For my reading, I chose Troy Duster’s article on race and the pharmaceutical industry. In this article, he discusses how drug manufacturers in the early 2000’s started marketing drugs to specific ethnic groups. However, this research was not backed by science. The most famous example, isosorbide dinitrate/hydralazine, or BiDil for short, was originally rejected by the Food and Drug Administration by an advisory panel vote of 9-3 after it failed to show efficacy in a multiracial sample. However, when run in a clinical trial with only people who self-identified as African American, the results were significant. This was a problem for multiple reasons. First, the difference between racial groups in the original study was not significant enough to warrant further testing for one group. Second, there was no control group included in the next round of clinical trials, essentially voiding all data collected. When the FDA approved the drug in 2005, it was thus a prime example of race-based medicine, and one that exemplified race essentialism. BiDil was also endorsed by the Association of Black Cardiologists. This demonstrates a lack of understanding even in the medical field. While BiDil has become a token example of race-based medicine, it is still sold today. This clearly suggests that while some progress has been made in recent years, we have a long way to go. 

After this example, Duster further counters race-based medicine. Referencing research done by Michael Klag, Duster draws attention to the finding that rates of hypertension increase when skin color is darker. However, this finding is not biological or genetic in origin. Rather, it is a biological effect due to stress-related outcomes of reduced access to social goods like employment, housing, stock, etc. This, to me, highlights one of the most important points of the article: environment and mental health can impact physical health in tangible ways. Clearly this idea makes sense when we think about pollution and the effects that it has on lung function. But the fact that stress can cause physical ailments is less widely appreciated.

When reading this article about pharmaceuticals and race, I was reminded of the Coronavirus pandemic. When vaccines first became available, I remember hearing constantly that people of color were hesitant to get the vaccine. According to the Kaiser Family Foundation, 62% of the White population has received at least one dose of the vaccine compared to 57% of the Black population. This is not a large difference! Further, a study published in JAMA Network Open found that while Black individuals were slightly less intent on getting vaccinated than White individuals when COVID-19 vaccines were first introduced in December 2020, the hesitant Black community was more likely to eventually get vaccinated than the hesitant White community. This highlights the fact that we have, as a society, been convinced that there are vast differences between ethnic groups in all aspects of the medical field, even when these assumptions are not factually supported. Perhaps these differences are due to greater medical access limitations in Black communities. While it would be entirely wrong to dismiss the fact that different ethnic groups have different experiences, we need to realize that these differences are not genetic in origin. It is up to us to further the education of the public, and it is something that I personally plan to make a focal point of my medical career.

Pilar Ossorio is a leading scholar and microbiologist at the University of Wisconsin, who studies the ethical limitations and impacts of genetic research. In it, she describes how races are a socially constructed idea with physically and socially real impacts. Although race is artificially created in that it has no tangible basis in biology, I believe that everyone is impacted by their race.

Ossorio talks about how we vary genetically from each other by only .1%. This reminds me of the moment in the film where students were guessing which peers’ genes they would be the most similar to, and all of them thought they would share the most similarities with those who look the same as them but they found out that was not the case at all. This illustrates how we can hold presumptions that race indeed does have a biological basis which, in turn, legitimizes racism. For example, slavery in America was accepted because Americans genuinely thought that African Americans were subhuman, in that African Americans were inferior biologically. This in turn justified their horrendous treatment of the slaves. Because if African Americans were biologically equal to white landowners, they have no excuse for their behavior.

Furthermore, Ossorio discusses that race is not simply defined by one’s skin color but also one’s attitude, speech, etc. She talks about how the definition of being black and white can differ between geographical locations. That is undeniable support for the fact that race is socially constructed, because if the idea of race varies based on where it is found, because true facts remain immutable. Ossorio also notes that, although race is not biologically real, scientists should not completely dismiss race as a factor that may impact our social and biological health. This reminds me of a documentary that I watched called “When the Bough Breaks”. It discusses how the infant mortality rates of African American women in high socioeconomic classes is higher than that of white women in low socioeconomic classes. The conclusion that was drawn for this peculiar phenomenon is that African American women undergo constant stress like “a thousand little cuts” everyday due to the discrimination they have to face and react to due to their races. Therefore, I think it’s critical that there are scholars who intersect biology and humanities subjects like anthropology so that we can shed light on topics like this.

This is an Interview with Joseph Graves Jr., a professor of evolutionary biology at Embry-Riddle University. In this interview, Graves is asked about the concept of race and genetics through a set-up of questions that lay the framework for how exactly race is perceived, racial theory concepts, and then transitions to asking if race impacts athleticism. The first few questions ask about the conventional notions of race, criteria for racial classification, and the state of genetic diversity. Graves says that societal norms of the 19th century caused physical appearances to shape the definition of race. Additionally, race scientists during that time period pushed forward the idea that genetics played a major role in the creation of different races- which only further supported the mainly Eurocentric public view on race and the role of genetics (and the perpretation of eugenics). 

For the criteria for racial classification prompt, the characterization of race is boiled down to the fact that societal constructs and political events have shaped the way we view race nowadays. It is usually based on the physical characteristics of an individual but when analyzing the genetic components of people from various groups (such as Africans and Europeans), there is little genetic variation and actually even more genetic variation within groups then between groups. This is discussed in the question posed to Graves asking about genetic diverity in humans. He states that this simple fact can be easily proved using statistical analysis, and goes to show how there is actually less genetic variation between races then what race scientists used to state. 

With this information, the main point made is that genetics do not play a role in which races “dominate” which sport. He highlights America’s social history and how that has shaped people’s views into believing African people or people of African descent are pre-disposed to be better at football or basketball or running and white people are likely to excel at baseball or golf or soccer. However this is all untrue and Graves argues that there are certain genetic factors that may predispose certain people to be better at sports/athletics then others (such as Inuits versus Scandinavians), but geography/the environment and how people train also play a role in athletic capabilities, not only race. The most important thing Graves says is: “It has to do with the interaction of individual genetic background, of opportunity, and training, and I think we should get used to the idea that that’s what we’re going to know, and we shouldn’t be worried about the fact that we can’t locate the athletic gene.”

Throughout the implementation of modern medicine there’s been a large issue regarding to testing based on race. Assuming that different races respond differently to some medications places a large misconception towards how the differences in anatomy can be exploited for economic benefit.

In “A Racialized Medical Genomics: Shiny, Bright and Wrong,” Robert Wallace discusses how pharmaceutical companies have placed people of similar races into a larger “race” based on health concerns. By placing African Americans and other minority groups into the category of having worse health than other races, racism in the medical industry shapes how people of color are perceived not as humans but as subjects that are susceptible to deadly diseases. Regardless of someones health, they are placed in certain categories based on their genes and allelic structure.

Wallace then goes on to discuss how there are only two paths to genetics: one involving population disparities in health outcomes that are driven by racism, rendering genetics’s role ancillary. And the second being pushing back and declaring race genetic. Though a third path is discussed that states how biologists and social scientists may work together to disperse this notion of racism in the medical industry. By altering social circumstances of placing people into larger races based on genetics, biologists would be able to navigate the greatest impact towards population health in the future.

I remember when watching the film Race: The Power of Illusion that there was one example of a kid with sickle cell disease–a kid who was not Black. Sickle cell disease, often generalized as a Black disease, is common for being of several geographic origins and is dependent more on whether ancestors lived in places where malaria is prevalent than the color of one’s skin. Richard Garcia’s article, The Misuse of Race in Medical Diagnosis, adds onto this. One example that he gives is how a little Black girl was not properly diagnosed with cystic fibrosis until she was eight years old because doctors did not even think to check because of her race. This is dangerous. This fixation on race during preliminary health screenings is harmful, especially when race is assumed via physical appearance without looking closely at genetic and geographic ancestry, and can lead to misdiagnoses or people of all races with chronic illnesses not getting the support they need. When race is conflated with an individual’s genetic makeup, medicine perpetuates stereotypes and begins to base care on social constructs rather than accurate medical assessment. It is important to examine the symptoms before looking at skin color when deciding how best to assess and treat a patient.