Book Review: Sheldon Krimsky and Kathleen Sloan, eds., Race and the Genetic Revolution: Science, Myth, and Culture. NY: Columbia University Press, 2011.

by Kenneth W. Krause.

Kenneth W. Krause is a contributing editor and “Science Watch” columnist for the Skeptical Inquirer.  Formerly a contributing editor and books columnist for the Humanist, Kenneth contributes regularly to Skeptic as well.  He may be contacted at krausekc@msn.com.

There’s no point in telling someone that being “black,” for example, no longer matters in the 21st Century.  As history plainly demonstrates, it will continue to matter profoundly so long as “blackness” exists.  The more helpful and, as it turns out, honest approach might be to explain that “race”—like clairvoyance, transcendence, or holiness, for instance—is, in reality, all in our heads.

We have a knotty problem indeed whenever society accepts or even emphasizes what science deems a dangerous myth.  In 1972, geneticist Richard Lewontin told us that more genetic diversity exists among West Africans than between West Africans and Europeans.  We also know that disease polymorphisms are totally inconsistent with the 19th Century notion of taxonomic race, and that blood types don’t sort by geographic region.

Yet the notion of race endures.  Why—and who should be targeted for blame?  Don’t waste all of your arrows on the easiest, most familiar targets—the uneducated or otherwise unworldly xenophobes who will likely never come within spitting distance of this publication or any remotely like it.  Racism is far more inclusive these days, even if seldom referred to as such.

Personal case in point: My former fiancée and I recently applied for a marriage license in Wisconsin.  Upon arrival, the county clerk asked each of us to designate our race.  “None,” we replied in turn, choosing our responses carefully.  But the clerk typed “refused” on our application, nevertheless, as she apparently had been instructed to do.

But the racist bug continues to spread deeper into the well-meaning but wrong-headed bastions of polite society.  Earlier this year, the University of Wisconsin-Madison—notably liberal and otherwise highly respected in scientific circles—was criticized for its admissions policies that intentionally discriminate against two races in favor of two others.

In 2010, the U.S. Census Bureau endeavored to segregate more than 300 million highly intermixed Americans into fourteen discrete racial categories.  And even social scientists routinely employ self-identified race as a variable in international studies—despite the fact that the concept’s meaning varies from country to country.

But, thankfully, we can depend on the “harder” sciences and their more rational practitioners to promote a relatively systematic and objective approach.  Or can we?

In his introduction to Race and the Genetic Revolution, Tufts University community health specialist and co-editor Sheldon Krimsky (along with human rights advocate Kathleen Sloan) confirms that race amounts to nothing more than a “scientific myth,”—a “vestigial cultural artifact” persisting only in our “minds and public policies.”

Race emerged from two projects launched by the Council for Responsible Genetics.  The first examined the effects of expanded DNA databases on racial disparities in criminal justice.  The second, more interesting to me, explored how modern scientific—especially medical—practices have actually revived a dangerous concept that should have been tagged and bagged years ago.

In a concise historical essay, contributor and Drexel University public health expert, Michael Yudell, considers the recent “upsurge” in race-based medicine and its possible drivers.  The genetic revolution, he finds, combined with our noble desire to resolve certain health disparities—especially in hearth disease, cancer, and diabetes, for example—has scientists rummaging for solutions in every possible direction.

Unfortunately, many well-intentioned researchers have reverted to race.  According to Yudell, this reckless trend suggests that “an analysis of the complex relationship between individuals, populations, and health will be surrendered to a simplistic, racialized worldview.”

Enter BiDil, a drug manufactured to treat heart failure.  A small Massachusetts biotech company called NitroMed brought BiDil to the FDA in 2001, expressly requesting race-specific approval.  Based on a trial in which every participant self-identified as “African American,” the FDA acceded in 2005.  The drug was subsequently labeled as indicated only for blacks.

In reality, however, BiDil is just a combination of two generic vasodilators—hydralazine and isosorbide dinitrate—used without regard to race for more than a decade.  Deeply troubled by the BiDil story for a number of reasons, contributor and Hamline University professor of law, Jonathan Kahn, indicts the FDA for opening a “Pandora’s box of racial politics.”

First, he says, no scientific evidence has ever suggested that race has anything to do with how the drug works.  BiDil was never evaluated on a control population of non-blacks, after all.  Nor did common sense support the drug’s designation.  The FDA never approves and companies never market the numerous drugs tested only on white people as “white drugs.”  Second, had NitroMed requested and acquired only race-neutral approval, its patent would have expired in 2007 rather than 2020.  Though scientifically inappropriate, in other words, the company’s strategy was very impressive from a purely economic perspective.

Third, one wonders who counts as “African American”—or “black,” as BiDil’s label designates.  Should we revert to Jim Crow era blood ratios to figure it out?  Are Australian Aborigines or dark-skinned South Asians included?  Fourth, race-based labeling might prevent non-blacks from obtaining beneficial or even life-saving medicine, and, in effect, it might render insurance companies the defining agents of race.  Finally, the author stresses, by granting race-specific approval, the federal government fallaciously endorsed the use of race as a biological category.

Khan’s argument, however, is not that race should never play any role in genetic research.  “There may be occasions where race can be productively used,” he instructs, but we must “differentiate between using a racial group to characterize a gene versus using a gene to characterize a race.”  It is entirely acceptable, for example, to study the Pima Indians of the American Southwest to characterize the genetic basis for diabetes.  But scientists should never employ genetics to brand the Pima as a people burdened with the gene or genes for diabetes.

The proponents of “racialized medicine” thus allege the reliable predictability of a person’s disease predisposition through determination of his or her biological race.  Critics, on the other hand, emphasize the lack of any solid and consistent bases for biological race.  And even if such foundations existed, they say, we could never be certain that members of one race would share specific disease-related genes distinct from those of other races.

Contrastingly, advocates of evolutionary medicine claim that diseases result from combinations of infection, genes, novel environments, design compromises, and evolutionary legacies.  Affecting all humans, the first and the latter two tend not to cause health disparities.

In the United States, these discussions focus on maladies like cancer, stroke, heart disease, and diabetes—all of which are influenced by several genes along with copious environmental factors.  Thus, to address health disparities, according to Joseph Graves, Jr., contributor and biologist at North Carolina A & T University, “we really must utilize the full intellectual arsenal of evolutionary genetics.”

The evolutionary theory of aging informs us that genes causing certain diseases in old age can be either neutral or beneficial early on in life (mutation accumulation or antagonistic pleiotropy, respectively).  Stomach cancer represents one such evolutionary legacy in mammals generally.   In the U.S., however, the disease tends to afflict East Asians at a higher rate than others.  But contrary to common medical opinion, according to Graves, the primary explanation for this disparity is obviously not genetic.  Rather, infection, frequent tobacco use, high salt intake, and low fruit and vegetable consumption are more culpable.

The National Institutes of Health spends $2.7 billion on health disparity research every year.  But much of the resulting literature presumes genetic predisposition—a false paradigm and a “fool’s errand,” Graves concludes, that will persist until both the government and the science it supports choose to abandon the bizarre and highly toxic concept of race.

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