain officially invisible, never to materialize as a health priority. At the same time, scientists’ attribution of a less severe form of Senegalese sickle cell to isolated DNA sequences closed off other explanations of this population’s measured biological success.

The Enculturated Gene reveals how the notion of an advantageous form of sickle cell in this part of West Africa has defined–and obscured–the nature of this illness in Senegal today.

Table of Contents

  • List of Illustrations
  • Preface
  • Acknowledgments
  • Chapter One: Introduction: The Powers of Association
  • Chapter Two: Healthy Sicklers with “Mild” Disease: Local Illness Affects and Population-Level Effects
  • Chapter Three: The Biosocial Politics of Plants and People
  • Chapter Four: Attitudes of Care
  • Chapter Five: Localized Biologies: Mapping Race and Sickle Cell Difference in French West Africa
  • Chapter Six: Ordering Illness: Heterozygous “Trait” Suff ering in the Land of the Mild Disease
  • Chapter Seven: The Work of Patient Advocacy
  • Conclusion: Economic and Health Futures amid Hope and Despair
  • Notes
  • References
  • Index
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Race, Identity, and Medical Genomics in the Obama Age (Lecture by Duana Fullwiley)

Posted in Africa, Health/Medicine/Genetics, Live Events, Media Archive, Social Science, Women on 2010-10-11 03:27Z by Steven

Race, Identity, and Medical Genomics in the Obama Age (Lecture by Duana Fullwiley)

Fall 2010 Honors Colloquium: RACE
University of Rhode Island
Edwards Auditorium, URI Kingston Campus
Tuesday, 2010-10-05, 19:00 ET (Local Time); (23:00Z)

Duana Fullwiley, Assistant Professor of African and African American studies and of Medical Anthropology
Harvard University

A series of public programs at the University of Rhode Island presented by the URI Honors Program

Join us! The public is invited to attend this series of free events.

Perceptions about race shape everyday experiences, public policies, opportunities for individual achievement, and relations across racial and ethnic lines. In this colloquium we will explore key issues of race, showing how race still matters.

Watch the lecture below:

Other articles by or about Duana Fullwiley:

From “Race in a Genetic World”:

“I am an African American,” says Duana Fullwiley, “but in parts of Africa, I am white.” To do fieldwork as a medical anthropologist in Senegal, she says, “I take a plane to France, a seven- to eight-hour ride. My race changes as I cross the Atlantic. There, I say, ‘Je suis noire,’ and they say, ‘Oh, okay—métisse—you are mixed.’ Then I fly another six to seven hours to Senegal, and I am white. In the space of a day, I can change from African American, to métisse, to tubaab [Wolof for “white/European”]. This is not a joke, or something to laugh at, or to take lightly. It is the kind of social recognition that even two-year-olds who can barely speak understand. Tubaab,’ they say when they greet me.”

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Change of Venue. Change of Race.

Posted in Excerpts/Quotes on 2010-10-05 21:48Z by Steven

“I am an African American,” says Duana Fullwiley, “but in parts of Africa, I am white.” To do fieldwork as a medical anthropologist in Senegal, she says, “I take a plane to France, a seven- to eight-hour ride. My race changes as I cross the Atlantic. There, I say, ‘Je suis noire,’ and they say, ‘Oh, okay—métisse—you are mixed.’ Then I fly another six to seven hours to Senegal, and I am white. In the space of a day, I can change from African American, to métisse, to tubaab [Wolof for “white/European”]. This is not a joke, or something to laugh at, or to take lightly. It is the kind of social recognition that even two-year-olds who can barely speak understand. Tubaab,’ they say when they greet me.” —Duana Fullwiley

Race in a Genetic World,” Harvard Magazine, Volume 110, Number 5 (May-June, 2008): http://harvardmagazine.com/2008/05/race-in-a-genetic-world.html.

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Fall 2010 Honors Colloquium: RACE

Posted in Asian Diaspora, Health/Medicine/Genetics, History, Identity Development/Psychology, Live Events, New Media, Politics/Public Policy, Social Science, United States, Videos on 2010-09-27 20:45Z by Steven

Fall 2010 Honors Colloquium: RACE

University of Rhode Island
Tuesday evenings, 19:00 ET (Local Time); (23:00Z through November; 00:00Z on Wednesday after November 9).
2010-09-14 through 2010-12-07
Edwards Auditorium, URI Kingston Campus

A series of public programs at the University of Rhode Island presented by the URI Honors Program

Join us! The public is invited to attend this series of free events.

Perceptions about race shape everyday experiences, public policies, opportunities for individual achievement, and relations across racial and ethnic lines. In this colloquium we will explore key issues of race, showing how race still matters.

You will be able to watch the Colloquium live by clicking here or watching below. This link will only work in real time, while the presentation is going on.

Note: the live feed is only active during live events.

Includes noted scholars (Times and dates below are in UTC.  Please read carefully!):

2010-10-05, 23:00Z
Race, Identity, and Medical Genomics in the Obama Age
Duana Fullwiley, Assistant Professor of African and African American studies and of Medical Anthropology
Harvard University

2010-10-12, 23:00Z
The Invisible Weight of Whiteness: The Racial Grammar of Everyday Life in Contemporary America
Eduardo Bonilla-Silva, Professor of Sociology
Duke University

2010-11-31, 00:00Z
How Black Women’s Stories Complicate Race and Gender Politics
Melissa Harris-Lacewell, Associate Professor of Politics and African American Studies
Princeton University

For more information, click here.

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Race and Genetics: Attempts to Define the Relationship

Posted in Anthropology, Articles, Census/Demographics, Health/Medicine/Genetics, Media Archive, Social Science, United States on 2010-03-14 20:15Z by Steven

Race and Genetics: Attempts to Define the Relationship

BioSocieties
Volume 2, Issue 2 (June 2007)
pages 221-237
DOI: 10.1017/S1745855207005625

Duana Fullwiley, Associate Professor Anthropology
Stanford University

Many researchers working in the field of human genetics in the United States have been caught between two seemingly competing messages with regard to racial categories and genetic difference. As the human genome was mapped in 2000, Francis Collins, the head of the publicly funded project, together with his privately funded rival, announced that humans were 99.9 percent the same at the level of their genome. That same year, the National Institutes of Health (NIH) began a research program on pharmacogenetics that would exploit the .01 percent of human genetic difference, increasingly understood in racial terms, to advance the field of pharmacy. First, this article addresses Collins’ summary of what he called the ‘vigorous debate’ on the relationship between race and genetics in the open-access special issue of Nature Genetics entitled ‘Genetics for the Human Race’ in 2004. Second, it examines the most vexed (if not always openly stated) issue at stake in the debate: that many geneticists today work with the assumption that human biology differs by race as it is conceived through American census categories. It then presents interviews with researchers in two collaborating US laboratories who collect and organize DNA by American notions of ‘race/ethnicity’ and assume that US race categories of classification largely traduce human biogenetic difference.  It concludes that race is a practical and conceptual tool whose utility and function is often taken for granted rather than rigorously assessed and that ‘rational medicine’ cannot precede a rational approach to addressing the nature of racial disparities, difference and inequality in health and society more broadly.

…Race and nominalism
Race is a thing of our world like no other. Americans in general often use the word without much reflection. It might indeed occupy a tiny portion of what philosopher Martin Heidegger amorphously termed ‘the background’, that which just is and does not warrant our reflection until its unity ‘breaks down’. Even when the breakdown of race occurs in many areas of American social life, it is often reconstructed and made ‘whole’ again. One recent example of this was in the 2000 US census race classification that allowed respondents to report themselves as ‘mixed race’. Many African-Americans with mixed ancestry did not choose this option, but simply marked the category that best represented descriptions that they had been raised to understand themselves ‘to be’ in North America—that is ‘monoracially’ black (Lee and Bean, 2004: 233). The decision to mark oneself or not mark oneself as mixed-race differed according to where respondents lived—notably between those who lived in the deep South and those who lived in the ten states where 64 percent of all multiracial identification took place (New York and California among them, as well as Hawaii). In general, those in cosmopolitan centers, with high rates of immigration, diversity, and more demonstrated tolerance of others, were more likely to report racial mixing (Lee and Bean, 2004: 235). Perhaps more telling, when Americans acted on the liberty of marking more than one category, the National Center for Health Statistics created a formula that, in effect, ‘reallocated’ the multiracial population back into a single race group (Wellner, 2003: 2). This move, and the technology permitting it, was presented as an aid to market researchers who were vexed by the 2000 census data, which complicated their traditional formulas of ‘niche’ advertising to racial groups (Wellner, 2003: 2)…

Read the entire article here.

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Race in a Genetic World

Posted in Anthropology, Articles, Health/Medicine/Genetics, Media Archive, Social Science, Women on 2010-03-14 18:49Z by Steven

Race in a Genetic World

Harvard Magazine
Volume 110, Number 5
May-June 2008

hosptial
Duana Fullwiley
Photograph by Stu Rosner

“I am an African American,” says Duana Fullwiley, “but in parts of Africa, I am white.” To do fieldwork as a medical anthropologist in Senegal, she says, “I take a plane to France, a seven- to eight-hour ride. My race changes as I cross the Atlantic. There, I say, ‘Je suis noire,’ and they say, ‘Oh, okay—métisse—you are mixed.’ Then I fly another six to seven hours to Senegal, and I am white. In the space of a day, I can change from African American, to métisse, to tubaab [Wolof for “white/European”]. This is not a joke, or something to laugh at, or to take lightly. It is the kind of social recognition that even two-year-olds who can barely speak understand. Tubaab,’ they say when they greet me.”

Is race, then, purely a social construct? The fact that racial categories change from one society to another might suggest it is. But now, says Fullwiley, assistant professor of anthropology and of African and African American studies, genetic methods, with their precision and implied accuracy, are being used in the same way that physical appearance has historically been used: “to build—to literally construct—certain ideas about why race matters.”

Genetic science has revolutionized biology and medicine, and even rewritten our understanding of human history. But the fact that human beings are 99.9 percent identical genetically, as Francis Collins and Craig Venter jointly announced at the White House on June 26, 2000, when the rough draft of the human genome was released, risks being lost, some scholars fear, in an emphasis on human genetic difference. Both in federally funded scientific research and in increasingly popular practice—such as ancestry testing, which often purports to prove or disprove membership in a particular race, group, or tribe—genetic testing has appeared to lend scientific credence to the idea that there is a biological basis for racial categories.

In fact, “There is no genetic basis for race,” says Fullwiley, who has studied the ethical, legal, and social implications of the human genome project with sociologist Troy Duster at UC [University of California], Berkeley. She sometimes quotes Richard Lewontin, now professor of biology and Agassiz professor of zoology emeritus, who said much the same thing in 1972, when he discovered that of all human genetic variation (which we now know to be just 0.1 percent of all genetic material), 85 percent occurs within geographically distinct groups, while 15 percent or less occurs between them. The issue today, Fullwiley says, is that many scientists are mining that 15 percent in search of human differences by continent…

Read the entire article here.

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Racial Categories in Medical Practice: How Useful Are They?

Posted in Articles, Brazil, Census/Demographics, Health/Medicine/Genetics, Media Archive, Politics/Public Policy on 2010-02-08 19:50Z by Steven

Racial Categories in Medical Practice: How Useful Are They?

PLoS Medicine
Volume 4, Number 9 (September 2007)
pages 1423-1428
DOI: 10.1371/journal.pmed.0040271

Lundy Braun
Departments of Pathology and Laboratory Medicine and Africana Studies
Brown University, Providence, Rhode Island

Duana Fullwiley, Assistant Professor of African and African American Studies and of Medical Anthropology
Harvard University

Anne Fausto-Sterling
Department of Molecular and Cellular Biology and Biochemistry, Program in Women’s Studies, and Chair of the Faculty Committee on Science and Technology Studies
Brown University, Providence, Rhode Island

Evelynn M. Hammonds, Senior Vice Provost for Faculty Development and Diversity
History of Science and of African and African American Studies programs
Harvard University, Cambridge, Massachusetts

Alondra Nelson
Departments of Sociology and African American Studies
Yale University, New Haven, Connecticut

William Quivers
Department of Physics
Wellesley College, Wellesley, Massachusetts

Susan M. Reverby
Women’s Studies Department,
Wellesley College, Wellesley, Massachusetts

Alexandra Shields
Harvard/MGH Cente on Genomics, Vulnerable Populations and Health Disparities,
Massachusetts General Hospital
Harvard Medical School, Boston, Massachusetts

The Trouble with Race

Is it good medical practice for physicians to “eyeball” a patient’s race when assessing their medical status or even to ask them to identify their race? This question was captured in a 2005 episode of “House M.D.,”  Fox television’s medical drama. In the episode, a black patient with heart disease refuses a hospital physician’s prescription for what is clearly supposed to be BiDil, the drug approved by the United States Food and Drug Administration only for “self-identified” African-Americans. Dr. House, on seeing the patient for followup, insists on the same prescription.  The patient again refuses, telling House, “I’m not buying into no racist drug, OK?” House, a white physician asks, “It’s racist because it helps black people more than white people? Well, on behalf of my peeps, let me say, thanks for dying on principle for us.” The patient replies, “Look. My heart’s red, your heart’s red.  And it don’t make no sense to give us different drugs.”  Who is right here, House or his patient? And what does this episode tell us about the way race plays itself out in the physician-patient clinical encounter? What of clinical importance can be learned by making a quick racial assessment?  That an ACE (angiotensin-converting enzyme) inhibitor may not be effective? That screening for sickle cell anemia is a waste of time? Sorting patients by race may seem useful during a time constrained interview, but we argue that acting on rapid racial assessment can lead to missed diagnoses and inappropriate treatments…

Racial Categories Are Historical, Not Natural

…Racial definitions are historically and nationally specific. In her comparison of the history of racial categories in the US and Brazilian census from the late 18th century to the present, political scientist Melissa Nobles demonstrated that categories emerge and are  deployed in different ways over time. For example, during the mid-19th to the early 20th centuries, at the height of US anxiety about “miscegenation,” categories such as “mulatto” were vehicles for expressing and containing cultural anxiety about racial purity.  Bolstered by scientific ideas about race, data collected on the numbers of “mulattoes” were shaped by the desire to prove that “hybrids” would die out

…A dark-skinned, curly-headed person who identifies as African American may, indeed, have much in his or her history and upbringing to justify that identification. But he or she may also have a white grandparent and several Cherokee ancestors. Thus, returning to the example of glaucoma, it is more important to know a patient’s family history than to assess his or her race.  And collecting family history ought to mean not only compiling a list of which diseases family members have, but making some attempt to assess common (familial) habits such as diet and life experiences (e.g., first- versus second-generation immigrants, living conditions, or same versus widely varied work experience and geographical locations). Similarly, when the history of passing for white is ignored, those who identify themselves as “white” are assumed to have no ancestral “black blood.”  Finally, immigration patterns constantly change. A “black” person walking into a Boston, Massachusetts clinic could easily be the child of a recent immigrant from Ethiopia or Brazil who has a genetic makeup as well as cultural and environmental exposures that differ significantly from the descendents of 19th century US slaves from the western coast of Africa…

Read the entire article here.

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