Mixed Race Studies

How Not To Talk About Race And Genetics

BuzzFeed
2018-03-30

Micah Baldwin / Via Flickr: micahb37

Race has long been a potent way of defining differences between human beings. But science and the categories it constructs do not operate in a political vacuum.

This open letter was produced by a group of 68 scientists and researchers. The full list of signatories can be found below.

In his newly published book Who We Are and How We Got Here, geneticist David Reich engages with the complex and often fraught intersections of genetics with our understandings of human differences — most prominently, race.

He admirably challenges misrepresentations about race and genetics made by the likes of former New York Times science writer Nicholas Wade and Nobel Laureate James Watson. As an eminent scientist, Reich clearly has experience with the genetics side of this relationship. But his skillfulness with ancient and contemporary DNA should not be confused with a mastery of the cultural, political, and biological meanings of human groups.

As a group of 68 scholars from disciplines ranging across the natural sciences, medical and population health sciences, social sciences, law, and humanities, we would like to make it clear that Reich’s understanding of “race” — most recently in a Times column warning that “it is simply no longer possible to ignore average genetic differences among ‘races’” — is seriously flawed…

Read the entire letter here.

Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics by Lundy Braun (review)

Configurations
Volume 23, Number 1, Winter 2015
pages 127-130
DOI: 10.1353/con.2015.0000

Lindsey Andrews, Visiting Scholar of English
Center for Interdisciplinary Studies in Science and Cultural Theory
Duke University, Durham, North Carolina

Braun, Lundy, Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics (Minneapolis: University of Minnesota Press, 2014).

Lundy Braun’s account of the ongoing and often invisible implementation of race-correction in pulmonary medicine is as much about the absence of the spirometer—a machine developed to measure lung function with accuracy—as it is about its presence. Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics asks how it is possible that, well into the twenty-first century, doctors continue to use technologies that “correct” for racial differences in lung function despite no existing physiological difference. How did buttons establishing separate norms based on race and sex come to be a surreptitious, yet pervasive feature of diagnostic machinery? The answer lies in a much larger story about the desirability, across multiple domains and professions, of a technically precise means for measuring the elusive quality that physicians, scientists, and insurance companies came to think of as “vital capacity” or “fitness.” Building explicitly on Keith Wailoo’s Drawing Blood: Technology and Disease Identity in Twentieth-Century America (1997) and contributing to a growing body of literature on race in science and technology, Braun’s study “examine[s] the complex and contradictory historical processes by which differences such as race, class, and gender actually get embedded into the very architecture of scientific instruments” (p. xxi).

Braun tracks the proliferation of spirometric uses, from the machine’s earliest emergence as a tool for monitoring laborers’ fitness in the middle of the nineteenth century, through its development as a medical diagnostic tool in the twentieth century, to its contemporary role in adjudicating worker’s compensation claims. One of the most intriguing aspects of Braun’s book—and at times its most challenging feature—is its attempt to account for the ways in which the spirometer’s flexibility (rather than its specificity) as a precision tool and its unclear object of measurement (vital capacity) made it, in fact, such a powerful tool that would come to play a crucial global role in health- and insurance-policy decisions. What Braun ultimately shows is that separate though related epistemological problems regarding vital capacity emerged across multiple fields—including labor surveillance, fitness culture, and diagnostic medicine—to which precision and numeracy appeared to be the answer. The spirometer provided both. As Braun notes, spirometry was not central to any one discipline, but instead found myriad uses in physical education, military testing and training, and insurance assessment. “As its epistemological relevance faded in one domain,” she writes, “it was taken up, adapted, and investigated in another” (p. xxv). Whether shoring up Anglo-Saxon masculinity by establishing the superiority of upper-class white lungs in nineteenth-century physical culture or enforcing anti-black workers’ compensation policies that required blacks to demonstrate even lower lung functioning than similarly positioned white workers in order to receive remuneration, the capacity of the spirometer to produce numeric data was both its appeal in terms of authority and simultaneously its most easily racialized feature—a feature made invisible in the apparent “value neutrality” of a scientific virtue (a concept that Braun draws from Lorainne Daston and Peter Galison) like precision.

Tracing the international and professional border-crossing of the spirometer is one of the book’s primary accomplishments, but also one of its challenges for readers. In the course of seven chapters, Braun is tasked with moving back and forth from the twenty-first to the early nineteenth century, and from Wales, to the US South, to South Africa, negotiating a narrative that is neither straightforward nor linear, although always following a through-line in which assessment of the laboring body and management of the laboring class drive spirometric racialization. Early chapters cover the stabilization of whiteness as a meaning of lung-capacity measurements. In the first chapter, Braun shows how John Hutchinson, a Victorian scientist and early developer of the spirometer, reconfigured pulmonary studies in terms of physiological functioning rather than anatomical construction, thus tapping into growing investments in scientific experimentalism and the “quantifying spirit” of the Victorian era by adapting the spirometer’s use to large-scale population studies. Chapter 1 thus lays the groundwork for the third and fourth chapters, which also detail the ways in which lung-capacity measurements, along with anthropometry…

How Racism Creeps Into Medicine

The Atlantic
2014-08-29

Hamza Shaban
Washington, D.C.

The history of a medical instrument reveals the dubious science of racial difference.

In 1864, the year before the Civil War ended, a massive study was launched to quantify the bodies of Union soldiers. One key finding in what would become a 613-page report was that soldiers classified as “White” had a higher lung capacity than those labeled “Full Blacks” or “Mulattoes.” The study relied on the spirometer—a medical instrument that measures lung capacity. This device was previously used by plantation physicians to show that black slaves had weaker lungs than white citizens. The Civil War study seemed to validate this view. As early as Thomas Jefferson’s Notes on the State of Virginia, in which he remarked on the dysfunction of the “pulmonary apparatus” of blacks, lungs were used as a marker of difference, a sign that black bodies were fit for the field and little else. (Forced labor was seen as a way to “vitalize the blood” of flawed black physiology. By this logic, slavery is what kept black bodies alive.)

The notion that people of color have a racially defined deficiency isn’t new. The 19th century practice of measuring skulls, and equating them with morality and intelligence, is perhaps the most infamous example. But race-based measurements still persist. Today, doctors examine our lungs using spirometers that are “race corrected.” Normal values for lung health are reduced for patients that doctors identify as black. Not only might this practice mask economic or environmental explanations for lower lung capacity, but the logic of innate, racial difference is built into things like disability estimates, pre-employment physicals, and clinical diagnoses that rely on the spirometer. Race has become a biologically distinct, scientifically valid category despite the unnatural and social process of its creation.

In her recent book Breathing Race into the Machine, Lundy Braun, a professor of Africana studies and medical science at Brown University, reveals the political and social influences that constantly shape science and technology. She traces the history of the spirometer and explains its role in establishing a hierarchy of human health, and the belief that race is a kind of genetic essence. I spoke with her about the science of racial difference, its history, and its resurgence.

Hamza Shaban: How did the idea of race corrections and differing lung capacity come about?

Lundy Braun: My research suggests that Samuel Cartwright, a Southern physician and plantation owner, was the first person to use the spirometer to compare lung capacity in blacks and whites. The first major study making racial comparisons of lung capacity with a large sample size was the anthropometric study of Union soldiers directed by Benjamin Apthorp Gould, published in 1869.

The idea about the pathology of black lungs circulated in medical groups in the late 19th century but the next scientifically modern racial comparison was published in the Journal of the American Medical Association in 1922. This paper was followed by a flurry of studies in the 1920s, some of which continue to be cited in the 2000s. Gould’s book also continues to be cited…

Read the entire interview here.

Medicating Race: Heart Disease and Durable Preoccupations with Difference by Anne Pollock (review)

Bulletin of the History of Medicine
Volume 88, Number 2, Summer 2014
pages 393-395
DOI: 10.1353/bhm.2014.0025

Lundy Braun, Professor of Pathology and Laboratory Medicine; Africana Studies
Brown University, Providence, Rhode Island

Anne Pollock, Medicating Race: Heart Disease and Durable Preoccupations with Difference (Durham: Duke University Press, 2012).

Science and technology studies (STS) scholar Anne Pollock’s Medicating Race uses the lens of “durable preoccupations” to explore the racialization of different categories of heart disease from the early twentieth century when cardiology emerged as a medical specialty. The book is a useful reminder that the intense and sometimes vitriolic debate over BiDil, a medication for heart failure and the first race-based drug, is but one moment—though a very public one—in a long history of the mobilization of race in cardiology. Drawing on rich and varied sources, including archival materials, scientific articles, interviews, and professional conferences, Pollock extends prior analyses of BiDil to examine the intersection of race with the numerous epistemological debates that characterize the history of heart disease. Why, Pollock asks, has race proved so resilient in the history of heart disease, despite relentless critique?

This deeply theorized account tracks “epistemologically eclectical” racial preoccupations as they travel among the social worlds of science, the clinic, and the pharmaceutical industry. Weaving together three main themes—the role of heart disease research in constituting Americanness, the persistence of racial categorization throughout this history, and the social and political dimensions of health disparities activism—Pollock argues that the durability of race in theories of heart disease is a dynamic biosocial process enmeshed in ambiguous and changing classifications of both disease and race and the persistence of unequal access to power, resources, and treatment. As Pollock writes, “Preoccupations with racial differences always exceed the data itself” (p. 19).

Beginning with early twentieth-century beliefs about infectious etiologies of heart disease, racial discourses shaped the emergence and professionalization of cardiology in complex ways. So deeply entrenched were ideas of syphilitic heart disease in blacks, for example, that Booker T. Washington’s death from arteriosclerosis in 1915 remained a matter of dispute until the 2000s. For African American physicians committed to providing medical care to their neglected communities, engagement with black heart disease also provided them with access to the modern technologies of scientific medicine, albeit limited. As others have shown with diseases such as tuberculosis and cancer, discourses of modernity, stress, and civilization were central to the whitening of coronary heart disease by midcentury.

Particularly fascinating is Pollock’s detailed examination of the complicated relationship between the famed Framingham Heart Study organized in 1948 and the Jackson Heart Study organized in 2000. Framingham researchers constructed their population as both white and normal through changing coding practices, categorizations, computerization, and data analysis, all of which cohered to produce hypertension as a distinct disease category. Modeled on Framingham, the Jackson Heart Study recruited only self-identified blacks, constructing a population that was simultaneously representative and different. Unlike the Framingham investigators, the Jackson investigators incorporated the social dimensions of health disparities, in addition to lifestyle and genetics, into the study design. In chapter 3, Pollock traces the complexity of social processes that produced African American hypertension as a distinctive disease category—and the consequent emergence of the category of African American itself as a risk factor for heart disease. Moving to “durable preoccupations” in contemporary race science in later chapters, Medicating Race analyzes the debates about the salt-slavery hypothesis of hypertension, thiazide diuretics, and BiDil.

While arguing throughout the book for careful attention to biology in any constructivist analysis, for this reader Pollock underestimates the consequences of genetic essentialism and market imperatives in medicine. Yet, in making explicit the tensions in democracy embedded in the historical debates over black heart disease, this book provides fresh insight into a key aspect of the dilemma of difference: when and how to use race in contemporary research. Despite at least a decade of careful social and scientific scrutiny, the academic and public debate about race and race science is not, nor can it be, settled as long as race remains such a salient marker of inequality in U.S. society.

This theoretically sophisticated book does an excellent job of making many familiar STS concepts relevant to medical history. Placing current arguments over race and heart disease in a broad historical context, Pollock adds valuable nuance to the historiography of race and heart disease and their material-semiotic natures. For all its semiotic ambiguity, heart…

Mexico boasts a staggering genetic diversity, study shows

Los Angeles Times
2014-06-12

Geoffrey Mohan

SHARELINES

▼ DNA offers a nuanced answer to what it means to be Mexican
▼ Ancient genetic signal survived conquest in Mexico
▼ Latino and Hispanic labels don’t do justice to Mexico’s genome

Writers, artists and historians have long pondered what it means to be Mexican. Now science has offered its answer, and it could change how medicine uses racial and ethnic categories to assess disease risk, testing and treatment..

The broadest analysis of the Mexican genome ever undertaken reveals a nation of staggering genetic diversity, where European conquest only thinly masks the ancestral DNA of Native Americans, and where some populations remain as distinct from one another as Europeans are from Chinese, according to findings published Thursday in the journal Science.

Forty researchers, who share Latino heritage as well as professional qualms over the significance of ethnic and racial categories, teamed up across borders to analyze more than 1 million variations in the building blocks of DNA. They examined more than 500 samples collected in Mexico’s remote Indian villages and polyglot cities, and from Mexican Americans in California.

“Because these populations are so rich, so genetically differentiated, you can’t just lump them all in,” said lead investigator Carlos Bustamante, a population geneticist and co-director of Stanford University’s Center for Computational, Evolutionary and Human Genomics. “You really have to embrace that diversity and think about doing medical genetic studies on a very large scale.”

To illustrate their point, the researchers compared their new genetic data with the results of lung function tests for children in Mexico City and Latinos in the San Francisco Bay Area. They discovered that pulmonary function varied in ways that were mirrored in DNA. It was as if someone with a fraction of Maya ancestry had lungs that were 10 years older than someone with a bit of northern indigenous heritage…

…Researchers not involved in the study, however, caution that correlations between disease risk and ancestry may not have much of a genetic basis at all. In many cases, they might mask socioeconomic or environmental factors — where and how you live.

The suggestion that differences in DNA are responsible for observed differences in lung capacity “is an enormous leap,” said UC Berkeley sociologist Troy Duster, who has written extensively on the intersection of race, biology and public policy.

Lundy Braun, an Africana studies professor at Brown University who studies the intersection of race and medicine, said medicine’s focus on genetics may be overshadowing other avenues of research.

“The effects of social class on lung function have been largely ignored in favor of the focus on race and ethnic difference,” she said.

Braun and Duster worry that such genomic studies may unwittingly lend legitimacy to widely discredited ideas about racial disparities.

“There is always lurking danger that this kind of research, which emphasizes the genetic structure of ethnic and racial groups, fuels the notion that the biology or genetics of those groups explains their condition,” Duster said…

Read the entire article here.

Book Release of Prof. Lundy Braun’s Breathing Race into the Machine

Brown University
Providence, Rhode Island
Program in Science and Technology Studies
2014-03-26

This February, Royce Family Professor in Teaching Excellence, professor of medical science and Africana studies, and a member of the Science and Technology Studies Program, Lundy Braun released her new book Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics.

In her book, Lundy Braun traces the little-known history of the spirometer to reveal the ways medical instruments have worked to naturalize racial and ethnic differences, from Victorian Britain to today. An unsettling account of the pernicious effects of racial thinking that divides people along genetic lines, this book helps us understand how race enters into science and shapes medical research and practice.

In the antebellum South, plantation physicians used a new medical device—the spirometer—to show that lung volume and therefore vital capacity were supposedly less in black slaves than in white citizens. At the end of the Civil War, a large study of racial difference employing the spirometer appeared to confirm the finding, which was then applied to argue that slaves were unfit for freedom. What is astonishing is that this example of racial thinking is anything but a historical relic…

Read the entire article here.

Approaching race as a social rather than biological construct

The Daily Pennsylvanian
Philadelphia, Pennsylvania
2014-04-08

Laura Anthony

The Program on Race, Science and Society will examine the role of race in scientific research at upcoming symposium

In 1851, University of Pennsylvania Perelman School of Medicine graduate Samuel Cartwright delivered a report to the Medical Association of Louisiana claiming that blacks’ health was improved by slavery.

He theorized that forced physical labor improved blacks’ inferior lung capacity, so slavery was actually a necessity to bettering their health.

Penn Law School professor Dorothy Roberts first heard this anecdote from a talk by Brown University professor Lundy Braun detailing the history of the spirometer, a medical device used to measure lung capacity.

Some spirometers historically, and even in modern medicine, adjust the measurements according to the race of the patient. Cartwright used the device to justify the need for continued slavery to protect blacks’ health. Braun’s presentation included a picture of a modern spirometer with a button labeled “race,” and through numerous conversations with medical students, Roberts has found that some medical students are still trained to use spirometers based on patients’ race.

For Roberts, this is a major problem. “My definition of race is that it is a political system to govern people based on invented biological demarcation, and it is not a natural division of human beings,” she said. “So it is much more plausible that inequities in health that fall along racial lines are caused by social determinants.”

Braun’s talk sparked an idea for a future project in the new program she developed at Penn this year called the Program on Race, Science and Society…

Read the entire article here.

Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics

University of Minnesota Press
February 2014
304 pages
29 b&w photos
6 x 9
Cloth/jacket ISBN: 978-0-8166-8357-4

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

In the antebellum South, plantation physicians used a new medical device—the spirometer—to show that lung volume and therefore vital capacity were supposedly less in black slaves than in white citizens. At the end of the Civil War, a large study of racial difference employing the spirometer appeared to confirm the finding, which was then applied to argue that slaves were unfit for freedom. What is astonishing is that this example of racial thinking is anything but a historical relic.

In Breathing Race into the Machine, science studies scholar Lundy Braun traces the little-known history of the spirometer to reveal the social and scientific processes by which medical instruments have worked to naturalize racial and ethnic differences, from Victorian Britain to today. Routinely a factor in in clinical diagnoses, preemployment physicals, and disability estimates, spirometers are often “race corrected,” typically reducing normal values for African Americans by 15 percent.

An unsettling account of the pernicious effects of racial thinking that divides people along genetic lines, Breathing Race into the Machine helps us understand how race enters into science and shapes medical research and practice.

Contents

• Acknowledgments
• Introduction: Measuring Vital Capacity
• 1. “Inventing” the Spirometer: Working-Class Bodies in Victorian England
• 2. Black Lungs and White Lungs: The Science of White Supremacy in the Nineteenth-Century United States
• 3. Filling the Lungs with Air: The Rise of Physical Culture in America
• 4. Progress and Race: Vitality in Turn-of-the-Century Britain
• 5. Globalizing Spirometry: The “Racial Factor” in Scientific Medicine
• 6. Adjudicating Disability in the Industrial Worker
• 7. Diagnosing Silicosis: Physiological Testing in South African Gold Mines
• Epilogue: How Race Takes Root
• Notes
• Index

Defining race/ethnicity and explaining difference in research studies on lung function

European Respiratory Journal
Volume 41, Number 6  (June 1, 2013)
pages 1362-1370
DOI: 10.1183/09031936.00091612

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

Melanie Wolfgang
Brown University

Kay Dickersin, Professor, Director, Center for Clinical Trials
Johns Hopkins Center for Global Health
U.S. Department of Housing and Urban Development

The 2005 guidelines of the American Thoracic Society/European Respiratory Society recommend the use of race- and/or ethnic-specific reference standards for spirometry. Yet definitions of the key variables of race and ethnicity vary worldwide. The purpose of this study was to determine whether researchers defined race and/or ethnicity in studies of lung function and how they explained any observed differences.

Using the methodology of the systematic review, we searched PubMed in July 2008 and screened 10 471 titles and abstracts to identify potentially eligible articles that compared “white” to “other racial and ethnic groups”.

Of the 226 eligible articles published between 1922 and 2008, race and/or ethnicity was defined in 17.3%, with the proportion increasing to 70% in the 2000s for those using parallel controls. Most articles (83.6%) reported that “other racial and ethnic groups” have a lower lung capacity compared to “white”; 94% of articles failed to examine socioeconomic status. In the 189 studies that reported lower lung function in “other racial and ethnic groups”, 21.8% and 29.4% of explanations cited inherent factors and anthropometric differences, respectively, whereas 23.1% of explanations cited environmental and social factors.

Even though researchers sought to determine differences in lung function by race/ethnicity, they typically failed to define their terms and frequently assumed inherent (or genetic) differences.

Read or purchase the article here.

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.