Mixed Race Studies

Black and Blue: The Origins and Consequences of Medical Racism

University of California Press
April 2012
304 pages
Paperback ISBN: 9780520274013
Hardcover ISBN: 9780520248908

John Hoberman

Black & Blue is the first systematic description of how American doctors think about racial differences and how this kind of thinking affects the treatment of their black patients. The standard studies of medical racism examine past medical abuses of black people and do not address the racially motivated thinking and behaviors of physicians practicing medicine today.

Black & Blue penetrates the physician’s private sphere where racial fantasies and misinformation distort diagnoses and treatments. Doctors have always absorbed the racial stereotypes and folkloric beliefs about racial differences that permeate the general population. Within the world of medicine this racial folklore has infiltrated all of the medical sub-disciplines, from cardiology to gynecology to psychiatry. Doctors have thus imposed white or black racial identities upon every organ system of the human body, along with racial interpretations of black children, the black elderly, the black athlete, black musicality, black pain thresholds, and other aspects of black minds and bodies. The American medical establishment does not readily absorb either historical or current information about medical racism. For this reason, racial enlightenment will not reach medical schools until the current race-aversive curricula include new historical and sociological perspectives.

Contents

• Acknowledgments
• 1. THE NATURE OF MEDICAL RACISM: THE ORIGINS AND CONSEQUENCES OF MEDICAL RACISM
  • Introduction
  • “Avoidance and Evasion”
  • Judging How Physicians Behave
  • Judging Physician Conduct: Privacy and the “Halo Effect”
  • The Oral Tradition
  • Physicians Share the Racial Attitudes of Their Fellow Citizens
  • The Medical Liberals
• 2. BLACK PATIENTS AND WHITE DOCTORS
  • The African American Health Calamity: The Silence
  • Medical Vulnerability and Racial Defamation
  • How Do (White) Physicians Think about Race?
  • Evidence or Medical Racism
  • Resistance to the Critique of Racial Bias in Medicine
  • Medical Liberalism and the Medical Literature
  • The Physician’s Private Sphere
  • Playing Anthropologist
  • From Racial Folklore to Racial Medicine
• 3. MEDICAL CONSEQUENCES OF RACIALIZING THE HUMAN ORGANISM
  • Racial Interpretations of Human Types and Traits
    • Introduction
    • Racial Interpretations of Black Infants and Children
    • Racial Interpretations of the Black Elderly
    • Racial Interpretations of the Black Athlete
    • Racial Interpretations of Black Musical Aptitude
    • Racial Interpretations of Losing Consciousness
    • Racial Interpretations of the Nervous System
    • Racial Interpretations of Pain Sensitivity
    • Racial Interpretations of Heart Disease
  • Racial Interpretations of Human Organs and Disorders
    • Racial Interpretations of the Eyes
    • Racial Interpretations of Black Skin
    • Racial Interpretations of Human Teeth
    • Racial Interpretations of “While” and “Black” Disorders
    • Black “Hardiness”
    • Physical Hardiness
    • Emotional Hardiness
    • Conclusion: How Human Organ Systems Acquire Racial Identities
  • Racial Folklore in Medical Specialties
    • A Century of Racial Pharmacology: From Racial Folklore to Racial Genetics
    • The Role of Racial Folklore in Obstetrics and Gynecology during the Twentieth Century
• 4. MEDICAL APARTHEID, INTERNAL COLONIALISM, AND THE TASK OF AMERICAN PSYCHIATRY
  • Introduction
  • “Africanizing” the Black Image
  • American Psychiatry as Racial Medicine
  • The Racial Primitive in American Psychiatry
  • The Task of Black Psychiatry
  • Colonial Medical Status
• 5. A MEDICAL SCHOOL SYLLABUS ON RACE
  • Introduction
  • The Doctor-Patient Relationship
  • The Problem Patient
  • Medical Authors’ Aversion to Race
  • Race and Medical Education: The Search for “Cultural Competence”
  • Two Official Versions of “Cultural Competence”
  • Physicians’ Beliefs about Racial Differences: A (Belated) Study
  • A Medical Curriculum on Race
  • Practical Advice for Physicians
  • Social Class, Misdiagnoses, and Therapeutic Fatalism
  • “Cultural Competence” as Knowledge of Stereotype Systems
  • Raceless Humanism: “Medical Humanities” and the Evasion of Difference
  • Medical Curriculum Change Is Possible: The Case of Abortion Training
• Notes
• Index

The Trend of the Race: A Study of Present Tendencies in the Biological Development of Civilized Mankind

Harcourt, Brace and Company
1921
396 pages
(Digitized by Google)

Samuel J. Holmes (1868-1964), Ph.D., Professor of Zoology
University of California, Berkeley

CONTENTS

• I. An Introductory Orientation
• II. The Hereditary Basis
• III. The Inheritance of Mental Defects and Disease
• IV. The Heritable Basis of Crime and Delinquency
• V. The Inheritance of Mental Ability
• VI. The Decline of the Birth Rate
• VII. The Causes of the Decline of the Birth Rate
• VIII. Natural Selection in Man
• IX. The Selective Influence of War
• X. Sexual Selection and Assortative Mating
• XI. Consanguineous Marriages and Miscegenation
• XII. The Possible Role of Alcohol and Disease in Causing Hereditary Defects
• XIII. The Alleged Influence of Order of Birth and Age of Parents upon Offspring
• XIV. The Racial Influence or Industrial Development
• XV. The Selective Function of Religion
• XVI. Retrospect and Prospect

PREFACE

The present volume is the outgrowth of a course of lectures on Eugenics which has been given for several years in the University of California. Its aim is to present an account of the various forces which are at present modifying the inherited qualities of civilized mankind. In dealing with so extensive and complex a subject I have doubtless committed a number of errors and have probably not altogether escaped from being misled by statistical fallacies into which I have so often accused others of having fallen. The more extensively I have delved into the varied literature on the biological evolution of man, the more I have become impressed with the necessity of employing extreme caution in drawing conclusions. Few subjects, in fact, present so many pitfalls for the unwary. It is with the conviction that it is especially important in this field to be sure one is right before going ahead that I have devoted so much effort to critical analysis at the risk of becoming tedious to the general reader.

I am indebted to my colleagues Professor F. B. Sumner and Professor F. J. Teggart for reading my original manuscript and for making a number of valuable suggestions.

The preparation of the present work has involved the compilation of an extensive bibliography which is to be published as an additional volume so that the references may be rendered avail able for other investigators.

S. J Holmes

Berkeley, Calif.
Jan. 1921.

Read the entire book here or here.

Prisoners of Abstraction? The Theory and Measure of Genetic Variation, and the Very Concept of “Race”

Biological Theory
July 2012
12 pages
DOI: 10.1007/s13752-012-0048-0

Jonathan Michael Kaplan, Associate Professor of Philosophy
Oregon State University

Rasmus Grønfeldt Winther, Assistant Professor of Philosophy
University of California, Santa Cruz

It is illegitimate to read any ontology about “race” off of biological theory or data. Indeed, the technical meaning of “genetic variation” is fluid, and there is no single theoretical agreed-upon criterion for defining and distinguishing populations given a particular set of genetic variation data. By analyzing three formal senses of “genetic variation,” viz., diversity, differentiation, and heterozygosity, we argue that the use of biological theory for making claims about race inevitably amounts to a pernicious reification. Biological theory does not force the concept of “race” upon us; our social discourse, social ontology, and social expectations do. We become prisoners of our abstractions at our own hands, and at our own expense.

Read the entire article here.

Genetic Explanations: Sense and Nonsense

Harvard University Press
February 2013
384 pages
6-1/8 x 9-1/4 inches
2 graphs, 4 tables
Hardcover ISBN: 9780674064461

Edited by

Sheldon Krimsky, Professor of Urban & Environmental Policy & Planning in the School of Arts; Sciences and Adjunct Professor of Public Health & Community Medicine in the School of Medicine
Tufts University

Jeremy Gruber, President and Executive Director
Council for Responsible Genetics

Can genes determine which fifty-year-old will succumb to Alzheimer’s, which citizen will turn out on voting day, and which child will be marked for a life of crime? Yes, according to the Internet, a few scientific studies, and some in the biotechnology industry who should know better. Sheldon Krimsky and Jeremy Gruber gather a team of genetic experts to argue that treating genes as the holy grail of our physical being is a patently unscientific endeavor. Genetic Explanations urges us to replace our faith in genetic determinism with scientific knowledge about how DNA actually contributes to human development.

The concept of the gene has been steadily revised since Watson and Crick discovered the structure of the DNA molecule in 1953. No longer viewed by scientists as the cell’s fixed set of master molecules, genes and DNA are seen as a dynamic script that is ad-libbed at each stage of development. Rather than an autonomous predictor of disease, the DNA we inherit interacts continuously with the environment and functions differently as we age. What our parents hand down to us is just the beginning. Emphasizing relatively new understandings of genetic plasticity and epigenetic inheritance, the authors put into a broad developmental context the role genes are known to play in disease, behavior, evolution, and cognition.

Rather than dismissing genetic reductionism out of hand, Krimsky and Gruber ask why it persists despite opposing scientific evidence, how it influences attitudes about human behavior, and how it figures in the politics of research funding.

Racial Medicine: Not So Fast

The Daily Beast
2008-08-19

Sharon Begley, Senior Health and Science Correspondent
Reuters

Next time you want to start a bar fight, proclaim to everyone within earshot that “race is not real; it is just a social and cultural construct and has no biological validity.” Then duck before you get punched in the face. . . . but as you’re avoiding injury try to hand your would-be assailants a new paper published online this afternoon by the journal Clinical Pharmacology & Therapeutics, which concludes that classifying people by the crude category of race—as in, of African, Asian or European ancestry—for medical purposes, as some people want to do, is really, really stupid…

…Which brings us to the new study. Scientists at the J. Craig Venter Institute got the cool idea of analyzing the genomes of two white guys who, according to the conventional racial categories, belong to the same race. The two are Venter himself and James Watson, co-discoverer of the double-helix structure of DNA. Venter led the private effort to sequence the human genome, winding up in a tie with the public project to do the same.

It happens that the genomes of both men are in the public domain. Watson agreed to have his sequenced and published last year, with Venter right behind. So what do the genomes reveal?

The two men metabolize drugs, including antidepressants, codeine, antipsychotics and the cancer drug tamoxifen, differently. Venter has two functional copies of the CYP2D6 form of the cytochrome P-450 gene, which metabolizes more than 75 percent of drugs, while Watson has two copies of the more-sluggish variant of the gene. That’s rare for Caucasians (only 3 percent of whites have the sluggish version), but common in East Asians (49 percent of whom have it). Funny, Watson doesn’t look Chinese. But if Watson’s doctor decided to use race-based medicine to predict how he would metabolize drugs, she’d say, well, we have a white guy here, and whites rarely have the sluggish version, so I’ll assume Watson doesn’t have it either. As a result, the drug would stay in Watson’s system longer, with stronger effects compared to someone in whom the drug was quickly metabolized and cleared from the body. “It is unlikely that a doctor would guess that optimal drug dosages might differ for Drs. Watson and Venter,” the scientists write.

That’s why Venter and colleagues conclude that race is too crude a proxy for what genetic group—ethnicity or, as biologists say, population—someone belongs to. It is imperative to “go beyond simplistic ethnic categorization,” they write, since that can be seriously—and perhaps fatally—misleading. (In the U.S., some 100,000 people a year die of adverse drug reactions, many caused by an inability to properly metabolize the medication because of a particular CYP2D6 variation.) “Race/ethnicity should be considered only a makeshift solution for personalized genomics because it is too approximate,” they write…

Read the entire article here.

Mixed Race Blood, Bone Marrow Donors Needed To Save Gen Y Lives

The Huffington Post-Canada
2013-01-31

Andree Lau

One of Lourdess Sumners’ most vivid memories of her childhood battle with cancer was pining for real food while hooked up to a feeding tube and watching The Food Channel on TV.

“It was horrible. I hated it,” recalls the now 14-year-old from her home in Duncan, B.C. “That would make me even more hungry. And I would draw pictures of sausages and hamburgers, whatever I felt hungry for.”

For her parents, that period was highlighted by the distressing and ultimately futile search for a bone marrow donor for their middle daughter, hampered mainly because she happens to be part of the fastest growing demographic in Canada.

Sumners, whose mother is Filipino and father is Caucasian, is among the more than 340,000 Canadian children growing up in a mixed-race family.

Only about four per cent of Canada’s couples are made up of people from different ethnic backgrounds — but they’re growing five times faster than other unions, according to data from the 2006 census.

Statistics Canada said mixed couples were most common among Canadians aged 25 to 34, followed by those aged 15 to 24 — a cohort that encompasses Generation Y, which generally refers to young adults born after 1980 (also known as millennials).

What hasn’t kept up with the growing population of mixed-race children is the registry of stem cell and marrow donors from blended ethnicities — donors that Sumners needed. She required a bone marrow transplant to fight acute myeloid leukemia, an aggressive cancer of the blood and bone marrow.

“It wasn’t even a consideration in my mind that finding bone marrow would be an issue,” says Orlando Sumners, Lourdess’ father. “There’s such a desperate need for mixed-race people on the registry … [but] most mixed-race adults wouldn’t have a clue what we’re talking about.”…

Read the entire article here.

Mixed Asian Americans and Health: Navigating Uncharted Waters

Chapter in: Handbook of Asian American Health

Springer
2013
pages 129-134
Print ISBN: 978-1-4614-2226-6
eBook ISBN: 978-1-4614-2227-3
DOI: 10.1007/978-1-4614-2227-3

Edited by:

Grace J. Yoo
San Francisco State University
 
Mai-Nhung Le
San Francisco State University

Alan Y. Oda
Azusa Pacific University, Azusa, California

Chapter Author:

Cathy J. Tashiro, PhD, RN, Associate Professor of Nursing
University of Washington, Tacoma

Over 2.6 million people who self-identified with more than one race in the 2010 U.S. Census claimed Asian ancestry, about 15% of the total population of Asians, making these individuals a significant part of Asian America. Mixed Asian Americans come from a variety of backgrounds, making it difficult to generalize about their health, though some common characteristics have emerged. While research on physical health outcomes of mixed Asian Americans is still limited, there is a growing body of research that may indicate increased risk for behavioral problems among some subgroups. The chapter reviews the existing research and discusses social and genetic factors relevant to the health and wellbeing of mixed Asian Americans.

Introduction

What are the health implications of being a mixed Asian American? Very little is known about this diverse and rapidly expanding population. The little we do know is complicated by the collision between biological concepts of “race” and the social process of racial categorization. Asian America includes such diverse populations that it’s difficult to make biological generalizations about them. Yet there are some well-established differences between certain Asian groups and the majority population that have important health implications. Two examples will be discussed in this chapter. For people of mixed Asian ancestry who may also have ancestral roots in Europe, Africa, and/or the Americas, the complexities of possible combinations and their implications are daunting. But there is an urgent need to tease apart the social and biological meanings of being a mixed Asian American. Researchers whose studies are discussed in this chapter are beginning to do this important work. Hopefully, in the near future, a mixed Asian American confronted with health risks by race who asks “But what does this mean for me?” will find real answers…

When should medicine talk about race?

Scientific American
Unofficial Prognosis: Perceptions and prescriptions of a medical student
2012-08-25

Ilana Yurkiewicz
Harvard Medical School

Race is everywhere in medicine. Most health statistics are broken down by race. We routinely characterize diseases by which populations they affect more and less and medications by which ethnicities respond better or worse.
 
It’s so ubiquitous that it’s easy to take for granted as justified. But the use of race in medicine is a subject that is vigorously debated. Whenever a new study comes out stratifying results by race, there are inevitably supporters and critics.
 
The question under debate: is there a place for race in medicine?

There’s a growing number who say we should toss this way of thinking entirely. Many scholars now contend that race is closer to a social construct than a biological category, and there’s the legitimate fear that pointing out differences between races sends the message that the difference is biological. Even if there are certain genetic differences among populations, we know that self-reported race is at best a crude proxy for indicating them. Moreover, studies often do not adjust for all other variables besides genetics, such as socioeconomic status, culture, and discrimination – meaning if differences are shown, the knee-jerk tendency to think biology might overshadow important environmental disparities that deserve our attention. There are social concerns too, in that historically ethnicity in research has been abused by pseudoscientists with racist agendas of demonstrating the superiority of certain people over others. In light of that history, profound sensitivity toward using race as a variable in medicine is understandable and warranted…

…When comparing groups, we can draw the lines wherever we want. Telling of this point is that many studies that talk about race still only compare blacks to whites, ignoring all other groups along with cases of mixed ancestry…

Read the entire article here.

Study Links Highly Segregated Counties and Lung Cancer Deaths in Blacks

The New York Times
2013-01-16

Sabrina Tavernise

African-Americans who live in highly segregated counties are considerably more likely to die from lung cancer than those in counties that are less segregated, a new study has found.

The study was the first to look at segregation as a factor in lung cancer mortality. Its authors said they could not fully explain why it worsens the odds of survival for African-Americans, but hypothesized that blacks in more segregated areas may be less likely to have health insurance or access to health care and specialty doctors. It is also possible that lower levels of education mean they are less likely to seek care early, when medical treatment could make a big difference. Racial bias in the health care system might also be a factor…

…Dr. David Chang, director of outcomes research at the University of California San Diego Department of Surgery, who wrote an accompanying editorial, said he hoped that the study would focus attention on the environmental factors involved in the stark disparities in health outcomes in the United States because they lend themselves to change through policy. Medical researchers tend to focus on factors like the genetics and the behaviors of individuals that are harder to change.

“We don’t need drugs or genetic explanations to fix a lot of the health care problems we have,” he said.

Read the entire article here.

The End of Race History? Not Yet

Center for Genetics and Society
2012-12-14

Osagie K. Obasogie, Associate Professor of Law
University of California, Hastings

Have we gone beyond race? Many argue society has now overcome centuries of strife to become “post-racial”—a moment that law professor Sumi Cho of DePaul University in Chicago refers to as “the end of race history”.

Two seemingly disparate developments have been used to lend support to this claim. In politics, Barack Obama’s 2008 election as the first racial minority-member to become US president has been lauded as a racially transcendent moment. In science, the completion of the Human Genome Project’s first draft in June 2000 offered seemingly definitive evidence that race is not real. As geneticist Craig Venter noted at the HGP announcement, “the concept of race has no genetic or scientific basis”…

…Two recent books by legal scholars address these issues. Jonathan Kahn’s Race in a Bottle provides a stunning case study of BiDil, the first drug to receive approval by the US Food and Drug Administration as a race-specific therapy. It was designed to treat African-Americans suffering from heart failure—based mainly on a mistaken belief that there are meaningful disparities in heart failure outcomes between blacks and whites caused by biological differences. Although BiDil was initially created as a race-neutral drug, Kahn offers a compelling account of the many influences that turned what is in essence a combination therapy of two widely available generic treatments into a pill “for black people only”…

…Dorothy Roberts’s Fatal Invention, now out in paperback, extends this insight to examine how the re-emergence of biological race is having a broader impact—not only on innovations such as genetic ancestry-testing and racialised aspects of DNA forensics, but also on how we think about basic notions of racial difference. Advocates of biological race argue that today’s use of race in biomedicine is different from past usages within science that supported racism, eugenics and questionable research practices…

Read the entire article here.