Mixed Race Studies

On Race and Medicine: Insider Perspectives ed. by Richard Garcia (review)

American Studies
Volume 55, Number 1, 2016
pages 163-164
DOI: 10.1353/ams.2016.0057

David Colón-Cabrera

ON RACE AND MEDICINE: Insider Perspectives. Edited by Richard Garcia. Lanham, MD: Rowman & Littlefield. 2015.

The fields of anthropology and sociology, in addition to health sciences, have problematized the topic of race and medicine extensively. The dubious history of medical practice towards non-white bodies has left deep impacts on the manner in which biomedicine still speaks, treats, and cares for individuals who are not white. Medicine has its own white privilege problem in the way it often sets whiteness (and maleness) as the default body to research, treat, and care for. On Race and Medicine reflects on these challenges by providing an insight into the experiences of practitioners and researchers at the intersection of race and healthcare.

The book falls within the purview of current research and theory exploring the cultural, social, and political aspects of science. While the book does not specifically identify its aim and scope within Science and Technology Studies, it focuses on those involved in the production and practice of medicine. On Race and Medicine relies on narratives that characterize the multidisciplinary nature of medicine from the perspective of a diverse group of academics and health practitioners—though only a third are women. The book presents the experiences and trajectories of the collaborators and their induction to the topic of race within healthcare. Edited by Richard Garcia, the book’s four sections attempt to retrospectively challenge the manner in which health disparities have been evaluated in recent decades. The first section, Health Disparities, sets the tone by arguing how historical and environmental factors can help explain current health disparities. The Personal Essay presents the omnipresent effect that a racial and ethnic identity has in developing attitudes and behaviors towards healthcare. In Race and Medicine several collaborators reflect on their own biases, attitudes, privileges, and experiences at the intersection of race and medicine. Collaborators recount their challenging experiences encountering medicine while being an ethnic/racial other or being exposed to the ethnic/racial other. Finally, in Towards Solutions, the collaborators discuss the limitations that they deal with in their work and practice. The latter sections are the core of the book since they answer the editor’s central question: “But is this form—rather than the traditional writing of social science or public health—useful, or even necessary?” (31). The use of “forensic chapters” (4) by the collaborators exemplify the manner in which medicine deals with the lived experiences of ethnic and racial minorities, and invite the reader to reflect on those challenges.

Garcia and collaborators seem to be writing for health professionals who are reticent to appreciate the value of personal essays as a narrative tool to explain the complexity of race and healthcare. The editor makes a compelling, though limited, argument supporting the study of health disparities in the US. On Race and Medicine relies on an abundance of sociological and anthropological knowledge, but the editor’s discussions referencing these disciplines could have benefitted from more depth; for example, on pages 4–5 Garcia states: “I imagine the topic of health disparities as a section in a syllabus of an American studies course, along with the other sections that consider race in America.” He appears to overlook the fact that fields in anthropology, sociology, the humanities and public health have crafted entire programs and courses that examine race and medicine in a holistic manner. Similarly, Garcia’s exhortation, “I’d call for a moratorium on disparities studies if anyone were listening. We know. They exist. Enough studies already. Now let’s fix them” (160) misses the point by inadvertently minimizing the scholarship of the aforementioned disciplines.

Garcia and collaborators provide contrasting and dynamic insights that challenge some of the notions of race and healthcare in a very personal way. The value of this book lies in the personal contributions alluding to the diversity of socioeconomics and relative privilege within ethnic and racial communities, and their influence on health-seeking behaviors and attitudes. At the end of the book, in regard to the challenges that the interaction of race and healthcare cause, Garcia poses the question “What can I do?” (166). This seems an unspoken call…

The Misuse of Race in Medical Diagnosis

Pediatrics: Official Journal of the American Academy of Pediatrics
May 2004, Volume 113 / Issue 5

Richard S. Garcia

I am a 39-year-old Hispanic male born in Stockton, Calif, to a mother who—after many years of unwise eating—has recently been diagnosed with diabetes and to a father I didn’t know who floated away at the end of a needle in his sister’s garage. I prefer being called Mexican to Hispanic, though I’ve never been to Mexico. I eat a fat American’s diet. Speak American English. Although I don’t smoke, I have been living in a big city with polluted air. An American city where I recently was an assistant professor of pediatrics, working in a profession that tries to define my indefinable race without asking for my input.

I helped train medical students and residents who are all taught, as I was when I was a medical student, to assess each patient first in terms of age, race, and gender. Always in that order. A 52-year-old white female, a 3-month-old Asian male, a 39-year-old Hispanic male. The actual identity of patients remains ignored: A 47-year-old African American female—who’s never been to Africa and prefers to call herself black if ever asked by a white doctor, though none ever asks—two-pack-a-day smoker, still living with her mother in South Central Los Angeles, presents with fatigue.

The doctor asks the patient—or the parent of the patient, if you’re a pediatrician—for his or her age. The gender is determined during the physical examination…

Read or purchase the article here.

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.

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.