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June 28, 2005
Does Race Matter in Biomedical Research?
This is an old Forum piece, but I still wanted to post it: In Heart pill for blacks nears FDA approval, Glenn Howatt reports that the FDA is close to approving BiDil®, the first race-based drug for heart failure, which is actually a combination of two drugs, both of which are available in generic form. I attended a conference here at the U last spring, Proposals for the Responsible Use of Racial and Ethnic Categories in Biomedical Research, held at the Law School. I posted about the conference on my blog, and in that post, I describe the crux of the dilemma of whether or not to use racial and ethnic categories in biomedical research:
One thing that wasn't on the 'net when I first posted my notes from the conference but is up now: videos of the presentations! I think it's great that they are making these presentations publicly available. Score one for public understanding of science.Basically the conference's discussion centered on a specific dilemma: Race is, many scientists argue, a biologically meaningless category (though some, including those who have a stake in BiDil, would disagree); therefore, it shouldn't be used as a category in biomedical research. Using it brings associations with biological determinism and perhaps eugenics-tinged value judgments based on racist ideologies. Plus, attributing medical conditions to race ignores a host of other factors, including location; as Morris Foster argued in his talk, participants in studies are often aggregated by race in order to make statistically significant claims, but location plays a critical role in one's health. Isn't it possible, Foster asked, that the people living in one's same town -- whether they're the same race or not -- the people one interacts with on a daily basis, have more of an effect on one's health than people of the same race who live 1000 miles away? (Especially given environmental toxins, epidemics of infectious disease, etc.) Foster supports his arguments with data from a study he's doing on three rural African American communities in Oklahoma and three local tribal communities in Oklahoma.
However, in a racist society with clear disparities in wealth that are closely correlated with race, race can't be dismissed entirely. African Americans and whites do not have equal access to health care (this includes referrals to specialists, health insurance, expensive prescription drugs, etc.), and if you do look at health problems by race, the social context of health and disease is revealed, and as common sense would tell us, there's far more to health than genetics. As Dorothy Roberts argued, reducing health to genetics and looking for a solution in a pill (which not everyone could afford) lets the state off the hook. There are good reasons, from a social responsibility/public policy standpoint, to keep racial and ethnic categories in biomedical research.
Related: a three-part series in the Washington Post on racial and cultural diversity and mental health:
Registration required, but you should be able to use BugMeNot to bypass it.
Comments
I think Clancy is very courageous to post this blog as it is or can be a very controversial subject. I know that studies have not generally included non-white populations and researchers want to make general statements about all people based on one group. I think this also applies to the lack of medical research that has been conducted about women. Again, trying to make general observations and statements about women, based on studies completed on the male population.
Although I agree that studies need to consider race, culture and ethnicity in their research, I am very cautious about researchers and the scientists making classifications and presenting findings based on any particular group. This, I believe, could lead to even more racial disparities.
Posted by: Debbie at June 28, 2005 7:38 PM