Race


Definition



Race is a cultural and social construction that classifies humans into groups based on heritable biological characteristics, common geography and shared customs. It is a concept that is subject to cultural interpretation, and varies in meaning across cultures and throughout history.[1]

Racism, or racial discrimination, is the belief that a group of people with certain features common to all members, or "race," is inferior to another race.
Despite the acceptance by the anthropological community that race is not a biological category, race-as-biology is still used in health research as a means of classification and explanation.


In medical anthropology, race is studied from both a biological and a sociological viewpoint. Medical anthropologists recognize that, in addition to biomedical influences, the social environment matters. As medical anthropologist Clarence Gravlee notes, “racism affects people’s lives in ways that aren’t fully captured by education or by income or occupation.”[2]

Biological variation between human beings reflects both hereditary factors and the influence of natural and social environments. In most cases, these differences are due to the interaction of both.[3] For instance, human height is a trait that is inherited from parents through genes, but can also be affected during developmental life stages. Natural and social environmental factors, such as severe illness or perceived racism, experienced prenatally by the mother or during childhood, can cause changes in human height.

There is great genetic diversity within all human populations. Traits have high frequencies in some places, with diminishing frequency as geographic distance increases (also known as clinal variation). Genetic variation within a ‘racial’ group is much greater than variation among races. “Evidence from the analysis of genetics (e.g., DNA) indicates that most physical variation, about 94%, lies within so-called racial groups. Conventional geographic 'racial' groupings differ from one another only in about 6% of their genes.”[4]

Race as a biological category is inherently unable to explain the intricate and changing nature of human biological variation. “There is no clear place to designate where one race begins and another ends.”[5] Thusly, we cannot use race as a factor for identifying people, and hence can't use it as a factor for predicting diseases, for example.

Pure races, in the sense of genetically homogenous populations, do not exist in the human species today, nor is there any evidence that they have ever existed in the past.[6] The only true race is the human race.




History


The concept of race comes from the old European belief that the world was fixed and unchanging. European physical anthropologists created racial classification groups based on physical characteristics such as human skin color, hair type and skull measurements. In the 17th and 18th century, these early racial groups were referred to as Caucasoid, Mongoloid, and Negroid.




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Types of the Human Race
In the 18th century, the idea of race was exercised to classify European colonizers and the peoples they colonized. It was used to rationalize European treatment of the people they conquered and enslaved across the world.


“From its inception, this modern concept of 'race' was modeled after an ancient theorem of the Great Chain of Being, which posited natural categories on a hierarchy established by God or nature. Thus "race" was a mode of classification linked specifically to peoples in the colonial situation.”[7]

Racial categories during colonial times emphasized the differences between the Europeans, Africans, Native Americans, Indians and Asians and created a system of hierarchy. Traits of Europeans were considered superior to traits possessed by the natives. The inequality was justified on the basis that racial differences were natural or God-given.


The concept of race spread to other parts of the world. In the 19th century scientists conducted studies that were meant to support the idea that racial groups were different physically and biologically, and that some traits were inferior. Studies of skeletal remains, especially craniometry of Native American skulls, put forth the possibility that other races may even be separate species. These studies justified social, economic and political inequalities.


Franz Boas, a prominent American anthropologist in the early 20th century, argued against assumptions of innate racial inferiority. His research showed evidence that cranium size changed over time due to environmental influence.
“The old idea of absolute stability of human types must, however, evidently be given up, and with it the belief of the hereditary superiority of certain types over others”[8]
He insisted that culture, not nature, explained differences among people.




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Franz Boas
In the mid-twentieth century, the concept of race was further altered as a reaction to violent treatment of peoples based on perceived race. During World War II, Nazism made an argument for racism based on biological differences, and the United States government interned Japanese Americans. Despite these events, and others such as the civil rights movement of the 1960’s, the idea that race is biologically-based continues to pervade U.S. society.



Recently anthropologists have begun to reach a consensus on race. The American Anthropological Association’s official statement on race asserts that race is a real social and political process:
“Given what we know about the capacity of normal humans to achieve and function within any culture, we conclude that present-day inequalities between so-called "racial" groups are not consequences of their biological inheritance but products of historical and contemporary social, economic, educational, and political circumstances.”[9]




Case Studies in Race and Health




Hypertension

Hypertension is a chronic medical condition more commonly known as high blood pressure. A recent study by the American Heart Association reveals that over 40% of all African American adults live with chronic hypertension, while approximately 30% of white adults suffer from the condition. Living with untreated hypertension can lead to serious long-term effects in African Americans. The National Institutes of Health reports that African Americans experience kidney failure from hypertension at a rate of six times higher than whites.[10] Hypertension also tends to occur earlier and be more severe, resulting in mortality more often, in blacks than in whites.[11]


Dr. Janis Hutchinson, noting recent FDA approval of the drug BiDil for heart failure specifically in African Americans, has said that,
“Race has long been considered a biological trait and a predictor of health in medical studies in the same way that age and sex are. However, what we now know about the human genome tells us that human biological diversity does not conform to groups described as races. Genes linked to skin color have not shown to be determinants of disease.”[12]

It is important to note that vulnerability to hypertension does not derive exclusively from genetic sources. The American diet contains an abundance of salt, especially low-cost fast food that is more affordable for poor minorities, such as blacks. Their dietary environment, combined with experiences of racism, social inequality, and economic deprivation can lead to an increase of blood pressure and disease such as hypertension.[13]

A correlation has been shown between racial discrimination and mental distress and increased cardiovascular response (CVR). When placed under increased stress, as may happen when a person is subjected to racial discrimination, the body will increase nervous system activities, resulting in increased epinephrine secretion (responsible for “fight or flight” response) and elevated blood sugar, blood pressure and heart rate.[14]

Clarence Gravlee et al, in a study conducted in Puerto Rico, examined the relationship between skin color and blood pressure within populations of African ancestry.
“The pattern we observe is consistent with the hypothesis that social classification based on color entails differential exposure to social stressors related to blood pressure. In particular, there is ethnographic evidence that Puerto Ricans perceived as negro, as compared to trigueño or blanco, may encounter more frequent frustrating interactions in high-SES settings due to institutional and interpersonal discrimination.”[15]
The study results suggest that associations between genetic ancestry and health may not be might be accounted for by genetic differences between races, but by socio-cultural factors, such as racism.



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Clarence Gravlee
The American Anthropology Association’s Understanding Race Project provides some examples of how race and genes interplay in regard to the issue of hypertension, including the following studies. These studies have actually shown that continuous exposure to racial discrimination can cause an increased and maintained elevated CVR in African Americans. For example:
- African American women who experienced racial discrimination but did not report it were more likely to display hypertension than African American women who did report. (Krieger and Sidney, 1996).
- Extended exposure to aversive racism may have a cumulative effect leading to hypertension. (Merrit et al., 2006).
- Upper-class African American men with a darker complexion were more likely to have hypertension than African American men with a lighter complexion. Dressler hypothesized that African American men with a darker complexion were exposed to a higher level of racial discrimination because of the prevalence of stereotypes correlating darker skin with a lower economic status. (Dressler, 1991).
The above research strongly suggests that, as opposed to race being a direct genetic factor in predicting health, it is the societal perception of race that is significant.[16]




Race and Birth Weight

Preterm deliveries and low birth weight are the second leading cause of infant mortality in the United States. Low Birth Weight is defined as <2500 grams, and very low birth weight is defined as <1500 grams. Among African Americans, it is the first leading cause. In fact, African American women are two to three times more likely than white women to deliver preterm. For the past twenty years, workers and experts in the birth world have been fighting to bring these numbers down. There has been some success, with the overall number of preterm births reduced. However, this gain has been coupled with a widening black-white gap in infant mortality, with whites exhibiting a decline in preterm births at a much greater rate than blacks.[17]


Many epidemiological studies have attempted to explain the difference in terms of factors such as maternal age, education, lifestyle, and socio-economic position. However, the results of these studies show that, at best, these factors can account for only a tiny portion of the difference. Studies show that college-educated black mothers are more likely to deliver low birth weight infants than white college-educated mothers. Also, women who recently migrated to the United States are more likely to have infants of a higher birth weight than women in the same race/ethnic category born and raised in the United States, despite the majority of the migrant women falling into a lower socioeconomic class. These studies suggest “that growing up as a woman of color in the U.S. is somehow toxic to pregnancy, and imply a social etiology for racial/ethnic disparities in prematurity that is not solely explained by economics or education.”[18]

Similar to the studies showing a link between race and hypertension discussed above, studies have shown that the common factor among African American women having preterm births and low birth weight babies may be a common, negative experience. Among all socioeconomic levels, African American women who reported experiences of racial discrimination at least three or more times proved to be at more than three times the risk for preterm delivery than women who have never experience racial discrimination.[19]

Factors that might contribute to the disparity include racial differences in maternal medical conditions, stress, lack of social support, previous preterm delivery, and maternal health experiences that might be unique to black women.[20]



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UCLA OB/GYN Dr. Michael Lu believes that for many women of color, the experience of racism over a life time, increases the risk of preterm delivery. He suggests that to improve birth outcomes we must address the conditions that impact women's health not just when they become pregnant but from childhood, adolescence and into adulthood.





Resources


Race: The Power of an Illusion. An online companion to a 3-part documentary on race in society, science and history http://www.pbs.org/race/



Race: Are We So Different? A project of the American Anthropological Association http://understandingrace.org/

Clarence Gravlee’s website http://www.gravlee.org/

Racism and Low Birth Weight 101, including an informative slideshow http://www.theunnecesarean.com/blog/2010/9/28/racism-and-low-birth-weight-101.html

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References



  1. ^
    Wiley, Andrea & Allen, John.
    2009. “Race and Ethnicity and Health in the United States” In: Medical Anthropology: A Biocultural Approach. New York: Oxford University Press. Pp. 346-54
  2. ^
    Gravlee, Clarence
    2010 “Is Race Really Linked To Hypertension?” National Public Radio. Interview with Michel Martin, September 29 http://www.npr.org/templates/story/story.php?storyId=130212972&f=1128&sc=17
  3. ^
    American Association of Physical Anthropology
    1996 AAPA Statement on Biological Aspects of Race, In: American Journal of Physical Anthropology, vol. 101:569-570
  4. ^
    Smedley, Audrey
    1998. American Anthropological Association Official Statement on Race http://www.aaanet.org/stmts/racepp.htm, accessed 24 Sept 2010
  5. ^
    Goodman, Alan.
    2000. Why genes don’t count (for racial differences in health). In American Journal of Public Health 90(11):1669-1702
  6. ^
    American Association of Physical Anthropology
    1996 AAPA Statement on Biological Aspects of Race, In: American Journal of Physical Anthropology, vol. 101:569-570
  7. ^
    Smedley, Audrey
    1998. American Anthropological Association Official Statement on Race http://www.aaanet.org/stmts/racepp.htm, accessed 24 Sept 2010
  8. ^
    Boas, Franz
    1912 “The Instability of Human Types,” in Papers on Interracial Problems Communicated to the First Universal Races Congress Held at the University of London, July 26- 29, 1911, ed. Gustav Spiller. Boston: Ginn and Co. Pp. 99–103
  9. ^
    Smedley, Audrey
    1998. American Anthropological Association Official Statement on Race http://www.aaanet.org/stmts/racepp.htm, accessed 24 Sept 2010
  10. ^ American Anthropological Association
    2007 “Heath Connections: Do our Genes Determine our Health?” Race: Are We So Different? http://www.understandingrace.org/humvar/biotech.html, accessed 26 Sept 2010
  11. ^ Wiley, Andrea & Allen, John.
    2009. “Race and Ethnicity and Health in the United States” In: Medical Anthropology: A Biocultural Approach. New York: Oxford University Press. Pp. 346-54
  12. ^
    American Anthropological Association
    2007 “Heath Connections: Do our Genes Determine our Health?” Race: Are We So Different? http://www.understandingrace.org/humvar/biotech.html, accessed 26 Sept 2010
  13. ^
    Wiley, Andrea & Allen, John.
    2009. “Race and Ethnicity and Health in the United States” In: Medical Anthropology: A Biocultural Approach. New York: Oxford University Press. Pp. 346-54
  14. ^
    American Anthropological Association
    2007 “Heath Connections: Do our Genes Determine our Health?” Race: Are We So Different? http://www.understandingrace.org/humvar/biotech.html, accessed 26 Sept 2010
  15. ^
    Gravlee, Clarence; Amy L. Non; Connie J. Mulligan
    2009 “Genetic Ancestry, Social Classification, and Racial Inequalities in Blood Pressure in Southeastern Puerto Rico” PLoS One 4(9): e6821.
  16. ^
    American Anthropological Association
    2007 “Heath Connections: Do our Genes Determine our Health?” Race: Are We So Different? http://www.understandingrace.org/humvar/biotech.html, accessed 26 Sept 2010
  17. ^
    Center for Disease Control
    2002. ”Infant Mortality and Low Birth Weight Among Black and White Infants - United States, 1980—2000” in Morbidity and Mortality Weekly Report 51(27):589-592
  18. ^
    Rich-Edwards, J; Nancy Krieger, J Majzoub, Sally Zierler, E Lieberman, M Gillman
    2001.”Maternal experiences of racism and violence as predictors of preterm birth: rationale and study design” In: Paediatric and Perinatal Epidemiology. Vol 15:124-135
  19. ^
    Lock, M and V. Nguyen
    2010. Biomedical technologies in practice. In: An Anthropology of Biomedicine. Pp. 17-31
  20. ^
    Hogan VK, Richardson JL, Ferre CD, Durant T, Boisseau M.
    2000. A public health framework for addressing black and white disparities in preterm delivery. Journal of American Medicine Women’s Association, Vol. 56:177-80