Thursday, May 23, 2013

Race, Biology and Medicine

Here's an interesting article in The Atlantic that puts the critiques of Jason Richwine's doctoral dissertation into a larger theoretical perspective. You can go to the original article here, but I copied and pasted it below.


Race Is Not Biology

By Merlin Chowkwanyun
race is not biology main.jpg
aspidoscelis / flickr
During the past two weeks, much outrage has arisen over former Heritage Foundation staffer Jason Richwine's Harvard doctoral dissertation, which speculated that IQ differences between "Hispanic" and "non-Hispanic' populations were genetically rooted. The claims mirrored those of Richard Herrnstein and Charles Murray's scurrilous The Bell Curve: Intelligence and Class Structure in American Life, which made similar claims about the intelligence of blacks. (Murray receives thanks in Richwine's dissertation acknowledgments and filed a piece recently in defense of Richwine at the National Review Online.)

The fury continues. In the past couple days, a group of scholars has circulated a petition excoriating Harvard for approving the dissertation and condoning scientific racism in the process. Their petitionsituates Richwine within an odious lineage stretching back to the era of eugenics and charges that his work rests on shoddy intellectual foundations. (These scholars are right: the late J. Phillipe Rushton, best known for claiming associations among race, brain size, and penis length, is cited by Richwine.) A group of 1,200 Harvard University students has also put together their own petition .
But the attacks on Richwine are missing something far more insidious than neo-eugenic claims about innately inferior intelligence between races. The backlash against Richwine and Murray, after all, gives some indication that their views are widely considered beyond the respectable pale in the post-Bell Curve era. Richwine and Murray are really extreme branches of a core assumption that is much more pervasive and dangerous because it isn't necessarily racist on the surface: the belief in biological "races." This first assumption is required to get to claims like Richwine's, which argue that between Race A and Race B, differences exist (in "intelligence" or whatever else) that are grounded in the biological characteristics of the races themselves. Public outcry always greets the second Richwine-Murray-esque claim. But the first assumption required to reach it is more common and based on as shaky an intellectual foundation, even as it continues to escape equal scorn.
Even so, the critique of biologically innate race is hardly new. In 1972, the Harvard biologist Richard Lewontin famously observed more genetic variation within populations than between them, undercutting the case for fixed and timeless genetic boundaries that demarcated "races." A basic grasp of American racial history shows that today's commonly accepted racial categories -- what the historian David Hollinger calls the "ethno-racial pentagon" - have hardly looked that way during the nation's history. As I wrote in a 2007 piece, "the numbers, names, and members of respective races are always in flux. Go somewhere else on the planet or step back a century, and you'll likely encounter a different racial schema all together," pointing to the Dillingham Commission of the United States Congress, which wrote a century ago: "Some writers have reduced the number of such basic races to 3, while others have proposed, 15, 29, or even 63." The Commission went with five."
But since that piece, the belief in the intellectual validity of racial biology has persisted, along with claims about specific outcomes allegedly associated with distinct "races," including disease rates, physiological abilities, or intelligence. ("Intelligence" is the only one of the outcomes, it seems, to land one in trouble, as Richwine learned.) Disease information sheets available online and in physicians' offices are one common means of reinforcing the notion of biological races. For example, the popular site WebMd.com notes that "Caucasian and Asian ancestry" is a risk factor for developing osteoporosis, which elides the enormous heterogeneity (genetic and otherwise) that actually exists within the "Caucasian" and "Asian" classifications. Another WebMD fact sheet on hypertension similarly declares that "high rates of high blood pressure in African-Americans may be due to the genetic make-up of people of African descent." Just last week, in a news story accompanying actress Angelina Jolie's op-ed detailing her preventive mastectomy, three New York Times reporters wrote: "Mutations in BRCA1 and another gene called BRCA2 are estimated to cause only 5 percent to 10 percent of breast cancers and 10 percent to 15 percent of ovarian cancers among white women in the United States.
The mutations are found in other racial and ethnic groups as well, but it is not known how common they are," unintentionally accepting the premise that traits and characteristics of bounded racial and ethnic groups might contribute to differences in disease incidence among them. The medical literature (and uncritical reporting about it) is replete with other examples that perpetuate the notion of biological race as a key factor in disparate disease outcomes. (Elsewhere, NYU sociologist Ann Morning, in her fascinating The Nature of Race: How Scientists Think and Teach about Human Difference, has documented other channels through which biological notions of race are disseminated.)
In the past decade, a small but growing sub-field, anchored in multiple disciplines, has begun criticizing the unthinking racial essentialism that finds its way into scientific research more frequently than one might think, especially in medicine and public health orbits. One exemplar is the article " "Racial Categories in Medical Practice: How Useful Are They?" which appeared in PLOS Medicine. Its authors first review the degree to which common conceptions of race have in fact historically shaped by administrative imperatives (not biological reality). They then issue a warning on the use of race as a proxy, writing that "once race is presumed, the ways in which multiple genetic inheritances interact with the environment within that individual seem to disappear. Clinical clues can become invisible."
The dangers are not hard to see. Belief in innate racial predisposition to a disease may short-circuit examination of non-genetic factors behind a racially classified individual's condition, or in the population at large, health disparities between commonly understood racial groups. At its worst, it may lead to compromised patient care. The PLOS Medicine writers warn that for clinicians specifically, "rapid racial assessment is an attractive means to figure out what to do with a presenting patient. But we argue that even if there are short cuts for the medical interview, race is not a good one. There is, in the end (in addition to noting physical symptoms), no substitute for an inquiry into family history, an assessment of current circumstances, and knowledge about the biological and cultural histories of specific populations serviced by a particular treatment center."
The critique has not been easy to mount as biological notions of race are embedded in American thought. Drexel University's Michael Yudell and Brown University's Lundy Braun (one of the authors of the PLOS article) have completed two important forthcoming books showing just the extent. Yudell traces the notion throughout the twentieth century, demonstrating its remarkable resiliency even in the face of periodic challenges inside and outside formal scientific worlds. (A distilled article version of his book is here). Braun's work, meanwhile, examines a specific case: the history of lung function measurement and the entrenchment of different diagnostic criteria for different "races" - a practice called "race correction," in turn premised on the belief in biological race. In a recent disturbing review of almost a century's worth of pulmonary research, published in the European Journal of Respiratory Research, Braun and her colleagues found that biological-racial explanations for differences in lung faction are common, though they also found a fair share of articles with environmental explanations as well. The biological-racial strand of explanation, they note, is not just history:
 While the view that races and ethnic groups differ in the capacity of their lungs is widely accepted in pulmonary medicine, the continued practice of explaining racial and ethnic difference in lung function as rooted in inherent and fixed anthropometric difference has important health policy implications. Importantly, it could divert attention from much-needed research into the physiological mechanisms by which specific social and physical environments influence lung function.
In the end, calling Jason Richwine a scientific racist may be morally satisfying and justifiable intellectually. But it doesn't begin to touch on the wider and much more common commitment to biological race that is necessary in the first place before one argues for "racial" superiority or inferiority. Scientific racism, in other words, requires scientific race.
In and of itself, the biological race concept does not necessarily lead to claims of racial superiority or inferiority. But it certainly can lead there, or less malevolently, can obfuscate a complex litany of explanations for explaining observable population differences. Those condemning Harvard over Richwine would do better to avoid low-hanging fruit and instead turn their attention to those around them who accept common assumptions about race and biology. The latter have much more in common with Jason Richwine than might appear at first glance. And given the pervasiveness of talking in terms of "race," we all may be more complicit than we think.
This article available online at:
http://www.theatlantic.com/health/archive/2013/05/race-is-not-biology/276174/

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