Mixed Race Studies

The short life of a race drug

The Lancet
Volume 379, Issue 9811 (2012-01-14 through 2012-01-20)
pages 114-115
DOI: 10.1016/S0140-6736(12)60052-X

Sheldon Krimsky, Professor of Urban & Environmental Policy & Planning; Adjunct Professor of Public Health and Family Medicine
Tufts School of Medicine
Tufts University, Medford, Massachusetts

The headlines back in June, 2005, read “FDA approves a heart drug for African Americans”. The decision that gave the company NitroMed approval for its drug BiDil exclusively to a “racial group” represented a milestone in US drug policy. The decision ignited a debate that polarised the African American community, confounded proponents of personalised medicine, and dismayed groups opposed to reinscribing racial categories into science. Ever since Ashley Montagu published Man’s Most Dangerous Myth: The Fallacy of Race in 1964 [1942?], scientists have reached a broad consensus that “race” applied to human populations has no standing in science…

…In a historical context too, the use of such racial classification is shown to be a subjective process. The concept of “race” in the USA grew out of slavery when state laws dictated racial identity by percentage admixture. A person who self-identifies as African American could have one great-grandfather (or about one-eighth of his or her genome) as the exclusive source of that identity. Homer Plessy was the plaintiff in an 1896 US Supreme Court decision (Plessy v. Ferguson) that established the “separate but equal” foundations of segregation in the USA. Plessy, who was escorted off a train for whites only, was considered black based on the infamous “one drop rule”, even though he considered himself seven-eighths white. By contrast, Jean Toomer, author of the 1923 book Cane, which chronicled the lives of black Americans, sometimes identified himself as black and sometimes as white. Thus, two individuals, both with one-eighth African ancestry, might either be defined by others as black or self-identify as white or black. Why should the drug’s approval for a differentiated group be based upon such quixotic criteria? Despite all the reasons why “race” has no role in science, it was a science-based agency that approved BiDil for a racial group…

…While many commentators who supported the approval of BiDil for black patients state that “race” is not a scientifically precise term for identifying relevant genomic or physiological characteristics that differentiate population groups, nevertheless, they argue that “self-identified race” is a useful proxy for those characteristics. However, what is the evidence that the proxy “self-identified race” is a reliable surrogate? The best evidence derives from the fact that genetic variation conferring disease susceptibility is not equally distributed among ancestral populations. For example, sickle cell anaemia is more prevalent in populations whose ancestry can be traced to sub-Saharan Africa. However, “self-identified race” is a subjective term, influenced by cultural factors, and not even grounded in the ancestral genomics of, for example, the International HapMap Project. For the purpose of the clinical trials, “self-identified race” is interpreted as a dichotomous variable (black or non-black). If race were used as a proxy for ancestral African genomics it should be a continuous function (10%, 30%, 70%, etc). It makes no scientific sense to map a continuous function onto a dichotomous variable…

Read the entire article here or here.

While many commentators who supported the approval of BiDil for black patients state that “race” is not a scientifically precise term for identifying relevant genomic or physiological characteristics that differentiate population groups, nevertheless, they argue that “self-identified race” is a useful proxy for those characteristics. However, what is the evidence that the proxy “self-identified race” is a reliable surrogate? The best evidence derives from the fact that genetic variation conferring disease susceptibility is not equally distributed among ancestral populations. For example, sickle cell anaemia is more prevalent in populations whose ancestry can be traced to sub-Saharan Africa. However, “self-identified race” is a subjective term, influenced by cultural factors, and not even grounded in the ancestral genomics of, for example, the International HapMap Project. For the purpose of the clinical trials, “self-identified race” is interpreted as a dichotomous variable (black or non-black). If race were used as a proxy for ancestral African genomics it should be a continuous function (10%, 30%, 70%, etc). It makes no scientific sense to map a continuous function onto a dichotomous variable…

Sheldon Krimsky, “The short life of a race drug,” The Lancet, Volume 379, Issue 9811 (2012-01-14 through 2012-01-20): 114. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60052-X/fulltext.

A shameful history: Nowhere People: How International Race Thinking Shaped Australia’s Identity [Book Review]

The Lancet
Volume 366, Issue 9495 (October 2005)
page 1428
DOI: 10.1016/S0140-6736(05)67586

Caroline de Costa, Professor of Obstetrics and Gynaecology; Director of the Clinical School
James Cook University School of Medicine, Cairns Campus, North Queensland, Australia

Nowhere People: How International Race Thinking Shaped Australia’s Identity
Henry Reynolds
Viking, 2005
Pp 204. ISBN-0-670-04118-1

A few years ago my daughter, a poised young woman, found herself in a large rural Australian town she did not know well. She sought directions from an older white woman who, glancing briefly at her appearance, gave the required information, but in the slow and careful tones one might use for the mentally impaired. This incident annoyed but did not surprise my daughter; my husband is of Sri Lankan origin, and all of our six children, of varying hues and facial features, have at times been taken to be of mixed Aboriginal descent in rural Australia, and know something of the experience that can go with this.

So it was with great personal interest that I opened Henry Reynolds’ impressive study of the history of people of “mixed-race” in the 19th and 20th centuries in all those countries where colonists confronted people of different colour and physiognomy. As a 21st-century medical practitioner well aware that we are all one species, I was dismayed to find how much medical practitioners and scientists had contributed to repressive legislation and social engineering, both in Australia and elsewhere…

Read the entire article here.