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Anthony Valdez
Dr. Mary Scoggin
Anth. 410
March 8, 2013
“Race” Medicine
Introduction
Recently, the medical field have been making great strides in personalizing medicine.
However, in doing so, they took a giant leap backwards in the equality of healthcare. The hot
topic in medical research is the genetic studies of population differences in order to identify
diseases among specific ethnic groups in order to develop new targeted drugs. The heated
opinions center on whether this type of research is useful, or even ethical. Is this just one more
misstep in medicine‟s long history of race-related disasters? Throughout our anthropological
career we are taught that race has minimal relevance in our inner workings. In addition, research
has shown that there is more variation within populations than between populations. This paper
will review the literature for genetic studies of population differences, and against the genetic
studies of population differences.
Race as a Category in Epidemiology
Most statistics in the United States are stratified by race (Root, 2002). Because of this, it
is easier to document morbidity and mortality rates among a population. Epidemiologists
routinely use race as a control variable in their search for risk factors and typically find that race
is a good indicator of risk of death and disease in the United States (Jones et al, 1991). It is

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because of these classifications that we get statistics such as: blacks in the U.S. are seven times
more likely to die of tuberculosis than whites and three times more likely to die of HIV/AIDS
(Root, 2002). So, race, in the view of most epidemiologists, is an important category.
Many believed that race, for many years, was biological. They believed that blacks and
whites were divided by genes (Root, 2002). Today most biologist oppose the idea that race is
biologically determined. According to Root, “most epidemiologists believe that race can be
biologically salient category even though there are no biological races, and race can mark the
risk of a biological condition like diabetes or hear disease even though race is not itself a
biological condition but a social status.”
Use of race in a medical setting
Doctors sometimes use race as an individual variable, as a way to classify an individual
patient (Root, 2002). In addition, physicians use race an individual variable, for example, when
they use race as a proxy for an individual patient‟s response to a medical treatment or as a proxy
for a gene. Constance Holden, a writer for Science Magazine, reported that “researchers in the
last 35 years has uncovered significant differences among racial and ethnic groups in their rate of
drug metabolism, in clinical responses to drugs, and in drug side effects” (2003). According to
Root, “there is good evidence that race correlates with a disease, and that racial profiling in
medicine is reasonable and fair” (2002). “The reason that if it is legitimate for an
epidemiologists to stratify a population by race when explaining differences in disease rates with
the population, then it should be legitimate for doctors to divide their patients by race as well
when deciding how best to treat them” (2002).
Genetic studies of population differences

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Very few people dispute that some diseases affect disproportionately in some racial or
ethnic groups-thalassemia in people whose ancestors came from the Mediterranean area, sickle
cell anemia in people of African origins, for example (Holden, 2003). However, what scientists
are more concerned with the more subtle gene variants that occur in various populations and that
seem to influence a multitude of conditions (Holden, 2003). As of now, one of the main drug
trials that have been launched is directed at compensating for what is believed to be a nitric oxide
(NO) deficiency in many African Americans (Holden, 2003). In addition, other work that is
being done has to do with different levels of certain drug-metabolizing enzymes found in whites,
blacks, and Asians (Holden, 2003). Rosenberg et al explain that “most studies of human
variation begin by sampling from predefined “populations”- these populations are usually
defined on the basis of culture or geography and might not reflect underlying genetic
relationships” (2002).
“Population Profiling”
As stated before, as aspiring biological anthropologists, we are taught that race does not
exist-it is merely a myth. And that there are more variation within a population than between
populations. Although I do accept that certain diseases show up in certain populations, I believe
the science community is walking on thin ice when researching genetic differences among
groups. One must be wary of racial profiling and ignorance.
I agree with George Ellison when he explains that generating any data disaggregated by
race/ethnicity can fuel the use of biological reductionism or cultural essentialism to explain
inequalities in health (2005). In addition, by doing this, they are drawing on popular
misconceptions that groups categorized using race are homogeneous with innate genetic

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differences and/or distinct cultures (Ellison, 2005). It is believe that this practice will rationalize
differences and enact stereotyping and justify discrimination.
It has been proven that race does not exists biologically. However, it does not mean that
race doesn‟t exists at all. I accept the fact that race exists in cultural constructs, with that said, I
believe that there are many variables that come with establishing oneself a certain “race.” Some
of these variables include social class, cultural practices, and even genetic traits (Ellison, 2005).
Supports of the genetic studies of population differences say that racial data can be reliable, I
would have to disagree. Race/ethnicity appears inherently unreliable, there is little consensus on
what race/ethnicity means, or on how it should be defined and measured (Ellison, 2005). With
that said, racial data would be more reliable if there were a single official way of assigning race.
It will be more consistent if race is assigned in a single way. Therefore, although the evidence
that race matters in medicine is overwhelming, it not entirely reliable, for the data are not based
on a single understanding of race but many (Root, 2002).
Using race/ethnicity as a tool reflects too many assumptions about a group or groups.
Some might think that groups are relatively homogeneous, and the biological differences are
essential of group identity (Ellison, 2005). I accept that these assumptions might hold true for
some characteristics in a group, but they do not hold up for most characteristics (Ellison, 2005).
And using the data can create biases and not represent an entire population and some cultures
may be unrepresented.
The alternative of race medicine
There is no doubt that the body‟s ability to metabolize certain drugs can be influenced by
a genetic component. However, there are other ways of determining genetic variations in an

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individual without using race medicine. Personal genomics is a growing popular field in
medicine and offers the same personalized medicine as studies on genetic populations. Drug-
metabolizing genes have been characterized sufficiently to enable practitioners to go beyond
simplistic ethnic characterization and into the precisely targeted world of personal genomics (Ng
et al, 2008). There is a lot of variability in a group, and an example of this is CYP2D6, which is
involved in metabolizing codeine, antipsychotics, and antidepressants in African populations (Ng
et al, 2008). However, different population within Africa have different frequencies for variants
(Ng et al, 2008). Lumping together entire populations can obscure differences between
populations. The recent advent of whole-genome genotyping and whole-genome sequencing of
humans has opened up the possibility of personalized medicine-medicine based on many
individual characteristics in addition to ethnicity/race.
Conclusions
Although I agree with personalizing medicine by exploring differences among ancestral
groups as a way to learn more about complex diseases, I am concerned that this will play into
“racial” concepts. I agree that race is not biological, however, it is real enough in culture aspects
to be used in medicine, with a grain of salt. Unfortunately, or fortunately, race is such an
ambiguous concept and can vary from place to place. Ultimately, using race medicine helps
sustain a harmful racial ideology.

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Works Cited
Ellison, George T. H. "„Population Profiling‟ and Public Health Risk: When and How Should We Use
Race/ethnicity?." Critical Public Health, 15.1 (2005): 65-74.
Holden, Constance. "Race and Medicine." Science, 302.5645 (2003): 594-596.
Jones, C P, T A LaVeist, and M Lillie-Blanton. "'Race' in the Epidemiologic Literature: An Examination
of the American Journal of Epidemiology, 1921-1990." American Journal of Epidemiology,
134.10 (1991): 1079.
Ng, PC, Q Zhao, S Levy, RL Strausberg, and JC Venter. "Individual Genomes Instead of Race for
Personalized Medicine." Clinical Pharmacology & Therapeutics, 84.3 (2008): 306-309.
Root, Michael. "The Problem of Race in Medicine." Philosophy of the Social Sciences, 31.1 (2001): 20-
39.
Root, Michael. "The Use of Race in Medicine as a Proxy for Genetic Differences." Philosophy of Science,
70.5 (2003): 1173-1183.
Rosenberg, Noah A, Jonathan K Pritchard, James L Weber, Howard M Cann, Kenneth K Kidd, Lev A
Zhivotovsky, and Marcus W Feldman. "Genetic Structure of Human Populations." Science,
298.5602 (2002): 2381-2385.
Tishkoff, Sarah A, and Kenneth K Kidd. "Implications of Biogeography of Human Populations for 'Race'
and Medicine." Nature Genetics, 36.11 Suppl (2004): S21-S27.
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