After describing
her personal experience with direct-to-consumer
genetic testing in Boston magazine and
the potential health risks to women of providing
eggs in Time, journalist Catherine Elton
has tackled what she calls "racial
profiling" in medical research. In this, she asserts, there is a bias
toward attributing health differences among races and ethnic groups to
genetic differences, even when no specific difference has been
identified. Using a recent paper that revealed significantly different
cancer survival rates between blacks and whites, Elton writes:
Experts within
the research community say a small but stubborn streak of racial
profiling has long persisted in the medical literature, borne out in
studies that attribute health disparities between blacks and whites not
to socioeconomics or access to health care alone but also to genetic
differences between the races — a concept that implies that a
biological category of race exists....
But even while [the cancer study] and other similar
studies don't do much to shift the prevailing medical opinion — that
disparities in health are fueled mainly by socioeconomics and access to
care — they remind us that antiquated and unscientific ideas about race
are alive and well in medical research in America.
Her
cited experts emphasize two perspectives that, while are not necessarily
contradictory, do present a certain tension. On one hand,
researchers note that there
are some genetic differences among
races—regardless of however socially-constructed these categories may
be—and some of these differences
do have medical implications.
Lisa Carey, a breast cancer specialist at the University of North
Carolina, believes that biological differences may well contribute to
differences in health, such as the one Albain [the lead researcher in the cancer study] found, but that any
discussion of race turns automatically contentious. "The idea of
differences between races has been fraught with misuse over the years,
and not just in medicine. Everyone is leery that it could be misused
again," she says. "So we have to be careful how we interpret it, but
that doesn't mean we should ignore it."...
For Albain's part, she says race is a surrogate for unknown genes —
which, scientists agree, play a significant role in health outcomes.
"When we find out what the [genetic] 'it' is, we will be able to test
everyone for 'it' and we will find some Caucasians who have it and some
blacks who don't and we won't be talking about black and white
anymore," she says.
On
the other hand, critics assert that the scientists are too quick to
attribute differences that can't be pinned on socioeconomic status to
race.
Every few years, in fact, a new study like Albain's materializes,
each following a remarkably similar logic: Researchers identify a
disparity in health outcomes (cancer survival or response to treatment,
for example) that falls along racial fault lines; investigators then
adjust for socioeconomic status, and, when the disparity persists,
conclude it must be genetic. That consistent failure of reasoning
bemuses Jay Kaufman, a McGill University professor of epidemiology who
studies health disparities. "Why are we still doing this study?" he
says. "If you are trying to make the argument that [different health
outcomes] must be genetic by exhausting other possibilities and saying
what is left over must be genes, well, that's never going to work.
There are a million things that affect people's lives. If you think
it's genes, then measure genes."...
[S]uch studies insistently conclude that, having controlled for
socioeconomics, there must be some unknown biological factor (as
opposed to some unknown social or cultural factor) at play, says David
Williams, a Harvard professor of public health and African American
studies. "The biology is a fall-back black box that many researchers
use when they find racial differences," he says. "It is knee-jerk
reaction. It is not based on science, but on a deeply held, cultural
belief about race that the medical field has a hard time giving up."
Elton concludes:
Fundamentally researchers do not dispute the fact that biology —
namely genetics — helps determine individual health outcomes. But the
practice of categorizing patients by race has yet to further the
discovery of significant gene mutations. What's more, say critics, it
promotes racial thinking while dismissing the more germane issue of
socioeconomics.
Previously in Biopolitical Times:
