Race in Biomedicine

two levels where race is used in biomedical sciences

Population level (describing variations in morbidity/mortality) and individual level (diagnosis and treatment of individual patients).

OMB racial categories

The federal government's racial categories used by both population studies and clinicians to classify people, treating race and Hispanic ethnicity separately.

how race is used in epidemiology

Race is used to describe or explain differences within a population in the risk of injury, illness, or death.

how race is used in pharmacology

Studies show differences between OMB races in metabolism of drugs, which are clinically significant and recommend differences in treatment.

racial profiling in medicine

When statistical generalizations from population-level research are employed in individual medical decision-making.

problem with assigning race in research

No standard way; Census uses self-reports, National Center for Health Statistics uses birth/death certificates; these can differ.

complication of mixed-race individuals in biomedical research

No standard definition or criteria for assigning race to mixed-race individuals.

geographic ancestry vs folk race categories

Geographic ancestry captures medically relevant genetic variation better than folk race categories; less genetic variation within common ancestry groups than within racial groups.

mismatch problem in biomedical race classification

Folk race categories often do not align with genetic ancestry, leading to inaccurate predictions for individuals.

proxy variable in biomedicine

One variable X is used in place of another Y when Y cannot be measured directly; race is sometimes used as a proxy for geographic ancestry or risk factors.

eliminativism in biomedicine

The view that race's problems (social harm, poor fit) are sufficient grounds to eject race from biomedicine entirely.

conservationism in biomedicine

The view that race's usefulness in addressing health disparities and biological differences justifies its continued use in biomedicine.

major conservationist argument

Racial profiling in medicine is an important response to doctors' past indifference to racial differences in risks and treatment responses, and the only way to address major health disparities.

secondary conservationist argument

Differences among races are biological facts worthy of study; they only become problematic when used in pernicious value-laden ways for political ends.

eliminativist objection about race as cause

Even if there are average genetic differences between folk races, there are no race genes or chromosomes, so no reason to treat race as an independent variable that causes or explains differences.

eliminativist alternative to race

Use patient's actual genetic profile instead of racial categories.

restricted conservationism

Race concepts are not inherently unacceptable; only their incautious use is problematic. Race can be biological without being genetic because social environments create biological differences.

how race can be biological without being genetic

A social environment constructed with racist patterns of health benefits and detriments creates biological differences among racial groups.

National Research Council recommendation on race measurement

Rely on multiple methods of measurement to capture all the different ways race can affect health.

Institute of Medicine advice on race data

Collect not only broad race/ethnicity data but also locally relevant granular ethnicity data.

Cluster Stability Rule

Researchers can investigate particular populations but should not assume findings in one subgroup apply to all subgroups in that continental grouping.

Patient Standpoint Rule

Individual patients' needs and interests deserve highest priority; considerations of patient care supersede qualms researchers have about using race concepts.

Excluded Beneficiary Rule

When choosing between models or trial designs, prefer options that benefit subpopulations that would otherwise be neglected.

Permissibility Principle

It is acceptable to prevent a subpopulation from getting a treatment if that treatment would harm the normal functioning of other patients.