{"id":5137,"date":"2010-02-08T19:50:07","date_gmt":"2010-02-08T19:50:07","guid":{"rendered":"http:\/\/www.mixedracestudies.org\/wordpress\/?p=5137"},"modified":"2017-06-17T01:04:07","modified_gmt":"2017-06-17T01:04:07","slug":"racial-categories-in-medical-practice-how-useful-are-they","status":"publish","type":"post","link":"https:\/\/mixedracestudies.org\/wp\/?p=5137","title":{"rendered":"Racial Categories in Medical Practice: How Useful Are They?"},"content":{"rendered":"

Racial Categories in Medical Practice: How Useful Are They?<\/a><\/em><\/strong><\/p>\n

PLoS Medicine<\/a>
\nVolume 4, Number 9<\/a> (September 2007)
\npages 1423-1428
\nDOI: 10.1371\/journal.pmed.0040271<\/a><\/p>\n

Lundy Braun
\n<\/strong>Departments of Pathology and Laboratory Medicine and Africana Studies
\nBrown University, Providence, Rhode Island<\/em><\/p>\n

Duana Fullwiley<\/a><\/strong>, Assistant Professor of African and African American Studies and of Medical Anthropology
\nHarvard University<\/em><\/p>\n

Anne Fausto-Sterling<\/a>
\n<\/strong>Department of Molecular and Cellular Biology and Biochemistry, Program in Women\u2019s Studies, and Chair of the Faculty Committee on Science and Technology Studies
\nBrown University, Providence, Rhode Island<\/em><\/p>\n

Evelynn M. Hammonds<\/strong>, Senior Vice Provost for Faculty Development and Diversity
\nHistory of Science and of African and African American Studies programs
\nHarvard University, Cambridge, Massachusetts<\/em><\/p>\n

Alondra Nelson
\n<\/strong>Departments of Sociology and African American Studies
\nYale University, New Haven, Connecticut<\/em><\/p>\n

William Quivers
\n<\/strong>Department of Physics
\nWellesley College, Wellesley, Massachusetts<\/em><\/p>\n

Susan M. Reverby<\/strong>
\nWomen\u2019s Studies Department,
\nWellesley College, Wellesley, Massachusetts<\/em><\/p>\n

Alexandra Shields<\/strong>
\nHarvard\/MGH Cente on Genomics, Vulnerable Populations and Health Disparities,
\nMassachusetts General Hospital
\nHarvard Medical School, Boston, Massachusetts<\/em><\/p>\n

The Trouble with Race<\/strong><\/p>\n

Is it good medical practice for physicians to \u201ceyeball\u201d a patient\u2019s race when assessing their medical status or even to ask them to identify their race? This question was captured in a 2005 episode of \u201cHouse M.D.<\/a>,\u201d\u00a0 Fox television\u2019s medical drama. In the episode, a black patient with heart disease refuses a hospital physician\u2019s prescription for what is clearly supposed to be BiDil<\/a>, the drug approved by the United States Food and Drug Administration only for \u201cself-identified\u201d African-Americans. Dr. House, on seeing the patient for followup, insists on the same prescription.\u00a0 The patient again refuses, telling House, \u201cI\u2019m not buying into no racist drug, OK?\u201d House, a white physician asks, \u201cIt\u2019s 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.\u201d The patient replies, \u201cLook. My heart\u2019s red, your heart\u2019s red.\u00a0 And it don\u2019t make no sense to give us different drugs.\u201d\u00a0 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?\u00a0 That an ACE (angiotensin-converting enzyme<\/a>) 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…<\/p>\n

Racial Categories Are Historical, Not Natural<\/strong><\/p>\n

…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\u00a0 deployed in different ways over time. For example, during the mid-19th to the early 20th centuries, at the height of US anxiety about \u201cmiscegenation,\u201d categories such as \u201cmulatto\u201d were vehicles for expressing and containing cultural anxiety about racial purity.\u00a0 Bolstered by scientific ideas about race, data collected on the numbers of \u201cmulattoes\u201d were shaped by the desire to prove that \u201chybrids\u201d would die out<\/a>…<\/p>\n

…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<\/a> ancestors. Thus, returning to the example of glaucoma<\/a>, it is more important to know a patient\u2019s family history than to assess his or her race.\u00a0 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<\/a> is ignored, those who identify themselves as \u201cwhite\u201d are assumed to have no ancestral \u201cblack blood.\u201d \u00a0Finally, immigration patterns constantly change. A \u201cblack\u201d person walking into a Boston, Massachusetts<\/a> clinic could easily be the child of a recent immigrant from Ethiopia<\/a> or Brazil<\/a> 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…<\/p>\n

Read the entire article here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Is it good medical practice for physicians to \u201ceyeball\u201d a patient\u2019s race when assessing their medical status or even to ask them to identify their race? <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,83,33,2039,8,26],"tags":[2090,2087,2085,2084,2086,2083,2082,2089,2088],"class_list":["post-5137","post","type-post","status-publish","format-standard","hentry","category-articles","category-brazil","category-census","category-health-medicine","category-media-archive","category-politics","tag-alexandra-shields","tag-alondra-nelson","tag-anne-fausto-sterling","tag-duana-fullwiley","tag-evelynn-m-hammonds","tag-lundy-braun","tag-plos-medicine","tag-susan-m-reverby","tag-william-quivers"],"_links":{"self":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts\/5137","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5137"}],"version-history":[{"count":4,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts\/5137\/revisions"}],"predecessor-version":[{"id":54242,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=\/wp\/v2\/posts\/5137\/revisions\/54242"}],"wp:attachment":[{"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5137"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5137"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mixedracestudies.org\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5137"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}