The role of race in scientific research

5/10/2002 The role of race in scientific research 1

The role of race in scientific researchMay 10, 2002

Victor J. Schoenbach, Ph.D.vjs@unc.edu

School of Public Health, Department of Epidemiology and Minority Health Project (www.minority.unc.edu)

Oral Epidemiology for Health Policy and Administration (HPAA 228)

An epidemiologist is someone who doesn't know what he's talking about –

and makes you feel it’s your fault.(adapted from the Internet)

(So let’s all talk.)

Outline

• Why study race?

• What is race?

• Race vs. ethnicity

• Socioeconomic status

• Racism and American apartheid

• Diversity in the professions

Why we should not study race

• Sordid history of race research -

• Race “science”

• Eugenics

• Difficult (impossible?) to define – biological? cultural? political?

• Not a biological construct

• Not scientifically nor anthropologically based

Why we should not study race

• Can’t really measure it

• May stigmatize

• May distract from more modifiable risk factors• May implicitly encourage assimilation of minority

ethnic groups to the Western norm (Chaturvedi, 2001)

Why we should study race

• Public health: to eliminate “profound and consequential oral health disparities within the US population in relation to … race or ethnicity” (Oral health in America, 2000) – without data, disparities don’t “exist”

• Scientific understanding: race is one of the strongest, most consistent predictors of health status

What is race?“1. an ethnic stock or division of mankind; in a narrower sense, a national or tribal stock; in a still narrower sense, a genealogic line of descent; a class of persons of a common lineage. In genetics, races are considered as populations having different distributions of gene frequencies. 2. a class or breed of animals; a group of individuals having certain characteristics in common, owing to a common inheritance; a subspecies. (Source: Taylor EJ. Dorland's Illustrated Medical Dictionary. 27th ed. Philadelphia, W.S. Saunders, 1988, quoted in LaViest, 1996)

What is race?

“Persons who are relatively homogeneous with respect to biological inheritance. In a time of political correctness, classifying by race is done cautiously,1,2 although some organizations, e.g., the American Public Health Association, ask members to record their racial/ethnic group on membership forms.…” Last, John M. The dictionary of epidemiology 3rd ed. NY, Oxford, 1995 1 Cooper R, David R. 1986; 2 Osborne NG, Feit MD. 1992

What “races” exist?• African-American / Black / Negro / African –

greater genetic diversity than any other “race”

• Asian – enormous diversity of language, religion, culture, . . . (40% of world population)

• American Indian – over 550 federally recognized tribes, languages, cultures

(OMB categories, a “social-political construct designed for collecting data on the race and ethnicity of broad population groups in this country” [quoted from Oppenheimer 2001])

Historical view of race

Racism as a political/social/scientific force in Western Europe arose from: (1) nation states, ethnic group identify; (2) subjugation of native Americans; (3) African slave trade. Modern racism then received a “scientific” rationale and justification (Cooper and David, 1986)

Historical view of race• English colonization of Ireland – “savages”,

“uncivilized”, “lazy”, “loose”

• English colonists applied same characterizations to American natives and asserted that their “savagery” was inborn.

• Africans were “heathens”, then biologically inferior, the “antithesis of the English colonists”

(Oppenheimer 2001 citing Takaki and others)

Historical view of race• 19th century – “scientific” evidence of

heritability of morals, intellectual capacity, social differences between Blacks and Whites

• Blacks have inherited immunity to malaria, typhoid, tonsilitis, mumps, influenza but more prone to TB

• “Mixed race” Negroes especially vulnerable(Oppenheimer 2001)

Historical view of race“Communicable diseases find their favorite propagating grounds in the dirty negro sections of our cities, and in insanitary negro homes in the country. From dirty homes, in these disease-infested sections, negro people come into intimate contact with white people every day that passes.…The fact is not pleasant to contemplate, but it is nevertheless true, that there are colored persons afflicted with gonorrhea, syphilis, and tuberculosis employed as servants in many of the best homes in the South. Various disease often spread this way.”37

37 Allen IC. The Negro health problem. Am J Public Health 1915, reprinted in Gamble VN, 1989, 59-68, quoted in Oppenheimer 2001

Historical view of race• “Human variation is self-evident; the existence of

definable groups, or races, is not.”

• Geographic variation in gene frequency is mainly quantitative in nature.

• Human variation is primarily discordant.

• “Simultaneous treatment of many continuous variables … is the only appropriate method for studying human variation.”

(Cooper and David, 1986)

President’s Cancer Panel (1997)

• “Race as used in the United States is a social and political construct derived from our Nation’s history. It has no basis in science or anthropology.”

• “Biologically distinct races do not exist.”

• “Neither is there a genetic basis for racial classification.”

• “Racism, rooted in the erroneous concept of biological racial superiority, has powerful societal effects and continues to influence science.”

From the letter of transmittal to the President from Harold Freeman, 1/30/1998

Race vs. ethnicity“‘Race’ had been associated with supposed biological variation, which to many observers essentially meant distinct genetic differences between groups. This notion has been discredited, with a clear demonstration that genetic variation between ‘racial' groups is small, and considerably less than that between individuals from the same supposed racial group.5,6 Racial categorization based on these criteria are therefore inaccurate and misleading, yet studies persist in using this term.7” (Chaturvedi, International Journal of Epidemiology, 2001)

Race vs. ethnicity

“In contrast ‘ethnicity', the increasingly preferred term, is a complex construct of, assuredly biology, but also culture, language, religion, and, importantly for epidemiologists, distinct health beliefs and health behaviours. Therefore ethnicity cannot be treated as if it were another epidemiological exposure, such as smoking or cholesterol levels, as it encompasses a range of exposures, both biological and environmental.” (Chaturvedi, International Journal of Epidemiology, 2001)

Race vs. ethnicity“The [IOM] committee recommends an emphasis on ethnic groups rather than on race in NIH’s cancer surveillance and other population research. This implies a conceptual shift away from the emphasis on fundamental biological differences among ‘racial’ groups to an appreciation of the range of cultural and behavioral attitudes, beliefs, lifestyle patterns, diet, environmental living conditions, and other factors that may affect cancer risk.”Haynes MA, Smedley BD, eds. The unequal burden of cancer, quoted in Thomas SB, 2001.

Hispanic ethnicity• A cultural group – to a great extent share language,

religion, customs, history, geography – but also very diverse

• Mixture of American Indians, Europeans, Africans, and Asians, perhaps even more than North Americans – doesn’t “race” matter if one speaks Spanish?

• Latin America also subjugated Indians and enslaved Africans

Referent group

• “White” as the referent group (not a “racial/ethnic population”) – why?

• First “race”? – African

• Largest “race”? – Asian

• First “race” in America? – American Indians

• Who chooses?

Ethnocentricity

“Ethnocentricity is the inherent tendency to view one’s own culture as the standard against which others are judged.11… It will impinge on the design, aims, and methods of studies and the presentation and interpretation of results, making ‘value free’ observation impossible.11”

Senior PA, Bhopal R, BMJ, 199411Bond J, Bond S. Sociology and health care. Edinburgh, Churchill Livingstone, 1986

Race/ethnicity is largely a political construct

• History – U.S. and everywhere else

• “Race science” has followed history and political needs

• “Hispanic”, but not “Polish”, “Jewish”, “Irish”, etc. (before 1930 were called “races”)

• Classification schemes (e.g., “one drop rule” and contemporary)

Measuring race and ethnicity

• By observation vs. self-report

• Multiracial category

• Different races for different contexts?

• Inconsistencies over time, between data sources

“Socioeconomic status”

• Closely tied to race and ethnicity primarily for historical reasons

• History of most ethnic groups in U.S. – poverty, discrimination, advance, discriminate, become “white”

• Extensive legal and extra-legal forces to keep African Americans down

Socioeconomic status

• More scientific, but hard to define, measure

• Not part of routine data systems in U.S.

• Typically oversimplified – education, income, occupation

• Wealth disparities much greater than income disparities

Some reasons why SES hard to control for

• Grade in school ignores quality of education

• Income return on education differs

• Prices paid differ

• Family assets, expertise, information, access

• Public goods / community wealth and services

• Vehicles, appliances, needs

SES not the whole story

• America is more race conscious than class conscious (“classless society”, anti-Communist, anyone can succeed – historically true compared to Europe, but less so for nonwhites)

• Race and ethnicity are often more visible, impede upward socioeconomic mobility

Racism and American apartheid

“The problem of the Twentieth Century is the problem of the color line …” (W.E.B. DuBois, The souls of black folk, 1903)

Atlanta bus, 1956Source: Southern Poverty Law Center,

Intelligence Report issue 99, Summer 2000

www.splcenter.org

Governor George Wallace, stood in the doorway of the University of Alabama to

block its integration

Source: Southern Poverty Law Center, Intelligence Report issue 99,

Summer 2000www.splcenter.org

Firebombed bus carrying Freedom Riders into

Alabama in 1961

Civil rights workers James Chaney, Andrew Goodman, and Michael Schwernerdisappeared in Mississippi in 1964

Source: Southern Poverty Law Center, Intelligence Report issue 99, Summer 2000www.splcenter.org

Civil rights activist Vernon Dahmer died defending his family from a nighttime firebombing by the Klan, Hattiesburg MS, January 10, 1966;

he had been trying to register blacks to vote

Source: Southern Poverty Law Center, Intelligence Report issue 99, Summer 2000www.splcenter.org

1963 bombing of the 16th Street Baptist Church,

Birmingham, Alabama

Not shown

• Latinos

• Asian Americans

• Pacific Islander Americans

• “White” ethnic groups

• American Indians – the first immigrants

The Neo-Confederate movement

Neo-Confederate hate groups

Diversity in the professions

• Where is it?

• How long have we been talking about it?

• How long will it take?

• What will it take?

• Scientists make policy as well as science

“As we enter the 21st century, institutional racism remains an insidious and largely unmeasured obstacle to improving and eliminating the disparate health status of African Americans in America.” National Colloquium on African American Health, National Medical Association, March 12, 2001

Colleges and universities in the South - including NC remain “segregated and unequal” – 1995 report issued by the Southern Education Foundation

Resegregation in American Schools(Harvard University Civil Rights Project, Orfield G, Yun JT, June 1999)

• The American South is resegregating• Latino students are more segregated than

African Americans• African American and Latino students are

enrolled in suburban schools, but segregated• Most racial groups attend diverse schools;

whites remain in overwhelmingly white schools

• Spreading segregation has a strong class component.

• Non-white schools tend to have concentrated poverty; white schools almost always enroll high proportions of students from the middle class.

• Title I has had great difficulty achieving gains in schools where poverty is highly concentrated.

• Desegregation usually puts minority students in schools which have better opportunities and better prepared peer groups.

• Most white Americans believe that equal educational opportunity is being provided; national political leaders have largely ignored the growth of segregation in the 1990s.

• Educational policy decisions (e.g., testing) could punish students in segregated schools.

• In 1990, one-in-four African American males age 20-29 years was under some form of criminal justice supervision – in prison or jail, on probation, or on parole.

• In 1995, the figure was 32% on any given day

Selected bibliographyBhopal, R. (1998). Spectre of racism in health and health care: lessons from history and the United

States. BMJ 316: 1970-1973

Chaturvedi, Nish. Ethnicity as an epidemiological determinant - crudely racist or crucially important Intl J Epidemiol 2001;30:925-927

Cooper R, David R. The biological concept of race and its application to public health and epidemiology. J Health Polit Policy Law 1986; II(1):97-116

Gamble VN, ed. Germs have no color line: blacks and American medicine, 1900-1940. NY, Garland, 1989

Haynes MA, Smedley BD, eds. The unequal burden of cancer: an assessment of NIH research and programs for ethnic minorities and the medically underserved. Washington DC, National Academy Press, 1999

Institute of Medicine. Unequal treatment in American health care, 2002

Jones, Camara Phyllis. Levels of racism: theoretical framework and a gardener's tale. Am J Public Health 2000;90:1212-1215.

LaViest, Thomas A. Why we should continue to study race … but do a better job: an essay on race, racism and health. Ethnicity and Disease 1996;6:21-29.

Selected bibliography

National Colloquium on African American Health (Hood RG et al.) Racism in medicine and health parity for African Americans: “The slave health deficit” National Medical Association Concensus Paper, March 12, 2001

*Oppenheimer GM. Paradigm lost: race, ethnicity, and the search for a new population taxonomy. AJPH 2001;91:1049-1055

Orfield G, Yun JT. Resegregation in American schools. The Civil Rights Project, Harvard University, June 1999. www.law.harvard.edu/civilrights/publications/resegregation99.html

Osborne NG, Feit MD. The use of race in medical research. JAMA 1992;267:275-279

Senior PA, Bhopal R. Ethnicity as a variable in epidemiological research. Br Med J 1994;309:327-30.

Thomas SB, 2001. The Color Line: race matters in the elimination of health disparities. AJPH 2001; 91:1046-1048.

The role of race in scientific research

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