Race

toc = **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.

 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.”

 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. 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.”

 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.” 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. 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.

  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.”

 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. <span style="font-family: Arial,Helvetica,sans-serif;"> “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” <span style="font-family: Arial,Helvetica,sans-serif;"> He insisted that culture, not nature, explained differences among people.

<span style="font-family: Arial,Helvetica,sans-serif;"> 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.

<span style="font-family: Arial,Helvetica,sans-serif;"> 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: <span style="font-family: Arial,Helvetica,sans-serif;"> “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.”

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Case Studies in Race and Health
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**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. Hypertension also tends to occur earlier and be more severe, resulting in mortality more often, in blacks than in whites.

<span style="font-family: Arial,Helvetica,sans-serif;"> Dr. Janis Hutchinson, noting recent FDA approval of the drug BiDil for heart failure specifically in African Americans, has said that, <span style="font-family: Arial,Helvetica,sans-serif;"> “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.”

<span style="font-family: Arial,Helvetica,sans-serif;"> 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.

<span style="font-family: Arial,Helvetica,sans-serif;"> 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.

<span style="font-family: Arial,Helvetica,sans-serif;"> 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. <span style="font-family: Arial,Helvetica,sans-serif;"> “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.” <span style="font-family: Arial,Helvetica,sans-serif;"> 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.

<span style="font-family: Arial,Helvetica,sans-serif;"> <span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.5in; text-indent: 3pt;"> 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: <span style="font-family: Arial,Helvetica,sans-serif;"> - 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). <span style="font-family: Arial,Helvetica,sans-serif;"> - Extended exposure to aversive racism may have a cumulative effect leading to hypertension. (Merrit //et al// ., 2006). <span style="font-family: Arial,Helvetica,sans-serif;"> - 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). <span style="font-family: Arial,Helvetica,sans-serif;"> 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.

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**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.

<span style="font-family: Arial,Helvetica,sans-serif; margin-right: 0.5in;"> 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.”

<span style="font-family: Arial,Helvetica,sans-serif; margin-right: 0.5in;"> 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.

<span style="font-family: Arial,Helvetica,sans-serif; margin-right: 0.5in;"> 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.

<span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.25in; margin-right: 0.5in; text-indent: 3pt;"> <span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.25in; margin-right: 0.5in; text-indent: 3pt;"> media type="youtube" key="k8fuzh4d544?fs=1" height="385" width="640" <span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.25in; margin-right: 0.5in; text-indent: 3pt;"> 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.

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Resources
<span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.25in; margin-right: 0.5in; text-indent: 3pt;"> Race: The Power of an Illusion. An online companion to a 3-part documentary on race in society, science and history []

<span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.25in; margin-right: 0.5in; text-indent: 3pt;"> Race: Are We So Different? A project of the American Anthropological Association []

<span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.25in; margin-right: 0.5in; text-indent: 3pt;"> Clarence Gravlee’s website []

<span style="font-family: Arial,Helvetica,sans-serif; margin-left: 0.25in; margin-right: 0.5in; text-indent: 3pt;"> Racism and Low Birth Weight 101, including an informative slideshow []

Discussion Board
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