Tanner Miller
Intern Draft 2
8/14/14
Race being used as a scientific variable has been a point of controversy in healthcare
for many years. Both sides of the argument have been defended and there are substantial
journals and reviews that agree with both sides of the controversy, all of which provide
adequate information to back their opinion on the issue. Prior to the Human Genome
Project, people believed your health outcomes were all dependent on your race. However,
after the sequencing of human genomes became available, it became clear that race is not
the only factor that determines our health outcomes. Science now explained how
commonalities and differences between people of the same race and of different races are
not strictly due to their race, but rather their genetics.
As mentioned before, the Human Genome Project successfully published a 90
percent complete sequence of all three billion base pairs in the human genome, which
make up our human DNA in February 2001. With this advance in science and technology,
we can better understand diseases, identify mutations, and improve the design of
medications. After this information became available, it was clear which genetics we all
shared and which ones we did not. This left the ones we do not share up for debate as to
whether it was due to racial factors or not.
Before we explore the idea of race as a scientific variable when looking at health
outcomes, it is important to first define ‘race’. Author of The Fundamentals of Biological
Anthropology, John H. Relethford, defines race as “a group of populations that share some
biological characteristics…these populations differ from other groups of populations
according to these characteristics.” The Encyclopedia Britannica Concise defines race as, “a
term once commonly used in physical anthropology to denote a division of humankind
possessing traits that are transmissible by descent and sufficient to characterize it as a
distinct human type.”
Later in both of these definitions, they go on to say how race is not a reliable factor
when it comes to science. In Nittle’s article, What is Race?, she writes about Relethford and
how he says that the race concept does not work well with humans because we rarely
remain isolated from one another in different environments. We are always living in a wide
range of environments, which allows for a large amount of gene flow among people of
different groups, which makes it hard to completely classify and organize these people into
discrete groups (Nittle, 2014). The encyclopedia entry on race goes on to say, “Because all
human populations today are extremely similar genetically, most researchers have
abandoned the concept of race for the concept of a cline, a graded series of differences
occurring along a line of environmental or geographical transition” (Encyclopedia
Britannica Concise). This means genes are always flowing from one gene pool to another
and this is the reason why currently all groups existing are “mixed’ genetically. Both of
these definitions include information on how environmental differences have a huge
impact on genetic changes and differences among groups of people. For this reason, we
should focus on genetics as well as environmental factors when assessing the health of
people of every population, not race.
Along with environmental differences being responsible for the reason why race
cannot be considered in determining health outcomes, cultural differences also have a big
impact in the race argument. People of the same race live in different cultures, which
impacts their health even with similar genetics. Culture is based on habits of a group not on
inherited behaviors. Diet is a big part of someone’s culture. A review was done on
nutrition-related cultural variation among three ethnic populations, African Americans,
Asian Indians, and Mexican Americans. The review demonstrated the crucial importance of
asking patients about their specific food habits in order to have any hope of providing
culturally appropriate advice for modifying traditional eating pattern to prevent and treat
type II diabetes” (Kulkarni, 2004). Even something as simple as someone’s usual food
intake has huge importance when determining health outcomes. Someone could identify as
one race, but eat foods from another culture and have that be the reason for their health
outcomes, not just because of their race.
Even after the completion of the Human Genome Project, there are still researchers
who argue race is still an important factor to consider. Burchard et al. and their article The
importance of race and ethnic background in biomedical research and clinical practice
mention that there are disorders that demonstrate clinically important racial and ethnic
differences in gene frequency (2003). They provide an example of this with analyzing the
susceptibility of Crohn’s Disease based on your race. They say, “susceptibility to Crohn’s
Disease is associated with three polymorphic genetic variants in the CARD15 gene in
whites; none of these genetic variants were found in Japanese patients with Crohn’s
disease. Another important gene that affects a complex trait is CCR5-a receptor used by the
human immunodeficiency virus (HIV) to enter cells. As many as 25 percent of white people
(especially in northern Europe) are heterozygous for the CCr5-delta32 variant, which is
protective against HIV infection and progression, whereas this variant is virtually absent in
other groups, thus suggesting racial and ethnic differences in protection against HIV”
(Burchard et al., 2003). Although these findings are true, they failed to consider outside
factors such as environment, culture, economics, etc. that would lead to these differences in
health outcomes for different groups of people rather than just looking at it based on race.
Race is not an effective scientific variable when determining health outcomes for
different groups of people. Even with everyone having similar genetics, there are too many
factors such as environmental, social and cultural that determine our health outcomes.
Environmental changes are a huge reason for the differences in genes among different
racial groups. If each different group of people were completely stationary in one
environment, then yes, race would be a scientific variable when determining health
outcomes among different groups. Same goes for cultural differences. If each racial group
were to maintain one culture and never mix, then yes, race would be a reliable scientific
variable when determining health outcomes for each racial group. “Race is fluid and thus
difficult to pinpoint scientifically” says Nittle. The high genetic flow and drift is causing a
mix of all races. For this reason, race should be excluded when determining health
outcomes of different groups of people.
References:
"A Brief History of the Human Genome Project." A Brief History of the Human Genome Project.
National Institute of Health, 8 Nov. 2012. Web. 13 Aug. 2014.
Burchard, E., Ziv, E., Coyle, N., Gomez, S., Tang, H., Karter, A., ... Risch, N. (2003). New England
Journal of Medicine. The Importance of Race and Ethnic Background in Biomedical Research and
Clinical Practice, 348(12).
"Encyclopedia Britannica Concise." Race. Merriam-Webster. Web. 13 Aug. 2014.
Nittle, N. (2014). What Is Race? Debunking the Ideas Behind This Construct. About News. Retrieved
from http://racerelations.about.com/od/understandingrac1/a/WhatIsRace.htm
Royal, C., & Dunston, G. (2004). Changing the paradigm from 'race' to human genome
variation. Nature Genetics, 36, S5-S7. Retrieved August 10, 2014, from
http://www.nature.com/ng/journal/v36/n11s/full/ng1454.html#B29