How Medicine Is Advancing Beyond Race

Elizabeth Landau, CNN, July 8, 2011

No matter what race you consider yourself to be, you have a unique genetic makeup.

{snip}

Although we’ve been hearing for years that people of particular races are at higher risk for certain illnesses, personalized medicine will (in theory) make better predictions based on actual genetic makeup. And even now, race is less relevant to your own health care than you might think.

{snip}

Biologically, what is race?

When it comes down to it there’s, no clear-cut way of saying that one person “belongs” to one race or another–in fact, a person who has the skin color and hair type typical of one race may self-identify in a completely different way.

And if you think that race comes from location-based populations, many Americans don’t have a “pure” genetic heritage from only one world region. In fact, 9 million Americans identified as multiracial on the most recent census, so it’s hard to make these distinctions.

You probably have genes that came from several groups of ancestral communities. Based on archaeological evidence, everyone’s earliest ancestors came from Africa more than 2 million years ago, so we’re all descended from the same “race” anyway.

“There are genetic ancestries–markers that you can see–but those don’t necessarily perfectly correlate with what people consider their own race to be, because that’s sort of an artificial construct,” said Dr. Wendy Chung, assistant professor of pediatrics at Columbia University Medical Center.

{snip}

Although races are labels that humans have invented to categorize each other, research into reasons for race-based trends is ongoing.

There’s a heart failure drug, BiDil, approved specifically for African Americans. But since race itself does not predispose people to illness, this drug remains controversial.

{snip}

For decades, doctors thought that sickle cell disease was exclusively African, but some people of Mediterranean and Indian origin also have the genetic trait. We now know that the genetic trait for sickle cell disease protects against malaria, and that it is found among people with ancestry in places where malaria is, or used to be found, biologists Marcus Feldman and Richard Lewontin point out in their essay “Race, Ancestry, and Medicine.”

{snip}

Given the imperfect association between race and specific diseases, it makes sense that race would become less important to clinical medicine if your doctor could just look at your entire genome and pinpoint genetic variants that carry risk.

Genomic sequencing is getting cheaper, and researchers are working on identifying specific markers for many diseases.

For instance, we know that women who are Ashkenazi Jewish are at increased risk for carrying the BRCA1 and BRCA2 genetic mutations linked to breast cancer; there’s already a test to see whether a person has those mutations, making racial origin itself irrelevant. There are also genetic predispositions to disease that have nothing to do with race.

{snip}

Some anthropologists, like Armelagos, say race has already become meaningless in medicine. But doctors such as Dr. Sharonne Hayes, cardiologist and director of diversity at the Mayo Clinic, still see a purpose for race in public health.

Race has an important role in reaching populations at risk, Hayes said. Data about African-American risk can help target screening efforts for heart disease, for instance, she said. When it comes to allocating resources and focusing efforts on at-risk groups, race can be a useful tool, even if it is imperfect, she said.

{snip}

Topics:

Share This

We welcome comments that add information or perspective, and we encourage polite debate. If you log in with a social media account, your comment should appear immediately. If you prefer to remain anonymous, you may comment as a guest, using a name and an e-mail address of convenience. Your comment will be moderated.
  • Anonymous

    When it comes to allocating resources and focusing efforts on at-risk groups, race can be a useful tool, even if it is imperfect, she said.

    Amen, sister! When we are out in public, we are constantly aware that we are an at risk group (our White privilege makes us a justifiable target for robbery, rape, and murder), so we use our race as a useful tool to gauge who is to be avoided. It is perfect.

    Prejudice as a sacrament. Glory!

  • Anonymous

    “You probably have genes that came from several groups of ancestral communities.”

    Most people who have their DNA analyzed will discover that all or most of their ancestry comes from Africa, Asia, or Europe.

    But the existence of mixed-race individuals does not mean that race does not exist – they are the mixture of two different races, which only makes sense if race does exist.

    If mallards and wood ducks make and produces viable offspring, this does not mean that mallards and wood ducks are the same species.

    “Based on archaeological evidence, everyone’s earliest ancestors came from Africa more than 2 million years ago, so we’re all descended from the same ‘race’ anyway.”

    Using this logic, all organisms on the earth are the same “species,” because all are descended from an ancient species that existed billions of years ago.

    “Speciation” refers to the splitting of a single species into two distinct species over time.

    It can happen a lot quicker than 2 million years.

    If one species colonizes another continent. Thousands of miles away, environmental pressures may lead to speciation in just a few generations.

    It is extraordinary that the infantile, pseudoscientific gibberish above is peddled as objective fact.

    The fact that an individual’s genome may be useful in clinical contexts does not mean there are no races, it just means that the more specific genetic information we have, the better.

  • Anonymous

    In fact, 9 million Americans identified as multiracial on the most recent census, so it’s hard to make these distinctions.

    Actually it’s only hard for those 9 million.

    Everybody else can say “You’re not one of us.”

  • sbuffalonative

    “…in fact, a person who has the skin color and hair type typical of one race may self-identify in a completely different way.”

    A male transvestite will self-identify as a female but that doesn’t make him a female.

    “… we know that women who are Ashkenazi Jewish are at increased risk for carrying the BRCA1 and BRCA2 genetic mutations linked to breast cancer; there’s already a test to see whether a person has those mutations, making racial origin itself irrelevant.”

    We know Ashenazi Jews (a very specific racial/ethnic population) has a higher prevalence of a gene mutation but that’s irrelevant because there’s a test to find this mutation in anyone.

    How does that disprove genetic differences when the difference (higher rates found in Ashenazi Jews) are clearly there?

    More Orwellian double-think to make our heads spin.

  • Anonymous

    >race itself does not predispose people to illness

    This is a meaningless non-sequitur, shamefully ludicrous for an article purporting to elucidate the relationship between race and medicine. First, it is an established statistical fact that black Africans have higher rates than whites of illnesses such as diabetes and kidney disease, and the higher rate of mental illness among blacks as opposed to whites is a perennial hand-wringer for experts in the field. Second, BiDil was approved for blacks not because they are “predisposed” to heart disease by being black (although actually they are, suffering heart disease at a rate 20 times that of whites – can poverty and “racism” account for ALL of that gap?), but because the medicine works for them when other heart failure medicines developed by testing white people don’t. What’s “controversial” about a medicine that saves lives? The fact that it might burst some journalistic jerk’s “there’s-no-such-thing-as-race” balloon. Disgusting.

  • Ben

    Very interesting article.

    While Malaria is found in regions beyond Africa it doesn’t cause sickle cell (the post doesn’t state that however people I heard stated this). It almost states as if Malaria created sickle cell and doesn’t make it clear.

    Malaria comes from the Plasmodium genus. Asexual Sporozoites are injected into the organism (human) from the mosquito and starts to reproduce in liver cells and blood cells until they burst. They get drawn back into the mosquito and become sexual and reproduce in the mosquito.

    Also to note, environmental factors don’t reject biology or “race.” Certain genes can get turned on due to environment. Environment is a part of biology. Certain practices like endogamy among Ashkenazim Jews, which is a cultural or environmental create a biological effect (Tay-Sachs, etc).

    Nature vs. Nuture is a bad analogy. Rather, Nurture is a small part of Nature. It is annoying when I hear “sociologist” talk as if nurture is equal to nature when in reality one derives from another.

    Also just because one can see things on an microscopic level doesn’t discard macroscopic phenomena. If a commonality is shown outside of a group it doesn’t mean the group in and of itself is irrelevant or insufficient. There may be other factors that play on multiple levels. It basically in how you approach it.

  • Anonymous

    This such a dishonest interview! They ignore the factual results of 40+ years of AA and other Great Society programs, the Protected Groups laws, to tell us that we just don’t know how to share yet!

    It is a discussion among conspirators, set for luring the listener into forgetfulness of historical experience through the massage of neuro-linguistic revisionism.

    They are skilled liars, nothing more.

  • GetBackJack

    Self-identification and actual genetic makeup are two totally different things. Just because someone wants to be white does not necessarily make them white. As they say, never judge a book by its cover!

  • Anonymous

    I always say, of articles like this, it’s just STUFF TO FILL A PAGE, OR TO TAKE UP AIRTIME.

    WHAT IS TELEVISON?

    It is a mild drug, a calmative, or a stimulant, which billions of people take in every day. It kills time, and numbs the mind. That’s all.

    And it all exists to sell ad time, anyway. Watch at your own risk. Save for the TINY minority of programs, past and present that are not absolutely sick, much less, worthwhile, you are wasting your life to sit and drool in front of the idiot box.

    I’d sooner wipe my behind with any mainstream publication than read it. If it were softer, and multi- ply, It would have some use.

    Not joking, folks!

  • Steve

    Just another puff-piece intended to deny racial differences, particularly the one which identifies black Africans as (depending on where they came from in Africa) possessing IQs, on average, from fifteen to nearly forty points lower than those of white Europeans.

    I’d certainly call that significant, accounting for the black African condition everywhere they’re found.

  • François

    “Although races are labels that humans have invented to categorize each other, research into reasons for race-based trends is ongoing.”;

    “Some anthropologists, like Armelagos, say race has already become meaningless in medicine.”.

    I have a scientific background, and I must say I am not surprized that this came from CNN. They seem to be stuck in “liberal propaganda” mode…

    When biologists compare specimens, they will compare not just their morphology, but their respective genetic make-ups, and decide whether they belong the same species, or whether they are subspecies, or different races of the same living organism, depending upon the number of genes they share.

    Genes are not social constructs! They are detectable biochemical entities. So this is not about ideology or politics.

    I think this «races do not exist» thing goes back to the works of leftist anthropologist, Franz Boas, if I am not mistaken. And some contemporary anthropologists seem to perpetuate his ideology. But I believe medicine and biology, should be left to physicians, medical researchers of various backgrounds, and biologists.

    I wrote about Franz Boas’ “ideology”, because, that’s what it really is, and not science, I think.

  • Anonymous

    Malaria was found all over Northern Europe and the Northern part of the United States and Canada until recently. It was rampant in England, Northern France, Belgium and the Netherlands. Why? Because those areas have heavy rainfall and lots of rivers, creeks, ponds marshes and other areas where mosquitos breed.

    Oliver Cromwell died of malaria. In early America it wasn’t just Georgia and the Carolinas where malaria was rampant. It was also in the New England states. Washington DC is on a river with many creeks and lakes and swamps. During the 19th century malaria was so prevalent there that foreign diplomats got hardship allowances because of it.

    Greek cities had outbreaks of malaria recently. Health authorities discovered it was because of potted plants. Standing water collects in the saucer that holds the pot and mosquitos breed. All those apartment balconies filled with flowers looks beautiful and improves the appearance of the most ordinary drab building but the water breeds mosquitoes.

    There is a program urging people to water less at a time to avoid the standing water. It worked.

    Malaria is widespread all over the world. Asian rice paddies are man made breeding grounds for mosquitoes.

    Florida Indians lived there for at least 10,000 years. Chinese have lived there for thousands of years. So why didn’t they get sickle cell? There are many swampy areas of India and lots of creeks,lakes and ponds. Also rice paddies and water barrels all around the homes. Why don’t they have sickle cell?

    Sickle cell is dying out in America. Both parents must carry the gene. There is only a 25 percent chance that they will have a sicle cell child. So if the 2 parents have 1 sickle cell child

    that child would have to find a partner with sickle cell to have a 25 percent possibility of having a sickle cell child.

    So it is 2 sickle cell grandparents, 1 sickle cell parent, no sickle cell grandchildren.

  • margaret

    Anyday now I expect some lunatic leftist Judge to issue a ruling that from now on all males must wear that lead apron over the abdomen during x-rays and must answer “when was your last period” “how many pregnancies” “how many live births”

    “any abortions/miscarriages” when filling out medical forms.

    Mustn’t differentiate between the sexes. NOW is probably preparing the lawsuit as I write.

  • Anonymous

    What does an anthropologist know about medicine? Absolutely nothing. Anthropology is not even a soft science. It is nothing but a lot of theories that change every few years. Who is an anthropologist to tell Drs what to do?

    For several decades political correctitude aka marxist propaganda overemphasized race in medicine.

    On and on it went.

    Black women were supposed to yell a lot more during childbirth.

    Asian men allegedly refused to admit that they had pain and felt it unmanly and a loss of face to take pain pills. All White women would eventually get osteoporisis.

    It was all part of the divide and conquer leftist program. Now I suppose the idiot intellegentsia is on a there is only one race the human race campaign.

    It may not be just liberal propaganda. Maybe these pundits and pontificators are just trolling for more grants. God Forbid that anthropologists, sociologists, and all the ethnic studies crew should actually have to get out and get a real job.