Mixed Race Studies

Status and Stress

The New York Times
2013-07-27

Moises Velasquez-Manoff

Although professionals may bemoan their long work hours and high-pressure careers, really, there’s stress, and then there’s Stress with a capital “S.” The former can be considered a manageable if unpleasant part of life; in the right amount, it may even strengthen one’s mettle. The latter kills.

What’s the difference? Scientists have settled on an oddly subjective explanation: the more helpless one feels when facing a given stressor, they argue, the more toxic that stressor’s effects.

That sense of control tends to decline as one descends the socioeconomic ladder, with potentially grave consequences. Those on the bottom are more than three times as likely to die prematurely as those at the top. They’re also more likely to suffer from depression, heart disease and diabetes. Perhaps most devastating, the stress of poverty early in life can have consequences that last into adulthood.

Even those who later ascend economically may show persistent effects of early-life hardship. Scientists find them more prone to illness than those who were never poor. Becoming more affluent may lower the risk of disease by lessening the sense of helplessness and allowing greater access to healthful resources like exercise, more nutritious foods and greater social support; people are not absolutely condemned by their upbringing. But the effects of early-life stress also seem to linger, unfavorably molding our nervous systems and possibly even accelerating the rate at which we age…

…“Early-life stress and the scar tissue that it leaves, with every passing bit of aging, gets harder and harder to reverse,” says Robert Sapolsky, a neurobiologist at Stanford. “You’re never out of luck in terms of interventions, but the longer you wait, the more work you’ve got on your hands.”

This research has cast new light on racial differences in longevity. In the United States, whites live longer on average by about five years than African-Americans. But a 2012 study by a Princeton researcher calculated that socioeconomic and demographic factors, not genetics, accounted for 70 to 80 percent of that difference. The single greatest contributor was income, which explained more than half the disparity. Other studies, meanwhile, suggest that the subjective experience of racism by African-Americans — a major stressor — appears to have effects on health. Reports of discrimination correlate with visceral fat accumulation in women, which increases the risk of metabolic syndrome (and thus the risk of heart disease and diabetes). In men, they correlate with high blood pressure and cardiovascular disease.

Race aside, Bruce McEwen, a neuroscientist at Rockefeller University in New York, describes these relationships as one way that “poverty gets under the skin.” He and others talk about the “biological embedding” of social status. Your parents’ social standing and your stress level during early life change how your brain and body work, affecting your vulnerability to degenerative disease decades later. They may even alter your vulnerability to infection. In one study, scientists at Carnegie Mellon exposed volunteers to a common cold virus. Those who’d grown up poorer (measured by parental homeownership) not only resisted the virus less effectively, but also suffered more severe cold symptoms…

Read the entire article here.

Study explores race differences of lung cancer risk

Vanderbilt University Medical Center Reporter
2013-08-01

Mimi Eckhard

Vanderbilt research scientist Melinda Aldrich, Ph.D., MPH, has been awarded a National Institutes of Health Academic Career Award to investigate some of the genetic secrets behind a greater risk of lung cancer among African-Americans compared with other racial and ethnic groups.

Aldrich, assistant professor of Thoracic Surgery and Epidemiology, will study the genetic ancestry of African-Americans to identify the genetic and environmental risk factors associated with a higher incidence of lung cancer in this population.

To date, this represents the largest study of African-Americans with lung cancer.

Though smoking is certainly a well-documented risk factor for lung cancer, it does not explain the racial disparity in lung cancer risk. Therefore, Aldrich believes a genetic difference may lie at the root of the problem…

…This five-year research study will be the largest to examine the genetics of lung cancer in a population whose ancestry is mixed and separated by thousands of years. African-Americans have ancestry in both Africa and Europe, and genetic mapping could identify common key regions that contribute to racial differences in lung cancer incidence…

Read the entire article here.

Medical Experimentation and Race in the Eighteenth-century Atlantic World

Social History of Medicine
Volume 26, Issue 3 (August 2013)
pages 364-382
DOI: 10.1093/shm/hkt011

Londa Schiebinger, The John L. Hinds Professor of History of Science
Stanford University

This article examines medical experimentation with humans in the Atlantic world. Physicians in this period tended to use bodies interchangeably in medical trials; subjects were scarce and, for the most part, used with extreme care. Experimentalists in this period, however, faced a paradox. In the second half of the eighteenth century naturalists across Europe began focusing attention on what they perceived to be racial differences. At the same time medical experimentalists required that human bodies be fully interchangeable if results were to hold universally. The dilemma, then, was this: on the one hand, physicians tended to emphasize racial difference with respect to the science of race; on the other hand, they assumed uniformity across humans with respect to developing drug therapies. It was in this context that important questions arose about whether experiments done among Caribbean slave populations were valid for Europeans.

Read or purchase the article here.

Taking race out of the equation in measuring women’s risk of osteoporosis and fractures

UCLA Newsroom
University of California, Los Angeles
2012-10-18

Enrique Rivero

For women of mixed racial or ethnic backgrounds, a new method for measuring bone health may improve the odds of correctly diagnosing their risk of osteoporosis and bone fractures, according to a UCLA-led study.

Currently, assessing osteoporosis and the risk of fractures from small accidents like falls requires a bone density scan. But because these scans don’t provide other relevant fracture-related information, such as bone size and the amount of force a bone is subjected to during a fall, each patient’s bone density is examined against a national database of people with the same age and race or ethnicity.

This approach, however, doesn’t work for people of mixed race or ethnicity because comparison databases can’t account for mixed heritage. A similar problem exists for those from smaller racial or ethnic groups for which there are not comparison databases.

“All the current ways of determining your risk for fractures require knowing your race and ethnicity correctly, and they ignore the fact that racial and ethnic groups are not homogenous,” said study co-author Dr. Arun Karlamangla, a professor of medicine in the geriatrics division at the David Geffen School of Medicine at UCLA. “It also flies in the face of the current reality in Southern California, where so many people are of mixed ethnicity.”

Given that osteoporosis and hip fractures are leading causes of injury in older people, alternative means of measuring risk are needed. Now, a UCLA-led team of researchers has found a way of assessing risk without knowledge of a person’s race or ethnicity. The method involves combining bone mineral density measures with body size and bone size to create composite bone strength indices.

The findings are published in the October issue of the Journal of Clinical Endocrinology and Metabolism…

…”The importance of bone size to fracture risk has been recognized by engineers and radiologists for some years now,” said the study’s lead investigator, Dr. Shinya Ishii, who started the research while a fellow in the UCLA Division of Geriatrics and is now at the University of Tokyo. “But no one, until now, has combined bone density, which is the traditional measure of osteoporosis, with bone size and body size to get at a more uniform way of assessing osteoporosis that applies across racial lines and does away with the need to know the person’s race or racial mixture.“…

Read the entire article here.

Fracture Risk Assessment without Race/Ethnicity Information

The Journal of Clinical Endocrinology & Metabolism
Volume 97, Number 10 (2012-10-01)
pages 3593-3602
DOI: 10.1210/jc.2012-1997

Shinya Ishii
Department of Geriatric Medicine (S.I.)
Graduate School of Medicine
University of Tokyo

Gail A. Greendale
David Geffen School of Medicine
University of California, Los Angeles

Jane A. Caule
Graduate School of Public Health
University of Pittsburgh

Carolyn J. Crandall
David Geffen School of Medicine
University of California, Los Angeles

Mei-Hua Huang
David Geffen School of Medicine
University of California, Los Angeles

Michelle E. Danielson
Graduate School of Public Health
University of Pittsburgh

Arun S. Karlamangla
David Geffen School of Medicine
University of California, Los Angeles

Context: Dual-energy x-ray absorptiometry-derived bone mineral density (BMD) does not explain interracial differences in fracture risk; thus, BMD-based fracture risk assessment requires patient race/ethnicity information and ethnicity-specific BMD reference databases.

Objective: The objective of the study was to investigate whether composite femoral neck strength indices, which integrate dual-energy x-ray absorptiometry-derived femoral neck size, femoral neck BMD, and body size, will allow fracture risk assessment without requiring race/ethnicity information.

Design: This was a prospective cohort study.

Setting and Participants: A total of 1940 community-dwelling women aged 42–53 yr from four race/ethnicity groups (968 Caucasian, 512 African-American, 239 Japanese, and 221 Chinese) were followed up for 9 yr.

Outcome Measurements: Self-reported, nondigital, noncraniofacial fractures were measured.

Results: Two hundred and two women (10.4%) sustained fractures and 82 (4.3%) had minimum-trauma fractures. Each sd increment in any of the strength indices was associated with a 34–41% reduction in fracture hazard over 9 yr (each P < 0.001). Race/ethnicity predicted fracture hazard independent of BMD (P = 0.02) but did not predict fracture hazard independent of any of the composite indices (P = 0.11–0.22). Addition of race/ethnicity did not improve risk discrimination ability of the strength indices, but did significantly improve the discrimination ability of BMD. The discrimination ability of BMD with race/ethnicity was not statistically different from that of any of the strength indices without race/ethnicity.

Conclusions: Composite strength indices of the femoral neck can predict fracture risk without race/ethnicity information as accurately as bone mineral density does in combination with race/ethnicity information and therefore would allow risk prediction in people of mixed race/ethnicity and in groups without a BMD reference database.

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Racial profiling in medicine

Nature Medicine
Volume 19, Number 7 (July 2013)
page 808
DOI: 10.1038/nm.3254

Aravinda Chakravarti, Professor of Medicine
McKusick-Nathans Institute of Genetic Medicine
Johns Hopkins University

Jonathan Kahn, Race in a Bottle: The Story of BiDil and Racialized Medicine in a Post-Genomic Age, Columbia University Press, 2012. 28 pp., ISBN: 0231162987

The field of human genetics is moving beyond using genomics as a tool for deeper understanding of human disease pathophysiology to the possibility of translating this knowledge for efficient treatment. A particular emphasis is being placed on Individualized medicine’, promising to tailor treatment based on each of our genomes. This ideal vision, however, can cause unease when our notions of genetic individuality intersect with those of ancestry and race. Jonathan Kahn’s book, Race in a Bottle, is a contemporary medical story born of this nexus. In it, he skillfully uses the story of the drug BiDil, a therapeutic for heart failure marketed specifically for African Americans (but whose use has declined markedly because it provides no unique benefit in comparison to similar drugs), as the backdrop for examining the expanding role of race in medical genomics, even when the same science has called the existence of race into serious doubt.

As Kahn highlights in the book, the innocuous birth of BiDil in 1992 was no predictor of its contorted history. BiDil is a combination of two vasodilators, hydralazine and isosorbide dinitrate (H-I), which are presumed to act through the nitric oxide pathway to provide benefit to patients with congestive heart failure. They were combined into one pill for easier administration, although each was already available in generic form. Between 1980 and 1991, two major clinical trials in the United States, involving patients of both European and African ancestries, clearly established that angiotensin-converting-enzyme inhibitors should be the preferred drug for patients with heart failure and that the H-1 combination should be used in individuals who did not benefit from this frontline therapy. Sensing a market opportunity, Medco Research obtained the intellectual property rights to BiDil, demonstrated its bioequivalence to the H-1 formulation and approached the US Food and Drug Administration(FDA) in 1996 for approval to market this ‘new’ drug. The FDA refused, arguing that clinical trials showing the utility of H-1 for heart failure did not meet the stiff criteria for such approval.

There was a suspicion that the nitric oxide response, and heart failure, was somehow different in blacks than in whites. So Jay Cohn, a respected cardiologist and owner of the original BiDil patent, reanalyzed the original clinical trial data to demonstrate that H-1 did work better in blacks than whites, a contention described and contested in the book. This finding not only led to a new patent but prompted its new owner, NitroMed, to conduct a fresh clinical trial in 2001, involving only African-American patients with heart failure, to demonstrate BiDils utility in this group. None of these facts are in doubt. What is doubted, however, is the implicit assumption that BiDil is not useful for white patients, the chronology of key events and the motivations of various actors in medicine, industry and government—factors that morphed an otherwise convenient drug formulation into a race-specific drug. Kahn makes the charge that “BiDil was not about personalizing medicine; it was about exploiting race to obtain cheaper, quicker FDA approval for a drug.”…

…Genetic analysis strongly suggests that early humans first arose in Africa and emerged out of Africa only ~100,000 years ago, a fairly recent development, evolutionarily speaking, which explains why we are all closely related. Any classification of biological races within our species is arbitrary because there are no major discontinuities in our diversity across the globe. Importantly, genetic data show that currently populous groups are not necessarily reflected by their past abundance, and human history is one of repeated admixture, not maintenance of purity. It is this genetic admixture that has left an imprint on every human disease with a genetic component, including common chronic ones. Thus, it is quite unlikely that the genetic variations underlying our diseases, which represent only a small fraction of our genetic diversity, will vary markedly across humanity…

Read or purchase the article here.

Heredity and Racial Science for Elementary and Secondary Schools (Erblehre und Rassenkunde für die Grund- und Hauptschule) 2nd edition

Verlag Konkordia
Bühl-Baden, Germany
1937

Karl Bareth, Author

Alfred Vogel, Author

Source: German Propaganda Archive, Calvin College, Grand Rapids, Michigan

Archived and Translated by:

Randall Bytwerk, Professor of Communication Arts and Sciences
Calvin College, Grand Rapids, Michigan

Background: This is a teacher’s guide to racial instruction, covering the 4th through the 8th grades. I provide a translation of sections that strike me as particularly interesting. Bareth was an experienced teacher, and Vogel’s title is Rektor. Vogel also produced a set of posters to be used in classroom instruction. Published in 1937, before the alliance with Japan, there is some material on the “Yellow Peril.” Such material disappeared later.

…b) Race mixing among humans.

We have already spoken about one racial mixing. That had to do with the racial development of the German people. May we also speak of it as bastardization? If we look into the face of the German people, peering deeply into its spiritual life, we are absolutely convinced that the joining of these six races into one whole people was not a bastardization. Their genetic traits joined in a wonderful and harmonious way to form the German people, from which our German culture sprang.

We speak of bastardization in the case of a mixed race (Mischlinge) that develops from fundamentally different races or racial mixtures, as, for example, one between Europeans and Negroes, Europeans and Asians, Europeans and Indians, Europeans and Jews, etc. Such mixed race individuals carry the contradictory trains of both races, resulting in a confusion. Bastards are unhappy people. A bastard of European and Negroid decent has some of the characteristics of the white race, and some characteristics of the black race. He unsuited both for the jungles and hot sun of the south, but also for the north. Two souls live and compete within the breast of the bastard. He never finds peace and a harmonious, balanced life. The hard laws of blood force him to live a life of racial confusion and fragmentation…

Read the entire guide here.

Racial Discrimination in Medicine versus Race-Based Medicine: The Ethical, Legal and Policy Implications on Health Disparities

Georgetown Journal of Law & Modern Critical Race Perspectives
Volume 3, Issue 1 (Spring 2011)
pages 59-86

Christopher Ogolla, LL.M., J.D., M.A., M.P.H., B.A., Academic Support Instructor
Thurgood Marshall School of Law
Texas Southern University

This paper explores the history of racial discrimination in medicine and evaluates the ethical and policy issues raised by race-based medicine. It notes that proponents of race-based medicine have failed to frame the debate in such a way that distinguishes it from racial discrimination in medicine and suggests that race-based medicine is more likely to pass muster if it is framed in terms of elimination of health disparities among different segments of the population. The paper attempts to answer questions such as whether race was and is still a dominant factor in medicine, and whether it is ethical to tie one’s advice (as a medical professional) to a patient’s race. More importantly, the paper explores the issue of whether race-based medicine can ever be justified.

The paper argues that traditional medicine sometimes supported by the government, fostered bias and discrimination against minorities and suggests that this history has injected a level of suspicion and cynicism in public discussions of race-based medicine. The paper evaluates benefits and pitfalls of race-based medicine and analyzes the ethical, legal and policy implications of such a practice. It recommends that there is some value in understanding the variable response to drugs and the ethics of producing drugs for those who need it most, even if they happen to be members of one ethnic group. The paper concludes by noting that race-based medicine promises to achieve optimal medical outcomes by helping physicians and patients choose patient-specific disease management approaches based on a patient’s genetic profile.

Read the entire article here or here.

Race Based Medication BiDil and African Americans

New York University
2009-10-16

Ann Morning, Associate Professor of Sociology
New York University

Ann Morning, Assistant Professor of Sociology, discusses race-based medications.

Professor Dorothy Roberts — Challenging Concepts of Race

Mixed Race Radio
Blog Talk Radio
2013-06-26, 16:00Z (12:00 EDT)

Tiffany Rae Reid, Host

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

Dorothy Roberts is the fourteenth Penn Integrates Knowledge Professor, George A. Weiss University Professor, and the inaugural Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights at University of Pennsylvania, where she holds appointments in the Law School and Departments of Africana Studies and Sociology. An internationally recognized scholar, public intellectual, and social justice advocate, she has written and lectured extensively on the interplay of gender, race, and class in legal issues and has been a leader in transforming public thinking and policy on reproductive health, child welfare, and bioethics.

Professor Roberts is the author of the award-winning books Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (Random House/Pantheon, 1997) and Shattered Bonds: The Color of Child Welfare (Basic Books/Civitas, 2002), as well as co-editor of six books on constitutional law and gender. She has also published more than eighty articles and essays in books and scholarly journals, including Harvard Law Review, Yale Law Journal, and Stanford Law Review.  Her latest book, Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century, was published by the New Press in July 2011.

For more information, click here.