Mixed Race Studies

Race Correction and Inequalities in Medicine

ANTH 1310 S01: International Health: Anthropological Perspectives
Brown University, Providence, Rhode Island
2015-10-02

Methma Udawatta

The history of medicine is fraught with unnecessary racialization. In “The Diseased Heart of Africa: Medicine, Colonialism, and the Black Body,” Comaroff writes about how the black body became “associated with degradation, disease, and contagion” and how colonial medicine “link[ed] racial intercourse with the origin of sickness.” These overtly racist ideas have decreased in influence over time. However, even today, the remainders of these ideas still manifest themselves in racial inequalities in treatment and access to medical resources, and in the general racialization of medicine, both in the U.S. and around the world.

Smedley and Smedley write about the consistent racial and ethnic disparities in health care in their paper, “Race as Biology is Fiction, Racism as a Social Problem is Real.” They report a series of shocking statistics, which include that Africans Americans and Hispanics in the U.S. tend to receive lower quality health care across many different disease areas, African Americans are more likely than whites to “receive less desirable services, such as amputation,” and that these disparities are “found across a wide range of clinical settings including public and private hospitals, teaching and nonteaching hospitals.…” Similarly, Livingston details a scenario where a patient O (a black man) is expected to endure an incredible amount of pain during a bone-marrow biopsy without making any sounds of pain. When Mr. J (a white man) undergoes a similar bone marrow aspiration, Dr. A holds his hand and the Motswana nurse comforts him. Livingston writes that “his whiteness apparently creates different expectations around his stoicism.” Smedley and Smedley write that racialized science (and any science that looks for differences between racial groups) can only maintain and reinforce existing inequalities. Although many racial disparities in health are also the product of socioeconomic differences, Smedley and Smedley argue that when we accept this concept, there is the implicit idea that these socioeconomic differences are acceptable…

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Race as Biology Is Fiction, Racism as a Social Problem Is Real: Anthropological and Historical Perspectives on the Social Construction of Race

American Psychologist
Volume 60, Number 1, January 2005
pages 16–26
DOI: 10.1037/0003-066X.60.1.16

Audrey Smedley
Virginia Commonwealth University Institute of Medicine

Brian D. Smedley
Virginia Commonwealth University Institute of Medicine

Racialized science seeks to explain human population differences in health, intelligence, education, and wealth as the consequence of immutable, biologically based differences between “racial” groups. Recent advances in the sequencing of the human genome and in an understanding of biological correlates of behavior have fueled racialized science, despite evidence that racial groups are not genetically discrete, reliably measured, or scientifically meaningful. Yet even these counterarguments often fail to take into account the origin and history of the idea of race. This article reviews the origins of the concept of race, placing the contemporary discussion of racial differences in an anthropological and historical context.

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Changes in racial categorization over time and health status: an examination of multiracial young adults in the USA

Ethnicity & Health
Published online: 2015-06-08
DOI: 10.1080/13557858.2015.1042431

Karen M. Tabb, Assistant Professor of Social Work
University of Illinois, Urbana-Champaign

• Objective: Multiracial (two or more races) American health related to racial stability over the life course is a pressing issue in a burgeoning multi-ethnic and multicultural global society. Most studies on multiracial health are cross-sectional and thus focus on racial categorization at a single time point, so it is difficult to establish how health indicators change for multiracials over time. Accordingly the central aim of this paper was to explore if consistency in racial categories over time is related to self-rated health for multiracial young adults in the USA.
• Methods: Data were drawn from the National Longitudinal Study of Adolescent Health (Add Health) survey (N = 7957). Weighted multivariate logistic regression was used to exam health status in early adulthood between individuals who switched racial categories between Waves 1 and 3 compared to those who remained in the same racial categories.
• Results: There were significant differences in report of self-rated health when comparing consistent monoracial adults with multiracial adults who switch racial categories over time. Diversifying (switching from one category to many categories) multiracial respondents are less likely to report fair/poor self-rated health compared to single-race minority young adults in the fully adjusted model (OR = 0.20; 95% CI [0.06–0.60]).
• Conclusion: These results demonstrate the importance of critically examining changes in racial categories as related to health status over time. Furthermore, these results demonstrate how the switch in racial categories during adolescence can explain some variations in health status during young adulthood.

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Esther Cepeda: The complexities of race and ethnicity

GazetteXtra
Janesville, Wisconsin
2015-10-17

Esther Cepeda, Columnist
Washington Post Writers Group

CHICAGO

Our society gives a lot of lip service to the importance of diversity in fields such as science, medicine and technology because multicultural people bring unique viewpoints, varied life experiences and new ideas.

Rarely do we come upon an ideal example of how this plays out in real life.

Karen M. Tabb Dina, an assistant professor at the University of Illinois at Urbana-Champaign, recently published a paper in the journal Ethnicity and Health that found that adults who identified as one race when they were young but now identify as multiracial report being healthier compared with those who continue to identify as monoracial.

The idea for this study came 10 years ago when Tabb Dina was a health policy researcher in low-income communities studying how race and ethnicity impact long-term health. She noticed that the way some of her patients identified racially didn’t always match the way their medical records categorized them.

Identity is a complex and often thorny issue. There are many reasons—including education level, geographic location and gender—why someone with a multiracial background would choose to identify as a single race or multiracial, and why that could change throughout a lifetime…

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Health Care, Research Failing to Adapt to U.S.’s Growing Multiracial Population

School of Social Work
University of Illinois, Urbana-Champaign
2015-10-12

Data collection methods in research and health care settings have lagged behind in adapting to the rapidly growing population of multiracials, according to studies led by social work professor Karen M. Tabb Dina

Multiracial people who change their racial identity from a single race to multiracial over time may be healthier than their minority peers who consistently identify as monoracial, new research suggests.

Despite the U.S.’s rapidly growing population of multiracial individuals, researchers and health care systems continue to use outdated approaches to racial categorization that force people to classify themselves as monoracial, which may be masking the incidence of health conditions and obscuring disparities in health care access and utilization among multiracial populations, a University of Illinois scholar said.

Social work professor Karen M. Tabb Dina is the lead author of two recent studies that explored issues of racial identity and its impact on health care access and utilization among nearly 8,000 U.S. young people.

The subjects in both of Tabb Dina’s studies were participants in the National Longitudinal Study of Adolescent Health, one of the first surveys to allow respondents to identify themselves as multiracial using two or more racial categories, Tabb Dina said.

Participants in the Adolescent Health survey were asked about their racial background during the first wave of data collection in 1994 and again during the third wave, conducted in 2002.

Of the 7 percent of participants identified as multiracial at either wave, only 20 percent of these people selected the same racial categories both times, Tabb Dina found.

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Disparities in Health Services Use Among Multiracial American Young Adults

Journal of Immigrant and Minority Health
First online: 2015-09-29
8 pages
DOI: 10.1007/s10903-015-0289-7

Karen M. Tabb, Assistant Professor of Social Work
University of Illinois, Urbana-Champaign

Christopher R. Larrison, Associate Professor of Social Work
University of Illinois, Urbana-Champaign

Shinwoo Choi
School of Social Work
University of Illinois, Urbana-Champaign

Hsiang Huang, Instructor of Psychiatry
Cambridge Health Alliance
Harvard Medical School

Addressing disparities in health services utilization remains critical for improving minority health; however, most studies do not report on the health service use of multiracial young adults (age 22–34). This study compares past year health service use of self-identified multiracial (two or more races) young adults with monoracial White young adults. Weighted survey data from Add Health (N = 7296) and multivariate logistic regression analyses were used. Compared to monoracial White young adults, Black-White multiracial [OR 0.40, 95 % CI (0.17–0.90)] and Black-Native American multiracial [OR 0.23, 95 % CI (0.09–0.63)] young adults are less likely to report primary care service use in the past year. Multiracial young adults have different health care service utilization than their White monoracial peers with Black-Native American young adults appearing to be particularly vulnerable to under-utilization of primary care services. It is important to examine multiracial subgroups when studying patterns of health services utilization.

The Cost of Color: Skin Color, Discrimination, and Health among African-Americans

American Journal of Sociology
Volume 121, Number 2 (September 2015)
pages 396-444
DOI: 10.1086/682162

Ellis P. Monk Jr., Neubauer Family Assistant Professor of Sociology
University of Chicago

In this study, the author uses a nationally representative survey to examine the relationship(s) between skin tone, discrimination, and health among African-Americans. He finds that skin tone is a significant predictor of multiple forms of perceived discrimination (including perceived skin color discrimination from whites and blacks) and, in turn, these forms of perceived discrimination are significant predictors of key health outcomes, such as depression and self-rated mental and physical health. Intraracial health differences related to skin tone (and discrimination) often rival or even exceed disparities between blacks and whites as a whole. The author also finds that self-reported skin tone, conceptualized as a form of embodied social status, is a stronger predictor of perceived discrimination than interviewer-rated skin tone. He discusses the implications of these findings for the study of ethnoracial health disparities and highlights the utility of cognitive and multidimensional approaches to ethnoracial and social inequality.

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DNA from 4,500-year-old Ethiopian reveals surprise about ancestry of Africans

The Los Angeles Times
2015-10-08

Karen Kaplan, Science & Medicine Editor

DNA from a man who lived in Ethiopia about 4,500 years ago is prompting scientists to rethink the history of human migration in Africa.

Until now, the conventional wisdom had been that the first groups of modern humans left Africa roughly 70,000 years ago, stopping in the Middle East en route to Europe, Asia and beyond. Then about 3,000 years ago, a group of farmers from the Middle East and present-day Turkey came back to the Horn of Africa (probably bringing crops like wheat, barley and lentils with them).

Population geneticists pieced this story together by comparing the DNA of distinct groups of people alive today. Since humans emerged in Africa, DNA from an ancient Africa could provide a valuable genetic baseline that would make it easier for scientists to track genome changes over time…

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No, Native Americans aren’t genetically more susceptible to alcoholism

The Verge
2015-10-02

Maia Szalavitz

Time to retire the ‘firewater‘ fairytale

When Jessica Elm, a citizen of the Oneida Tribe of Indians of Wisconsin, was studying for her master’s degree in social work, she frequently heard about how genes were responsible for the high risk of alcoholism among American Indians. But her own family’s experience — and the research, she discovered — tells a very different story.

The “firewater” fairytale that Elm came to know all too well goes like this: Europeans introduced Native Americans to alcohol, which they were genetically unprepared to handle. That happenstance led to alcoholism rates that are around twice as high as those seen in whites — and alcohol-related death rates, which are at least tripled. In this view, colonization didn’t make conquered people susceptible to heavy drinking — genes did…

…In fact, there’s no evidence that Native Americans are more biologically susceptible to substance use disorders than any other group, says Joseph Gone, associate professor of psychology at the University of Michigan. American Indians don’t metabolize or react to alcohol differently than whites do, and they don’t have higher prevalence of any known risk genes…

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Genetic Approaches to Health Disparities

Chapter in Genetics, Health and Society (Advances in Medical Sociology, Volume 16) (2014)
pages 71-93
DOI: 10.1108/S1057-629020150000016003

Catherine Bliss, Assistant Professor of Sociology
University of California, San Francisco

Purpose

This chapter explores the rise in genetic approaches to health disparities at the turn of the twenty-first century.

Methodology/approach

Analysis of public health policies, genome project records, ethnography of project leaders and leading genetic epidemiologists, and news coverage of international projects demonstrates how the study of health disparities and genetic causes of health simultaneously took hold just as the new field of genomics and matters of racial inequality became a global priority for biomedical science and public health.

Findings

As the U.S. federal government created policies to implement racial inclusion standards, international genome projects seized the study race, and diseases that exhibit disparities by race. Genomic leaders made health disparities research a central feature of their science. However, recent attempts to move toward analysis of gene-environment interactions in health and disease have proven insufficient in addressing sociological contributors to health disparities. In place of in-depth analyses of environmental causes, pharmacogenomics drugs, diagnostics, and inclusion in sequencing projects have become the frontline solutions to health disparities.

Originality/value

The chapter argues that genetic forms of medicalization and racialization have taken hold over science and public health around the world, thereby engendering a divestment from sociological approaches that do not align with the expansion of genomic science. The chapter thus contributes to critical discussions in the social and health sciences about the fundamental processes of medicalization, racialization, and geneticization in contemporary society.

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