Medical Concerns and Race

 

A debate is taking place on social media regarding medical concerns and the multiracial community. It is a life and death issue and should not be taken lightly. Some critics have stated that since race is a “social construct,” we are all the same biologically and there are no physical differences. Therefore, they believe, that any medical differences are non-existent and should not be studied further. They believe that the reason for not having racial classifications is that no human medical differences have been found.

Project RACE finds the critics short-sighted and their beliefs dangerous. Perhaps there are physical and/or neurological differences or maybe not. We just do not know, but that is not a reason to cancel medical studies and findings. It is not a reason to prematurely do away with racial categories, although there may be other reasons in other circumstances. We can look mostly at the area of the need for donor increase for life-saving bone marrow and the need for as close to a racial and ethnic match as possible. If there were no physical differences in these areas, why would race and ethnicity be important? Obviously, these include very specific requirements in the medical realm. We simply cannot act as if it doesn’t exist. Bone marrow matching by race and ethnicity is a critical life and death matter.

Tay-Sachs is a disease that affects mostly Jewish people. Sickle Cell Anemia is mainly found in African Americans. There are many more examples. Should we discount race as a factor in medicine? Absolutely not; we should be finding out more. We must take the high road and push for more information to be sought, unlike our critics.

It’s lovely to live in a world where you think there are no racial and/or ethnic differences and perhaps that is true, but the truth is we just don’t know—not enough work has been done. An article appeared in U. S. News and World Report by HealthDay Reporter Maureen Salamon on December 6, 2018 called “Breast Cancer Deadlier for Black Women, Despite Same Treatments, which was revealed by a new trial. They did adjust for lifestyle differences and found that some drugs were metabolized differently by racial groups. The article can be read here:

https://www.usnews.com/news/health-news/articles/2018-12-06/breast-cancer-deadlier-for-black-women-despite-same-treatments

And here is another plea; http://www.fox46charlotte.com/news/4-year-old-alameda-girl-diagnosed-with-rare-genetic-disorder-family-urging-donors-to-join-registry

We need more of these kinds of studies, not fewer. We need to enlarge the pool of multiracial donors for bone marrow, not act as though it’s not a problem. We have a long way to go to save lives. We can’t afford to turn away.

 

 

 

Photo Credit: Depositphotos

RACE MATTERS

RACE MATTERS

Racial disparities in medical outcomes have emerged as an important topic in quality healthcare. Differences in outcomes have been associated with socioeconomic status, but new data are emerging that indicate certain cancers may have differing biology based on ethnicity. Below are links for some of those studies.

Inflammation, Race, and Atrial Fibrillation

http://www.practiceupdate.com/journalscan/21305/2/2?elsca1=emc_enews_daily-digest&elsca2=email&elsca3=practiceupdate_cardio&elsca4=cardiology&elsca5=newsletter&rid=NTk3MzgyODQ0ODIS1&lid=10332481

Genetic Differences Between Primary Breast Cancer Among Black and White Women

http://www.practiceupdate.com/journalscan/21601/2/0?elsca1=emc_enews_daily-digest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTk3MzgyODQ0ODIS1&lid=10332481

Comparative Effectiveness of ACE Inhibitor–Based Treatment on Cardiovascular Outcomes in Hypertensive Blacks vs Whites

http://www.practiceupdate.com/c/29626/2/2/?elsca1=emc_enews_daily-digest&elsca2=email&elsca3=practiceupdate_cardio&elsca4=cardiology&elsca5=newsletter&rid=NTk3MzgyODQ0ODIS1&lid=10332481

Effect of African-American Race on Tumor Recurrence After Radical Cystectomy for Urothelial Carcinoma of the Bladder

 http://www.practiceupdate.com/c/29430/2/0/?elsca1=emc_enews_daily-digest&elsca2=email&elsca3=practiceupdate_uro&elsca4=urology&elsca5=newsletter&rid=NTk3MzgyODQ0ODIS1&lid=10332481

 Blacks fare worse than whites after heart attacks

http://www.reuters.com/article/2015/09/14/us-health-racedisparity-heart-attacks-idUSKCN0RE27I20150914

 

 

 

Medical Monday

Race, Ethnicity May Affect Breast Cancer Survival

New research finds biological differences in tumor type, behavior
 Your chances of being diagnosed with early breast cancer, as well as surviving it, vary greatly depending on your race and ethnicity, a new study indicates.

“It had been assumed lately that we could explain the differences in outcome by access to care,” said lead researcher Dr. Steven Narod, Canada research chair in breast cancer and a professor of public health at the University of Toronto. In previous studies, experts have found that some ethnic groups have better access to care.

But that’s not the whole story, Narod found. His team discovered that racially based biological differences, such as the spread of cancer to the lymph nodes or having an aggressive type of breast cancer known as triple-negative, explain much of the disparity.

“Ethnicity is just as likely to predict who will live and who will die from early breast cancer as other factors, like the cancer’s appearance and treatment,” Narod said.

In his study, nearly 374,000 women who were diagnosed with invasive breast cancer between 2004 and 2011 were followed for about three years.

The researchers divided the women into eight racial or ethnic groups and looked at the types of tumors, how aggressive the tumors were and whether they had spread.

During the study period, Japanese women were more likely to be diagnosed at stage 1 than white women were, with 56 percent of Japanese women finding out they had cancer early, compared to 51 percent of white women.

But only 37 percent of black women and 40 percent of South Asian women got an early diagnosis, the findings showed.

When the researchers calculated the seven-year risk of death, black women had the highest risk, with a 6 percent death rate. South Asian women (Asian Indian, Pakistani) had the lowest, at less than 2 percent.

And black women were nearly twice as likely as white women to die following the diagnosis of small tumors, according to the study published Jan. 13 in the Journal of the American Medical Association.

The new research “makes significant strides in explaining the well-known racial disparities in breast cancer,” said Dr. Bobby Daly, a hematology-oncology fellow at the University of Chicago Medical Center. He co-authored an editorial that accompanied the study.

“It makes strides in showing how the difference in survival may reflect intrinsic differences in the biology of the tumor,” he added.

However, there still needs to be improvements in access to care, treating women according to established guidelines and avoiding treatment delays, Daly noted.

Regardless of race or ethnicity, women should be aware of any family history of breast cancer, be aware of other risk factors they may have, and obtain appropriate screening with mammograms, he said.

Women in minority groups must also be included in greater numbers in future research, the authors of the editorial said.

Medical Monday

The Social Science Creed and Evolution

 “Racism and discrimination are wrong as a matter of principle, not of science. Science is about what is, not what ought to be. Academics, who are obsessed with intelligence, fear the discovery of a gene that will prove one major race is more intelligent than another. But that is unlikely to happen anytime soon. Although intelligence has a genetic basis, no genetic variants that enhance intelligence have yet been found.”

From A Troublesome Inheritance: Genes, Race and Human History by Nicholas Wade

Medical Monday

This is a very interesting TedMed talk!

http://tedmed.com/talks/show?id=17961

 

Medical Monday

Medicine and Race

In the article on pharmacogenomics and race,” authors Rothstein and Epps define the following definitions for discussion purposes: The term “race” is defined as a distinct ethnic group characterized by traits that are transmitted through their offspring. An ethnic group is a social group or category of the population that, in a larger society, it set apart and bound together by common ties of race, language, nationality or culture.