Nigeria’s dangerous skin whitening obsession

Posted in Africa, Articles, Health/Medicine/Genetics, Media Archive, Social Science on 2013-04-07 01:29Z by Steven

Nigeria’s dangerous skin whitening obsession
 
Al Jazeera
2013-04-06

Mohammed Adow

Nigeria has the world’s highest percentage of women using skin lightening agents in the quest for “beauty”.

Lagos, Nigeria – After carefully washing her face, legs and arms, Taiwo Solomon vigorously rubs cream over her body. She is meticulous and makes sure she covers her entire face. Soloman, 32, is bleaching her skin. She believes fairer skin could be her ticket to a better life. So she spends her meager savings on cheap black-market concoctions that promise to lighten her pigment.

This has been a daily routine for the past 15 years. Now several shades lighter she says her new skin makes her feel more beautiful and confident.

“Bleaching just makes me feel special, like am walking around in a spotlight,” she told Al Jazeera. “I am not seeking to be totally white, I just want to look beautiful. I cannot stop using the lightening agents,” she adds.

Solomon is not alone. According to the World Health Organisation (WHO), 77 percent of women in Nigeria use skin-lightening products, the world’s highest percentage. That compares with 59 percent in Togo, and 27 percent in Senegal. The reasons for this are varied but most people say they use skin-lighteners because they want “white skin”.

In many parts of Africa, lighter-skinned women are considered more beautiful and are believed to be more successful and likely to find marriage.

It’s not only women though who are obsessed with bleaching their skins. Some men too are involved in the practice…

…Dangerous consequences

Skin bleaching comes with hazardous health consequences. The dangers associated with the use of toxic compounds for skin bleaching include blood cancers such as leukemia and cancers of the liver and kidneys as well as severe skin conditions.

Hardcore bleachers use illegal ointments containing toxins like mercury, a metal that blocks production of melanin, which gives the skin its colour, but can also be toxic…

Read the entire article here.

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The Genomic Revolution and Beliefs about Essential Racial Differences: A Backdoor to Eugenics?

Posted in Articles, Health/Medicine/Genetics, Media Archive on 2013-04-04 01:24Z by Steven

The Genomic Revolution and Beliefs about Essential Racial Differences: A Backdoor to Eugenics?

American Sociological Review
Volume 78, Number 2 (April 2013)
pages 167-191
DOI: 10.1177/0003122413476034

Jo C. Phelan,  Professor of Sociomedical Sciences
Mailman School of Public Health
Columbia University

Bruce G. Link, Professor of Epidemiology and Sociomedical Sciences (in Psychiatry)
Mailman School of Public Health
Columbia University

Naumi M. Feldman
Columbia University

Could the explosion of genetic research in recent decades affect our conceptions of race? In Backdoor to Eugenics, Duster argues that reports of specific racial differences in genetic bases of disease, in part because they are presented as objective facts whose social implications are not readily apparent, may heighten public belief in more pervasive racial differences. We tested this hypothesis with a multi-method study. A content analysis showed that news articles discussing racial differences in genetic bases of disease increased significantly between 1985 and 2008 and were significantly less likely than non–health-related articles about race and genetics to discuss social implications. A survey experiment conducted with a nationally representative sample of 559 adults found that a news-story vignette reporting a specific racial difference in genetic risk for heart attacks (the Backdoor Vignette) produced significantly greater belief in essential racial differences than did a vignette portraying race as a social construction or a no-vignette condition. The Backdoor Vignette produced beliefs in essential racial differences that were virtually identical to those produced by a vignette portraying race as a genetic reality. These results suggest that an unintended consequence of the genomic revolution may be the reinvigoration of age-old beliefs in essential racial differences.

Read or purchase the article here.

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Will Personalized Medicine Challenge or Reify Categories of Race and Ethnicity?

Posted in Articles, Health/Medicine/Genetics, Media Archive, Social Science on 2013-04-03 01:05Z by Steven

Will Personalized Medicine Challenge or Reify Categories of Race and Ethnicity?

Virtual Mentor: American Medical Association Journal of Ethics
Volume 14, Number 8 (August 2012)
pages 657-663

Ramya Rajagopalan, Ph.D., Postdoctoral Research Fellow
Department of Sociology
University of Wisconsin, Madison

Joan H. Fujimura, Ph.D., Professor of Sociology; Professor of Science and Technology Studies
Robert F. and Jean E. Holtz Center
University of Wisconsin, Madison

In the last 5 years, medical geneticists have been conducting studies to examine possible links between DNA and disease on an unprecedented scale, using newly developed DNA genotyping and sequencing technologies to quickly search the genome. These techniques have also allowed researchers interested in human genetic variation to begin to catalogue the range of genetic similarities and differences that exist across individuals from around the world, through initiatives such as the International Haplotype Mapping Project. These studies of human genetic variation promise to produce new kinds of information about our DNA, but they have also raised ethical questions.

Early results from genome-wide studies of possible links between DNA and various medical conditions are being used by various actors to develop what they call “personalized medicine,” the effort to tailor and individualize diagnoses and treatments for use during routine medical care. The promises of personalized medicine are built on the idea that each individual’s genome is unique. They are also built on the idea that genetic variation among individuals will help explain differential susceptibilities to disease and why some patients respond better to some treatments than others. To this end, researchers have focused on characterizing genetic differences between individuals and groups…

…We note two ethical dilemmas posed by the claims made by these and other similar studies that attempt to link genetics, ancestry, and disease, particularly when ancestries are described in terms of continent of origin, for example, European, African, and Asian. Such labels are based on socioculturally defined U.S. categories of race and ethnicity, such as white, black, and Asian. The first dilemma arises because these studies are based on a relatively small subset of individuals who identify within any of these continental ancestry or race groupings. Thus, any extension of study findings to others who identify within these broad groupings would be fraught with problems of accuracy and precision. Indeed, much genetic evidence suggests that those who identify with a particular U.S. race or ethnicity census category are quite genetically heterogeneous. Thus, there is no neat correspondence between genetic variation and one’s assumed race or ethnicity. Indeed, no single pattern of genetic variation is diagnostic of affiliation with any particular race or ethnicity.

Second, and consequently, many worry that the new technologies being used to develop personalized medicine may also become technologies that are used to define “genetic signatures” for, or “genetic stereotyping” of, different racial or ethnic groups. This aspect of personalized medicine, if developed and nurtured into broader clinical use, will popularize the idea that it is possible to infer underlying genetic makeup from an observer-defined or self-reported race or ethnicity, when even proponents of using race in genetics research argue that this is a logical fallacy. This possibility recalls some of the past attempts to link race and biology, e.g., the eugenics movements of the early twentieth century…

…Nor is race new to American medical genetics. Many scholars have analyzed the American eugenics movements of the early twentieth century and the more ethically aware field of medical genetics that they eventually gave rise to in the mid-twentieth century. Prior to the start of the Human Genome Project, medical genetics focused primarily on relatively rare, familially inherited diseases. Certain generalizations about the relationships between race and genetics, now part of popular understanding and medical training programs, grew out of these studies. For example, medical school and college biology curricula continue to propagate the idea that some single-gene, highly heritable diseases, like Tay-Sachs disease or sickle-cell anemia, are prevalent in only certain groups—as in Jewish and African American groups, respectively—than other groups. What is often not acknowledged is that Tay-Sachs has also been observed at high prevalence in non-Jewish groups in Quebec, Canada and that sickle-cell and other hemoglobin disorders are common in many groups around the world. The misconception that a particular disease like sickle-cell is specific to African Americans may lead to patients being misdiagnosed or diagnosed too late in the progression of disease simply because they are not of the ethnic group “marked” by the disease…

…Personalized medicine is at a crossroads. It may be used to sustain old beliefs about racial differences, yoking them to supposed differences in health and susceptibilities to illness. This in turn may fuel the view that our genetics establishes an innate, definitive roadmap of our future health. However, recent studies of hundreds of common complex diseases suggest that genetics has only a small part to do with our susceptibilities to these diseases.

An alternative route for personalized medicine is for its practitioners to take stock of the various environmental onslaughts that individuals are subjected to and tailor medical diagnoses and treatments by considering each patient’s unique complement of environmental and biological factors that may contribute to health or disease. If personalized medicine is to bear out its name and become truly “personalized,” then a focus on racial differences at the level of the genome constitutes a step off the path with many ramifications, including the possibility of racial and ethnic stereotyping and discrimination during routine medical care that could lead to misdiagnoses and ineffective treatment regimens. Efforts to achieve personalized medicine in clinical settings would do better to focus on patterns in genomes and how such patterns may be associated with disease, rather than trying to find genetic correlates for existing racial and ethnic categories…

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The Elusive Variability of Race

Posted in Articles, Brazil, Health/Medicine/Genetics, Identity Development/Psychology, Media Archive, Mexico, Social Science on 2013-03-31 04:59Z by Steven

The Elusive Variability of Race

GeneWatch
Council for Responsible Genetics
Volume 21, Issue 3-4 (July-August 2009)
2009-07-30
Pages 4-6

Patricia J. Williams, James L. Dohr Professor of Law
Columbia University

The question of race is, at its core, a questioning of humanity itself.  In various eras and locales, race has been marked by color of skin, texture of hair, dress, musical prowess, digital dexterity, rote memorization, mien, mannerisms, disease, athletic ability, capacity to write poetry, sense of rhythm, sobriety, childlike cheerfulness, animal anger, language, continent of origin, hypodescent, hyperdescent, religious affiliation, thrift, flamboyance, slyness, physical size, or presence of a moral conscience. These presumed markers may appear random in the aggregate, but they have nevertheless been deployed to rationalize the distribution of resources and rights to some groups and not others. Behind the concept of race, in other words, is a deeper interrogation of what distinguishes beasts from brothers;  of who is presumed entitled or dispossessed,  person or slave, autonomous or alien, compatriot or enemy.

In the contemporary United States, race is based chiefly on broad and variously calibrated metrics of African ancestry. To get a full sense of the ideological incoherence of race and racism, however, one must also include the longer history: the centuries-old Chinese condescension to native Taiwanese Islanders; the English derogation of the Irish for “pug noses”; the plight of the Dalit (i.e., untouchables) in India; or comprehensively eugenic regimes like Hitler’s.

Despite the enormous definitional diversity of what race even means, and despite the fact that the biological studies – from Charles Darwin’s observations to the Human Genome Project – have patiently, repetitively and definitively shown that all humans are a single species, there remain many determined to reinscribe a multitude of old racialist superstitions onto the biotechnologies of the future.  Despite the biological evidence – and a towering body of social science that is cumulative (observations over time), comprehensive (multiple levels of inquiry) and convergent (from a variety of sources, places, disciplines) – we are still asking the same centuries-old questions…

…So what is race if not biology?

Race is a hierarchical social construct that assigns human value and group power. Social constructions are human inventions, the products of mind and circumstance. This is not to say that they are imaginary. Racialized taxonomies have real consequences upon biological functions, including the expression of genes. They affect the material conditions of survival-relative respect and privilege, education, wealth or poverty, diet, medical and dental care, birth control, housing options and degree of stigma…

…If history has shown us anything, it’s that race is contradictory and unstable. Yet our linguistically embedded notions of race seem to be on the verge of transposing themselves yet again into a context where genetic percentages act as the ciphers for culture and status, as well as economic and political attributes. In another generation or two, the privileges of whiteness may be extended to those who are “half” this or that.  Indeed, some of the discussions about Barack Obama’s “biracialism” seemed to invite precisely such an interpretation. Let us not mistake it for anything like progress, however: biracialism always has a short shelf life. For example, by the time he was elected President, Barack Obama was no longer our first “half and half president” but had become all African-American all the time. Indeed, Obama himself seemed to acknowledge the more complex reality of his own lineage in an off-the-cuff aside, when, speaking about his daughters’ search for a puppy, he observed that most shelter dogs are “mutts like me.”

In fact, of course, we’re all mutts – and as Americans, we’ve been mixing it up faster and more thoroughly than anyplace on earth. At the same time, we live in a state of tremendous denial about the rambunctiousness of our recent lineage. The language by which we assign racial category narrows or expands our perception of who is more like whom, tells us who can be considered marriageable or untouchable. The habit of burying the relentlessly polyglot nature of our American identity renders us blind to how intimately we are tied as kin.

In the United States’ vexed history of color-consciousness, anti-miscegenation laws (the last of which were struck down only in 1967) enshrined the notion of hypodescent. Hypodescent is a cultural phenomenon whereby the child of parents who come from differing social classes will be assigned the status of the parent with the lower standing. Most parts of the Deep South adhered to it with great rigidity, in what is commonly called the “one drop and you’re black” rule. Take for example, New York Times editor Anatole Broyard, who denied any relation to his darker-skinned siblings and “passed” as white for most of his adult life. There were many who expressed shock when it was uncovered that he was “really” black. Some states, like Louisiana, practiced a more gradated form of hypodescent, indicating hierarchies of status with vocabulary like “mulatto,” “quadroon,” and “octaroon.” And even today, despite our diasporic, fragmented, postmodern cosmopolitanism, there is a thoughtless or unconscious tendency to preserve these taxonomies, no matter how incoherent. Consider Essie Mae Washington-Williams, the daughter Senator Strom Thurmond had by his family’s black maid. She lived her life as a “Negro,” then as an “African American,” and attended an “all-black” college. But in her 70s, when Thurmond’s paternity became publicized, she was suddenly redesignated “biracial.” Tiger Woods and Kimora Lee Simmons are alternatively thought of as African-American or “biracial,” but rarely as “Asian-American.”

In contrast, many parts of Latin America, like Brazil or Mexico, assign race by the opposite process, hyperdescent. That’s when those with any ancestry of the dominant social group, such as European, identify themselves as European or white, when they may also have African or Indian parents. As more Latinos have become citizens of the United States, we have interesting examples of this cultural cognitive dissonance: Just think about Beyoncé Knowles and Jennifer Lopez. Phenotypically they look very similar. Yet Knowles is generally referred to as black or African-American; Lopez is generally thought of as white (particularly among her Latino fan base) or Latina (among the rest of us), but she is never called black or even biracial…

Read the entire article here.

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“Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century,” talk by Dorothy Roberts

Posted in Health/Medicine/Genetics, Live Events, Media Archive, United States on 2013-03-29 03:42Z by Steven

“Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century,” talk by Dorothy Roberts

University of Michigan
Hatcher Library Gallery, Room 100
913 S. University Avenue
Ann Arbor, Michigan
2013-04-04, 16:00-17:30 CDT (Local Time)

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

Professor Roberts will be discussing her latest project in connection with the “Understanding Race” theme semester. In “Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century” she argues that America is experiencing a dangerous resurgence of classifying populations into biological races. By searching for differences at the molecular level, a new race-based science is obscuring racism in our society and legitimizing state brutality against communities of color at a time when many claim that the United States is “post-racial.” Moving from an account of the evolution of the concept of race—proving that it has always been a mutable and socially defined political division supported by mainstream science—Roberts delves deeply into the current debates, interrogating cutting-edge genomic science and biotechnology, interviewing its researchers, and exposing the political consequences of the focus on race-based genetic difference. Fatal Invention is a powerful call for us to affirm our common humanity by eliminating the social inequities preserved by the political system of race…

For more information, click here.

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Book Review: Race in a Bottle

Posted in Articles, Book/Video Reviews, Health/Medicine/Genetics, Media Archive on 2013-03-24 02:04Z by Steven

Book Review: Race in a Bottle

GeneWatch
Council for Responsible Genetics
Volume 26 Issue 1, March 2013

Lundy Braun, Royce Family Professor in Teaching Excellence and Professor of Medical Science and Africana Studies
Brown University

In Race in a Bottle, Jonathan Kahn tracks the contentious history of BiDil, the first drug targeted specifically to African Americans. Ironically, race-based drug treatment emerged in the wake of the sequencing of the human genome, a project that theoretically promised both to scientifically refute the notion of genetically distinct racial groups and to usher in an era of personalized medicine. Though hyped by researchers, the FDA, and the press as an important first step toward personalized medicine, BiDil is a drug administered to patients based on their membership in a group…

…Critical to Kahn’s argument regarding evidence is the fact that the clinical trials on which the company based its patent application for BiDil were never designed to compare racial difference in response to the drug. Using “care of the data” as an organizing theme, Kahn highlights one of the many troubling aspects of this controversy: the extraordinarily loose, if not sloppy, construction of what passed as evidence in the patent application and FDA hearings. From the use of misleading statistics on mortality from heart failure in African Americans, to the failure to define the central variable of race, to the design of a clinical trial (A-HeFT) that included only African Americans (and therefore could not determine differential efficacy) to the lack of any mechanistic understanding for a differential effect, Kahn shows that attention to the data was consistently problematic when it came to matters of race. The chapter on the FDA hearings is particularly illuminating…

Read the entire review here.

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this evidence invites a re-evaluation of the relevance of racial/ethnic labels

Posted in Excerpts/Quotes, Health/Medicine/Genetics on 2013-03-23 20:15Z by Steven

In conclusion, based on a consecutive series of patients from an urban medical center in New York City we demonstrate that a spectrum of mixed ancestry is emerging in the largest US minority groups. While consistent with previous descriptive studies, when viewed from the clinical perspective this evidence invites a re-evaluation of the relevance of racial/ethnic labels. In combination with evidence of locus heterogeneity within and between populations, this picture of extensive gene flow lends credence to the argument that the transfer of historical population labels which reflect language and other social categories onto patient samples will in many cases be unwarranted.

Tayo BO, Teil M, Tong L, Qin H, Khitrov G, et al., “Genetic Background of Patients from a University Medical Center in Manhattan: Implications for Personalized Medicine,” PLoS ONE, Volume 6, Number 5 (2011-05-04): 8-10. http://dx.doi.org/10.1371/journal.pone.0019166.

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Genetic Background of Patients from a University Medical Center in Manhattan: Implications for Personalized Medicine

Posted in Articles, Health/Medicine/Genetics, Media Archive, United States on 2013-03-23 20:09Z by Steven

Genetic Background of Patients from a University Medical Center in Manhattan: Implications for Personalized Medicine

PLoS ONE: A peer-reviewed, open access journal
Volume 6, Number 5 (2011-05-04)
11 pages
DOI: 10.1371/journal.pone.0019166

Bamidele O. Tayo
Department of Preventive Medicine and Epidemiology
Loyola University Chicago
Stritch School of Medicine, Maywood, Illinois

Marie Teil
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Liping Tong
Department of Preventive Medicine and Epidemiology
Loyola University Chicago
Stritch School of Medicine, Maywood, Illinois

Huaizhen Qin
Department of Biostatistics and Epidemiology
Case Western University, Cleveland, Ohio

Gregory Khitrov
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Weijia Zhang
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Quinbin Song
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Omri Gottesman
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Xiaofeng Zhu
Department of Biostatistics and Epidemiology
Case Western University, Cleveland, Ohio

Alexandre C. Pereira
University of Sao Paulo Medical School, Sao Paulo, Brazil

Richard S. Cooper
Department of Preventive Medicine and Epidemiology
Loyola University Chicago
Stritch School of Medicine, Maywood, Illinois

Erwin P. Bottinger
Charles R. Bronfman Institute for Personalized Medicine
Mount Sinai School of Medicine, New York, New York

Background

The rapid progress currently being made in genomic science has created interest in potential clinical applications; however, formal translational research has been limited thus far. Studies of population genetics have demonstrated substantial variation in allele frequencies and haplotype structure at loci of medical relevance and the genetic background of patient cohorts may often be complex.

Methods and Findings

To describe the heterogeneity in an unselected clinical sample we used the Affymetrix 6.0 gene array chip to genotype self-identified European Americans (N = 326), African Americans (N = 324) and Hispanics (N = 327) from the medical practice of Mount Sinai Medical Center in Manhattan, NY. Additional data from US minority groups and Brazil were used for external comparison. Substantial variation in ancestral origin was observed for both African Americans and Hispanics; data from the latter group overlapped with both Mexican Americans and Brazilians in the external data sets. A pooled analysis of the African Americans and Hispanics from NY demonstrated a broad continuum of ancestral origin making classification by race/ethnicity uninformative. Selected loci harboring variants associated with medical traits and drug response confirmed substantial within- and between-group heterogeneity.

Conclusion

As a consequence of these complementary levels of heterogeneity group labels offered no guidance at the individual level. These findings demonstrate the complexity involved in clinical translation of the results from genome-wide association studies and suggest that in the genomic era conventional racial/ethnic labels are of little value.

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Race in Contemporary Medicine

Posted in Anthologies, Books, Health/Medicine/Genetics, Media Archive, Politics/Public Policy, Social Science on 2013-03-23 20:03Z by Steven

Race in Contemporary Medicine

Routledge
2007
208 pages
Hardback ISBN: 978-0-415-41365-7

Edited by:

Sander L. Gilman

With the first patent being granted to “BiDil,” a combined medication that is deemed to be most effective for a specific “race,” African-Americans for a specific form of heart failure, the on-going debate about the effect of the older category of race has been renewed. What role should “race” play in the discussion of genetic alleles and populations today? The new genetics has seemed to make “race” both a category that is seen useful if not necessary, as The New York Times noted recently: “Race-based prescribing makes sense only as a temporary measure.” (Editorial, “Toward the First Racial Medicine,” November 13, 2004) Should one think about “race” as a transitional category that is of some use while we continue to explore the actual genetic makeup and relationships in populations? Or is such a transitional solution poisoning the actual research and practice.

Does “race” present both epidemiological and a historical problem for the society in which it is raised as well as for medical research and practice? Who defines “race”? The self-defined group, the government, the research funder, the researcher? What does one do with what are deemed “race” specific diseases such as “Jewish genetic diseases” that are so defined because they are often concentrated in a group but are also found beyond the group? Are we comfortable designating “Jews” or “African-Americans” as “races” given their genetic diversity? The book answers these questions from a bio-medical and social perspective.

This book was previously published as a special issue of Patterns of Prejudice.

Contents

  • Introduction: On Race and Medicine in Historical Perspective. Sander L. Gilman (Emory)
  • Reflections on Race and the Biologization of Difference. Katya Gibel Azoulay (Grinnell)
  • Against Racial Medicine. Joseph L. Graves, Jr. (North Carolina A&T State University) & Michael R. Rose (University of California, Irvine)
  • Blood and Stories: How Genomics is Rewriting Race, Medicine and Human History. Patricia Wald (Duke)
  • “Why are Genetic and Medical Researchers Accepting a Category Created by Slaveholders?” A Social History of the Reification of “Race” James Downs (Princeton)
  • Eugenics and the Racial Genome: Politics at the Molecular Level. Sharon Snyder and David Mitchell (University of Illinois – Chicago)
  • The Risky Gene: Epidemiology and the Evolution of Race. Philip Alcabes (Hunter College School of Health Sciences)
  • Folk Taxonomy, Prejudice and the Human Genome: Using Heritable Disease as a Jewish Ethnic Marker. Judith S. Neulander (Case Western Reserve University)
  • The price of science without moral constraints: German and American medicine before DNA and Today. Robert E. Pollack (Columbia)
  • Deadly Medicine Today: The Impossible Denials of Racial Medicine. C. Richard King (Washington State University)
  • Biobanks of a “Racial Kind”: Mining for Difference in the New Genetics. Sandra Soo-Jin Lee (Stanford)
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Black and Blue: The Origins and Consequences of Medical Racism by John Hoberman [Matt Wood Review]

Posted in Articles, Book/Video Reviews, Health/Medicine/Genetics, Media Archive, United States on 2013-03-16 16:55Z by Steven

Black and Blue: The Origins and Consequences of Medical Racism by John Hoberman [Matt Wood Review]

TriQuarterly: a journal of writing, art, and cultural inquiry from Northwestern University
2013-02-04

Matt Wood, Book Review Editor

We’ve heard the statistics on black and white mortality rates in the United States. Black infants are up to three times as likely to die as babies of other races. Black patients have lower survival rates from cancer and are hospitalized twice as often as whites for preventable conditions such as high blood pressure and type 2 diabetes.

How does this happen in the twenty-first century, when a black man is the president of the United States and three of the last four surgeons general have been black? Why do whites receive more potentially lifesaving cardiac procedures than blacks? Why are black patients less likely to have cancer surgery recommended to them? Why are black patients with diabetes and circulatory problems more likely to have limbs amputated?

Racism, says John Hoberman. In his scathing book Black and Blue: The Origins and Consequences of Medical Racism, he documents how the racial prejudices of the larger American society have influenced the diagnosis and treatment of black patients over the past century, and how those practices continue today. The book is a relentless and thoroughly researched account of racial discrimination by the largely white medical establishment, composed of medical school faculty, editorial boards of scientific journals, and professional associations such as the American Medical Association that develop medical school curricula and influence decisions about research. While Hoberman offers an unsatisfying solution to these problems, the book is thorough enough to make anyone—physician, layperson, black, white—question his or her own racial prejudices and assumptions…

…Hoberman calls this “racialization,” or using pseudoscientific rationales to define racial differences in physiology. The idea that blacks are more primitive human beings than whites stemmed from the same historical racist ideas that European colonizers used to justify black African slavery. This later developed into subtler stereotyping. Conditions associated with the stresses of modern “civilized” life were labeled “white.” Whites supposedly suffered more from myopia and other vision problems caused by the strain of reading too much. White businessmen were prone to digestive problems and ulcers because they shouldered “the burdens and responsibilities of administration and management in business and politics.” Blacks, on the other hand, supposedly possessed an innate physical “hardiness” that made them less susceptible to these “white” diseases. Instead, they were allegedly prone to sexually transmitted infections, drug abuse, and alcoholism because of their “careless” and “primitive” lifestyles. Hoberman points out a classic example of endometriosis. As late as 1950, some doctors believed that it occurred only in white women, because they assumed sexually transmitted diseases were the source of any gynecological problems in black women…

Read the entire review here.

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