Multiracial Medicine and the Genetic Revolution or… Confessions of a Closet Science Geek

TPR President Kendall Baldwin

Don’t you just love it when required summer reading is actually interesting and personally relevant?  My high school is a very demanding medically-themed career academy where every class is somehow connected to medicine. After a whirlwind summer, I was dreading the thought of plowing through all my reading in the last three days of vacation. That is until I opened Genetic Twist of Fate by Stanley Fields and Mark Johnston.

Fields and Johnson are not only distinguished geneticists, but master storytellers as well. They clearly explain the unprecedented progress scientists are making in discovering the genetic basis of disease and behavior as well as in the technologies used to analyze an individual’s DNA through fascinating true stories about the impact of one inherited gene rather than another on the health of their varied protagonists. It was interesting to learn the role of genes in such diseases as diabetes, Huntington’s disease, Alzheimer’s, cancer and more. But the aspects of the book that most enthralled me were those that directly pertain to our focus here at Project RACE on medical issues for multiracial people.

We have worked diligently on legislation involving bone marrow, cord blood, and stem cells, as progress in these areas will be of great benefit to the multiracial population. The first chapter that was particularly relevant to the progress we are advocating for dealt with both the scientific and ethical issues of regenerative medicine, primarily the use of embryonic stem cells in the treatment of disease.  I loved the simple way Fields and Johnston taught the function and operations of stem cells. Things I’d been hearing about for a long time now in school and in the news suddenly made perfect sense. They also introduced me to a new exciting alternative to embryonic stem cells that has recently burst onto the scientific scene: induced pluripotent stem cells, or iPS cells. These cells behave much like embryonic stem cells but can be obtained without the destruction of fertilized eggs, offering a path to regenerative medicine that is not plagued with messy ethical and political obstacles. This is a very promising discovery.

The authors later devote an entire chapter to the genetics of race, which begins and ends with the story of tennis legend Arthur Ashe. They acknowledge that, “given the history of race in America, the relationship between race and genetics is a landmine for researchers who attempt to study the subject.”  Addressing a host of hot issues including the definition of race, the dispute over racial categories, the question of which traits may have a race-specific genetic basis, using racial identity to find disease genes, and targeting drugs to certain racial groups dive into that landmine headfirst. These are some of the same issues I addressed in my previous TPR article, Mystery of Genetics in Multiracial Health Care

While recognizing the findings of the Human Genome Project they state that, “even when the statisticians account for economic inequality in access to healthcare and treatments, certain diseases have a much greater prevalence or significantly more severe outcomes in certain populations traditionally viewed as races.” By speeding through a 200,000 year history of humans, our geographic clustering and the spreading of our genetic variations in gradients, they begin to show why this is the case and what it means to us today.

This brings us to questions we at Project RACE have been asking for a very long time: If you are multiracial, or have parents from two distinct genetic “groupings”, which the authors say “you can call races if you want”, how are your risks determined?  If a pharmaceutical has been proven effective for one of your parents’ “grouping” but not the other, how will it affect you? Growth of the multiracial population is keeping pace with growth in the field of genetics. But is the field of genetics paying attention to us?

This is the first in a new TPR series of book reviews on books that are about, by or of special interest to multiracial people. If you have a book review you would like us to consider for our website, please email it to me (Kendall) at teenprojectrace@projectrace.com

SPECIAL NOTE: Proper identification in medicine is of critical importance. If you encounter medical forms that do not follow the current standards, allowing you to mark more than one race, please bring them to our attention by emailing the name and contact information for the medical facility and the form (if possible) to: Susan Graham susangraham@projectrace.com