Mixed Race Studies

Do genetic ancestry tests increase racial essentialism? Findings from a randomized controlled trial

PLOS ONE
Published 2020-01-29
DOI: 10.1371/journal.pone.0227399

Wendy D. Roth, Associate Professor of Sociology
University of Pennsylvania, Philadelphia

Şule Yaylacı, Banting Postdoctoral Fellow
Identity and Conflict Lab
University of Pennsylvania

Kaitlyn Jaffe, Ph.D. Candidate
Department of Sociology
University of British Columbia, Vancouver

Lindsey Richardson, Associate Professor of Sociology
University of British Columbia, Vancouver

Genetic ancestry testing is a billion-dollar industry, with more than 26 million tests sold by 2018, which raises concerns over how it might influence test-takers’ understandings of race. While social scientists argue that genetic ancestry tests may promote an essentialist view of race as fixed and determining innate abilities, others suggest it could reduce essentialist views by reinforcing a view of race as socially constructed. Essentialist views are a concern because of their association with racism, particularly in its most extreme forms. Here we report the first randomized controlled trial of genetic ancestry testing conducted to examine potential causal relationships between taking the tests and essentialist views of race. Native-born White Americans were randomly assigned to receive Admixture and mtDNA tests or no tests. While we find no significant average effect of genetic ancestry testing on essentialism, secondary analyses reveal that the impact of these tests on racial essentialism varies by type of genetic knowledge. Within the treatment arm, essentialist beliefs significantly declined after testing among individuals with high genetic knowledge, but increased among those with the least genetic knowledge. Additional secondary analysis show that essentialist beliefs do not change based on the specific ancestries reported in test-takers’ results. These results indicate that individuals’ interpretations of genetic ancestry testing results, and the links between genes and race, may depend on their understanding of genetics.

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Can Skeletons Have a Racial Identity?

The New York Times
2021-10-19

Sabrina Imbler

A growing number of forensic researchers are questioning how the field interprets the geographic ancestry of human remains.

Racial reckonings were happening everywhere in the summer of 2020, after George Floyd was killed in Minneapolis by the police. The time felt right, two forensic anthropologists reasoned, to reignite a conversation about the role of race in their own field, where specialists help solve crimes by analyzing skeletons to determine who those people were and how they died.

Dr. Elizabeth DiGangi of Binghamton University and Jonathan Bethard of the University of South Florida published a letter in The Journal of Forensic Science that questioned the longstanding practice of estimating ancestry, or a person’s geographic origin, as a proxy for estimating race. Ancestry, along with height, age at death and assigned sex, is one of the key details that many forensic anthropologists try to determine.

That fall, they published a longer paper with a more ambitious call to action: “We urge all forensic anthropologists to abolish the practice of ancestry estimation.”

In recent years, a growing number of forensic anthropologists have grown critical of ancestry estimation and want to replace it with something more nuanced…

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Very Little Is Keeping Doctors From Using Racist Health Formulas

Wired
2021-10-08

Jyoti Madhusoodanan

Photo-Illustration: Sam Whitney; Getty Images

If nothing in medicine changes, it’s just a matter of time before yet another race-based risk calculator harms people of color.

RECENTLY, TWO LEADING medical associations recommended ending a decades-old practice among doctors: using race as one of the variables to estimate how well a person’s kidneys filter waste out of their bodies. Before, clinicians would look at the levels of a certain chemical in blood, then multiply it by a factor of approximately 1.15 if their patient was Black. Using race to estimate kidney function contributes to delays in dialysis, kidney transplants, and other life-saving care for people of color, especially Black patients.

To make the recent decision, 14 experts spent approximately a year evaluating dozens of alternative options, interviewing patients, and weighing the impact of keeping race in the equation. Their final recommendation ensures the corrected kidney equation is equally precise for everyone, regardless of race.

Yet other risk equations that include race are still being used—including ones that have been used to deny former NFL players’ payouts in a concussion settlement, ones that might contribute to underdiagnosing breast cancer in Black women, and ones that have miscalculated the lung function of Black and Asian patients. Ending the use of race-based multipliers in these and dozens of other calculators will take more than a task force in one medical specialty. It’ll need researchers to not just believe, but act on the knowledge that race is not biology, and for the biomedical research enterprise to implement clearer standards for how these calculators are used. Otherwise, it’s just a matter of time before another tool that wrongly uses race to make decisions about patients’ bodies trickles into clinical care…

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After Denying Care to Black Natives, Indian Health Service Reverses Policy

The New York Times
2021-10-08

Mark Walker and Chris Cameron

The shift comes as the Biden administration pressures Native tribes in Oklahoma to desegregate their constitutions to comply with treaty obligations.

The Indian Health Service announced this week that Black Native Americans in the Seminole Nation, known as the Freedmen, will now be eligible for health care through the federal agency, which previously denied them coronavirus vaccinations and other care.

The shift in policy comes as the Biden administration and members of Congress are pressuring the Seminole and other Native tribes in Oklahoma to desegregate their constitutions and include the Freedmen, many of whom are descendants of Black people who had been held as slaves by the tribes, as full and equal citizens of their tribes under post-Civil War treaty obligations.

“The I.H.S.-operated Wewoka Indian Health Clinic provides services to members of the Seminole Nation of Oklahoma, and personnel at the clinic and other I.H.S. facilities in Oklahoma have been informed that they should provide services to Seminole Freedmen who present at their clinics and hospitals,” the Indian Health Service said in a statement.

The Seminole Nation did not immediately respond to a request for comment on the announcement.

Chuck Hoskin Jr., the principal chief of the Cherokee Nation, announced on Friday that his tribe would also start allowing Seminole Freedmen to visit their tribally operated I.H.S. hospital, near Wewoka…

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NKF and ASN Release New Way to Diagnose Kidney Diseases

National Kidney Foundation
2021-09-23

Both Organizations Recommend Race-Free Approach to Estimate GFR

Sept. 23, 2021, New York, NY – Today, the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases has released its final report, which outlines a new race-free approach to diagnose kidney disease. In the report, the NKF-ASN Task Force recommends the adoption of the new eGFR 2021 CKD EPI creatinine equation that estimates kidney function without a race variable. The task force also recommended increased use of cystatin C combined with serum (blood) creatinine, as a confirmatory assessment of GFR or kidney function. The final report, published today online in the American Journal of Kidney Diseases (AJKD) and the Journal of the American Society of Nephrology (JASN), was drafted with considerable input from hundreds of patients and family members, medical students and other trainees, clinicians, scientists, health professionals, and other stakeholders to achieve consensus for an unbiased and most reasonably accurate estimation of GFR so that laboratories, clinicians, patients and public health officials can make informed decisions to ensure equity and personalized care for patients with kidney diseases…

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Retrospection: Agassiz’s Expeditions in Brazil

The Harvard Crimson
2016-04-21

Michelle Y. Raji

Louis Rodolphe Agassiz

But for Agassiz, the trip to Brazil was about more than science. Not only was evolution—a process not immediately observable to the human eye—deeply antithetical to Agassiz’s staunch empiricism, evolution was profoundly at odds with his perceived world order.

Three decades after the then-obscure scientist Charles Darwin quietly sketched his now-famous finches aboard the HMS Beagle in the Galapagos, influential Harvard professor Louis Rodolphe Agassiz set out with much greater fanfare on a lesser-known expedition. In 1865, Agassiz and his wife, accompanied by a small group of Harvard scientists and students, set sail from New York to Rio de Janeiro on The Colorado.

In a lecture en route to Brazil, Agassiz challenged Darwin’s revolutionary theory of evolution on the grounds that the theory relied too much on argument and too little on fact. Agassiz posited that evolution was not plausible according to the geologic record. The trip to Brazil was an attempt to disprove Darwin once and for all. Agassiz saw in the unique biodiversity of Brazil a perfect laboratory to test his counter-theories of phylogenetic embryology and glacial catastrophe in the tropics.

But for Agassiz, the trip to Brazil was about more than science. Not only was evolution—a process not immediately observable to the human eye—deeply antithetical to Agassiz’s staunch empiricism, evolution was profoundly at odds with his perceived world order. Though only moderately religious, Agassiz believed in the existence of a creator in all his work. Fortunately for Agassiz, this belief fit well with comparative zoology, which at the time focused heavily on hierarchal classification…

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A birth certificate masked my multiracial truth. For me and 33 million others, the 2020 Census asserts it.

The Washington Post
2021-08-31

Steve Majors

More than 33 million people in the United States identify as being of two or more races, according to the 2020 Census, a 276 percent jump from the 2010 head count. (Paul Sancya/AP)

My face burned — whether with anger or shame, I wasn’t sure. In 1994, I stood outside human resources at the CBS offices in the Los Angeles neighborhood of Studio City and listened to my future boss over the phone. You want the job? You need to complete the paperwork and check just one box, he insisted. Hours earlier, my pencil had marked X’s in two boxes on the application form. One designated my race as White, the other Black. The HR representative had called him to intervene, and now she waited inside her office for my decision. In a split second, I decided. I wanted the job at CBS’s flagship TV station in Los Angeles; it would be career-changing. So, though no one had told me which box to check, I had a feeling what the HR rep wanted. The recruiter who had first connected me with the opportunity had explicitly told me CBS was looking to increase diversity among its producer ranks. So I grabbed the pencil and erased the mark that declared me half-White. After all, I thought, no one — not even my own family — had officially told me I was of mixed race. The only evidence I had otherwise was written all over my face.

Decades later, when the “23andMe” response jumped into my email inbox at work, I stopped talking to colleagues mid-meeting to read the results. After years of looking at my pale reflection in the mirror and questioning my identity, I already knew the truth. When I walked out into the world, people looked at my fair skin and perceived and treated me as White. I sensed that the birth certificate that claimed I had the same father as my all-Black siblings was a lie, as was the story of my birth that my mother held on to until her death. Even my family’s nickname for me, “High Yella,” has been a signal to me that I was different from them. Now the results I read confirmed it: 56 percent European, 42 percent sub-Saharan African, with a fraction of East Asian and Indigenous American and other thrown in. I felt a sense of recognition. Science had validated who I was.

This month, I felt a similar sense of validation. After filling out the 2020 Census and checking the box to declare myself as two or more races, I saw the final results. My multiracial identity counts, and I’m far from being alone. According to the data, I’m among 33.8 million people who identify as multiracial, a whopping 276 percent increase since the 2010 Census. It’s proof that the United States is truly a racial melting pot, with the most diverse population in its history…

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Abolish race correction

The Lancet
Volume 397, Issue 10268 (2021-01-02)
pages 17-18
DOI: 10.1016/S0140-6736(20)32716-1

Dorothy E. Roberts, George A. Weiss University Professor of Law and Sociology; Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights
University of Pennsylvania, Philadelphia, Pennsylvania

Several years ago my daughter sent me an alarming text. She copied the results of her routine blood work and wrote, “Look at eGFR!”. Under the estimated glomerular filtration rate (eGFR) were listed two numbers—one for non-African Americans and a higher one for African Americans. I was floored. Did this automatic adjustment mean the doctor interpreted my daughter’s eGFR differently based simply on her racial identity? The test’s categories themselves made no biological sense. “African American”, like all racialised populations, is a socially constructed grouping. In the USA, individuals with any amount of discernible African ancestry fit the definition—irrespective of the rest of their ancestral backgrounds. Although my daughter and I identify solely as Black, my mother was a Black Jamaican and my father was the son of white Welsh and German immigrants to the USA. The eGFR disregarded the fabricated nature of the racial distinction it made in calculating kidney function.

I later learned that eGFR race “correction” stems from study findings that participants who self-reported as Black, on average, released more creatinine than white participants for a given kidney function, which historically was attributed to Black people’s assumed higher muscle mass. Recent studies have challenged the muscle-mass hypothesis, but the upward adjustment for all Black patients remains embedded in eGFR calculations. Whatever the flawed rationale, there must be a better way to measure kidney function accurately than by using race—a social classification whose delineations change across time, geography, and political priorities.

Yet misguided ideas about race continue to feature in medicine. I was also dismayed when data on COVID-19 cases and deaths revealed staggering—and strikingly similar—racial disparities in the USA and the UK. As of Dec 10, 2020, the age-adjusted US mortality rates for COVID-19 for Black, Latinx, and Indigenous people were more than 2·7 times higher than for white people. The greater COVID-19 burden on these populations is not surprising: it stems from structural racism that impaired their health before the pandemic—eg, disproportionate exposure to unhealthy food, environmental toxins, shoddy housing, inadequate health care, and stress from racial discrimination—and forced them into risky front-line jobs with greater exposure to infection. Yet some researchers speculated that these unequal outcomes might be caused by Black people’s innate susceptibility—potentially resuscitating the same false racial concepts that underlie race correction.

My 2011 book, Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century, challenged the resurgence of biological concepts of race in genomics, biomedical research, and biotechnologies. As I wrote: “the delusion that race is a biological inheritance rather than a political relationship leads plenty of intelligent people to make the most ludicrous statements about Black biological traits”. Since then, I have warned dozens of audiences about the dangerous persistence of this racial ideology. Yet I have encountered resistance from many doctors, who tend to defend their use of race by saying it’s only part of a nuanced evaluation of many factors meant to produce more accurate diagnoses and therapies. But the eGFR race correction isn’t nuanced at all—it’s an automatic, across-the-board adjustment. It asserts that Black people, as a race, are biologically distinguishable from all others…

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How scientists are subtracting race from medical risk calculators

Science Magazine
2021-07-22

Jyoti Madhusoodanan
Portland, Oregon

Anuj Shrestha

To pediatrician Nader Shaikh, the rhythm of treating babies running high fevers is familiar. After ruling out the obvious colds and other common viruses, he must often thread a catheter into a months-old baby to draw a urine sample and check for a urinary tract infection (UTI). “You have to hold the baby down, the baby’s crying, the mother is usually crying too,” says Shaikh, who works at the University of Pittsburgh. “It’s traumatic.”

UTIs, although relatively rare in children under age 2, carry a high risk of kidney damage in this group if left untreated. Often, the only symptom is a high fever. But high fevers can also signal a brain or blood infection, or a dozen other illnesses that can be diagnosed without a urine sample. To help clinicians avoid the unnecessary pain and expense of catheterizing a shrieking infant, Shaikh and his colleagues developed an equation that gauges a child’s risk of a UTI based on age, fever, circumcision status, gender, and other factors—including whether the child is Black or white. Race is part of the equation because previous studies found that—for reasons that aren’t clear—UTIs are far less common in Black children than in white ones.

The UTI algorithm is only one of several risk calculators that factor in race, which doctors routinely use to make decisions about patients’ care. Some help them decide what tests to perform next or which patients to refer to a specialist. Others help gauge a patient’s lung health, their ability to donate a liver or kidney, or which diabetes medicines they need.

In the past few years, however, U.S. doctors and students reckoning with racism in medicine have questioned the use of algorithms that include race as a variable. Their efforts gained momentum thanks to the Black Lives Matter movement. In August 2020, a commentary published in The New England Journal of Medicine (NEJM) highlighted the use of race in calculators as a problem “hidden in plain sight.” It’s widely agreed that race is a classification system designed by humans that lacks a genetic basis, says Darshali Vyas, a medical resident at Massachusetts General Hospital and co-author on the paper. “There’s a tension between that [understanding] and how we see race being used … as an input variable in these equations,” Vyas says. “Many times, there’s an assumption that race is relevant in a biological sense.”…

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Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms

The New England Journal of Medicine
Volume 2020, Number 383
pages 874-882
2020-08-27 (published on 2020-06-17, at NEJM.org.)
DOI: 10.1056/NEJMms2004740

Darshali A. Vyas, M.D., Resident Physician
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
Harvard University, Cambridge, Massachusetts

Leo G. Eisenstein, M.D., Resident Physician
New York University Langone Medical Center, New York, New York

David S. Jones, M.D., Ph.D., A. Bernard Ackerman Professor of the Culture of Medicine
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts

Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics and could be clinically useful.¹ Others held that any small benefit was outweighed by potential harms that arose from the long, rotten history of racism in medicine.² Weighing the two sides, the accompanying Perspective article concluded that though the concept of race was “fraught with sensitivities and fueled by past abuses and the potential for future abuses,” race-based medicine still had potential: “it seems unwise to abandon the practice of recording race when we have barely begun to understand the architecture of the human genome.”³

The next year, a randomized trial showed that a combination of hydralazine and isosorbide dinitrate reduced mortality due to heart failure among patients who identified themselves as black. The Food and Drug Administration granted a race-specific indication for that product, BiDil, in 2005.⁴ Even though BiDil’s ultimate commercial failure cast doubt on race-based medicine, it did not lay the approach to rest. Prominent geneticists have repeatedly called on physicians to take race seriously,^5,6 while distinguished social scientists vehemently contest these calls.^7,8

Our understanding of race and human genetics has advanced considerably since 2003, yet these insights have not led to clear guidelines on the use of race in medicine. The result is ongoing conflict between the latest insights from population genetics and the clinical implementation of race. For example, despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice. One subtle insertion of race into medicine involves diagnostic algorithms and practice guidelines that adjust or “correct” their outputs on the basis of a patient’s race or ethnicity. Physicians use these algorithms to individualize risk assessment and guide clinical decisions. By embedding race into the basic data and decisions of health care, these algorithms propagate race-based medicine. Many of these race-adjusted algorithms guide decisions in ways that may direct more attention or resources to white patients than to members of racial and ethnic minorities…

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