Spirometry, Measurement, and Race in the Nineteenth Century

Posted in Articles, Health/Medicine/Genetics, History, Media Archive on 2012-10-27 21:43Z by Steven

Spirometry, Measurement, and Race in the Nineteenth Century

Journal of the History of Medicine and Allied Sciences
Volume 60, Number 2, April 2005
pages 135-169

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

Race correction is a common practice in contemporary pulmonary medicine that involves mathematical adjustment of lung capacity measurements in populations designated as “black” using standards derived largely from populations designated as “white.” This article traces the history of the racialization and gendering of spirometry through an examination of the ideas and practices related to lung capacity measurements that circulated between Britain and the United States in the nineteenth century. Lung capacity was first conceptualized as a discrete entity of potential use in the diagnosis of pulmonary disease and monitoring of the vitality of the armed forces and other public servants in spirometric studies conducted in mid-nineteenth-century Britain. The spirometer was then imported to the United States and used to measure the capacity of the lungs in a large study of black and white soldiers in the Union Army sponsored by the U.S. Sanitary Commission at the end of the Civil War. Despite contrary findings and contestation by leading black intellectuals, the notion of mean differences between racial groups in the capacity of the lungs became deeply entrenched in the popular and scientific imagination in the nineteenth century, leaving unexamined both the racial categories deployed to organize data and the conditions of life that shape lung function.

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Can Science Explain the Concept of Race?

Posted in Articles, Book/Video Reviews, Health/Medicine/Genetics, Media Archive on 2012-09-09 17:49Z by Steven

Can Science Explain the Concept of Race?

Volume 57, Release 16 (2012-04-18)
Article 4
5 pages

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

Amed Logrono, Senior Human Biology Major
Brown University

A review of Race and the Genetic Revolution: Science, Myth, and Culture by Sheldon Krimsky and Kathleen Sloan (Eds.) New York, NY: Columbia University Press, 2011. 296 pp. ISBN 978-0-231-15697-4 (paperback).

As many have written, genomics has ushered in a new era of disease- and behavior-related research. At the same time, biomedical researchers have become increasingly focused on health disparities. Consequently, when, how, and whether race should be used in medicine has been the topic of an intense, sometime contentious, and very public debate.

Less widely appreciated, though of perhaps even greater consequence, is that during this same period, there has been a radical expansion of DNA technologies for identifying individuals purported to be involved in criminal activities. The stakes in the use of DNA technologies in forensics are, if anything, higher than in the sphere of biomedicine. Race and the Genetic Revolution: Science, Myth, and Culture is a collection of essays, edited by Sheldon Krimsky and Kathleen Sloan, that address the intersection of race and genomics in several distinct but overlapping and mutually reinforcing spheres. It joins a growing number of books and edited volumes dedicated to exploring the origins and impact of the revitalization of the concept of race among scientists (see, e.g., Epstein, 2007; Roberts, 2011).

Race and the Genetic Revolution provides important insights into some of the most critical and highly charged applications of genomics. An important strength of this timely, engaging, and readable book—and what distinguishes it from some others—is the clarity with which it demonstrates how genomics findings in one discipline such as biomedicine are applied to other disciplines such as psychology, with the assumptions made about race unexamined…

…Although their perspectives vary, the majority of authors in this collection subscribe to the view that race is a social, not a biological, construction. They agree that historical classification systems based on physical and behavioral traits have established a hierarchy of human worth. Though it is not genetically defined, most authors argue that race is socially and politically real, with real social and biological consequences…

…That race is a social, not a genetic, construct is widely acknowledged, though not always well understood. To demonstrate the social nature of race, several authors point to changing classification systems over time and place and to the empirically demonstrated fact that the genetic variation within groups is greater than that between groups. None of the contributors denies the rich genetic variation that characterizes humans; what is at issue for the authors is whether this variation can be categorized scientifically and the uses made of the scientifically constrained data…

Read the entire review here.

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Racial Categories in Medical Practice: How Useful Are They?

Posted in Articles, Brazil, Census/Demographics, Health/Medicine/Genetics, Media Archive, Politics/Public Policy on 2010-02-08 19:50Z by Steven

Racial Categories in Medical Practice: How Useful Are They?

PLoS Medicine
Volume 4, Number 9 (September 2007)
pages 1423-1428
DOI: 10.1371/journal.pmed.0040271

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

Duana Fullwiley, Assistant Professor of African and African American Studies and of Medical Anthropology
Harvard University

Anne Fausto-Sterling
Department of Molecular and Cellular Biology and Biochemistry, Program in Women’s Studies, and Chair of the Faculty Committee on Science and Technology Studies
Brown University, Providence, Rhode Island

Evelynn M. Hammonds, Senior Vice Provost for Faculty Development and Diversity
History of Science and of African and African American Studies programs
Harvard University, Cambridge, Massachusetts

Alondra Nelson
Departments of Sociology and African American Studies
Yale University, New Haven, Connecticut

William Quivers
Department of Physics
Wellesley College, Wellesley, Massachusetts

Susan M. Reverby
Women’s Studies Department,
Wellesley College, Wellesley, Massachusetts

Alexandra Shields
Harvard/MGH Cente on Genomics, Vulnerable Populations and Health Disparities,
Massachusetts General Hospital
Harvard Medical School, Boston, Massachusetts

The Trouble with Race

Is it good medical practice for physicians to “eyeball” a patient’s race when assessing their medical status or even to ask them to identify their race? This question was captured in a 2005 episode of “House M.D.,”  Fox television’s medical drama. In the episode, a black patient with heart disease refuses a hospital physician’s prescription for what is clearly supposed to be BiDil, the drug approved by the United States Food and Drug Administration only for “self-identified” African-Americans. Dr. House, on seeing the patient for followup, insists on the same prescription.  The patient again refuses, telling House, “I’m not buying into no racist drug, OK?” House, a white physician asks, “It’s racist because it helps black people more than white people? Well, on behalf of my peeps, let me say, thanks for dying on principle for us.” The patient replies, “Look. My heart’s red, your heart’s red.  And it don’t make no sense to give us different drugs.”  Who is right here, House or his patient? And what does this episode tell us about the way race plays itself out in the physician-patient clinical encounter? What of clinical importance can be learned by making a quick racial assessment?  That an ACE (angiotensin-converting enzyme) inhibitor may not be effective? That screening for sickle cell anemia is a waste of time? Sorting patients by race may seem useful during a time constrained interview, but we argue that acting on rapid racial assessment can lead to missed diagnoses and inappropriate treatments…

Racial Categories Are Historical, Not Natural

…Racial definitions are historically and nationally specific. In her comparison of the history of racial categories in the US and Brazilian census from the late 18th century to the present, political scientist Melissa Nobles demonstrated that categories emerge and are  deployed in different ways over time. For example, during the mid-19th to the early 20th centuries, at the height of US anxiety about “miscegenation,” categories such as “mulatto” were vehicles for expressing and containing cultural anxiety about racial purity.  Bolstered by scientific ideas about race, data collected on the numbers of “mulattoes” were shaped by the desire to prove that “hybrids” would die out

…A dark-skinned, curly-headed person who identifies as African American may, indeed, have much in his or her history and upbringing to justify that identification. But he or she may also have a white grandparent and several Cherokee ancestors. Thus, returning to the example of glaucoma, it is more important to know a patient’s family history than to assess his or her race.  And collecting family history ought to mean not only compiling a list of which diseases family members have, but making some attempt to assess common (familial) habits such as diet and life experiences (e.g., first- versus second-generation immigrants, living conditions, or same versus widely varied work experience and geographical locations). Similarly, when the history of passing for white is ignored, those who identify themselves as “white” are assumed to have no ancestral “black blood.”  Finally, immigration patterns constantly change. A “black” person walking into a Boston, Massachusetts clinic could easily be the child of a recent immigrant from Ethiopia or Brazil who has a genetic makeup as well as cultural and environmental exposures that differ significantly from the descendents of 19th century US slaves from the western coast of Africa…

Read the entire article here.

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