There is no scientific rationale for race-based research. J Natl Med Assoc 99(6):690-692

SUNY-Buffalo, Buffalo, NY 14215, USA.
Journal of the National Medical Association (Impact Factor: 0.96). 07/2007; 99(6):690-2.
Source: PubMed


For centuries, the colonial governments used a combination of race and ethnic characteristics to subjugate and control people of color, and scientists of the day provided evidence of the "natural order of things" to support national policies of domination, segregation and control. There have been many examples of events in the past 70 years to suggest that achievements by ethnic peoples are not genetically determined and that race and ethnicity are merely terms to describe external features, language, culture, social mores and folklore. BiDil was the first drug in this country approved by the FDA for use in a single "race" after a clinical trial that enrolled only members of that race. Thus arose the question of the efficacy of doing race-based research in humans. In order for this kind of research to have any scientific basis, each individually defined or self-declared race would have to have a 100% pure gene pool, and the data show that the gene pool among whites, blacks and Hispanics in America is very heterogeneous. This makes for far greater similarities among U.S. citizens than any perceived differences, and genomic science has failed to support the concept of racial categories in medicine. Scientists involved with the first mapping of the human genome have noted that there is no basis in the genetic code for race. That being the case, there appears to be no justification for race-based research among human beings.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Pharmacogenetics research focuses on the identification of inherited DNA sequence variations that influence an individual's response to therapeutic agents. Discovering such variations is nontrivial and may require enormous and potentially unrealistic sample sizes for appropriately therapeutic-response powered studies, unless one has sufficient a priori knowledge about genomic regions likely to harbor relevant variations. In addition, once relevant variations have been identified, it is important to evaluate their clinical utility, especially with respect to the appropriate therapeutic agents. In this very basic review we consider strategies for identifying genetic variations that influence response to therapeutic agents. We also consider strategies for evaluating the use of these genetic variations in the design and conduct of clinical trials assessing the utility of these variations in guiding therapeutic decisions.
    No preview · Chapter · Jan 2008
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the influence of race on 7-day hospital readmission rates after discharge of critically ill patients. Racial status is a risk factor for early (within 7 days) hospital readmission after initial recovery from critical illness and respiratory failure. This was a retrospective cohort study that took place in a 350-bed community hospital. Adult patients who received mechanical ventilation during their intensive care unit stay were included. Study subjects were categorized as white, black (non-Hispanic), Hispanic, and Asian/other. The main outcome measure was readmission to the hospital within 7 days of discharge. Secondary outcomes were hospital mortality and durations of hospital and intensive care unit stay. Comparisons were made across racial groups. Of 772 patients, 172 (22.3%) died, and 96 of the 591 discharged patients (16.2%) were readmitted within 7 days. Race was not a determinant of rapid readmission: 11.6% of blacks (P = .2), 20.6% of Hispanics (P = .3) and 16.5% of whites were readmitted within 7 days. Readmitted patients were more likely to have been discharged to a rehabilitation or extended care facility rather than to home (22.1% vs 2.2%, P < .0001). Readmitted patients tended to have had prolonged duration of mechanical ventilation > or = 30 days (41% vs 15.1%, P = .004), to be aged > or = 80 years (24.4% vs 13.9%, P = .005), and to be female (19.5% vs 13.7%, P = .04). Multivariate logistic regression analyses demonstrated that discharge to a place other than home (odds ratio 10.1, 95% confidence interval 3.6-28.3) and prolonged duration of mechanical ventilation (odds ratio 2.8, 95% confidence interval 1.1-6.9) were independently associated with readmission. Race did not significantly influence in-hospital mortality. Overall, the deceased were older and more likely to be female, and had longer durations of mechanical ventilation and medical and surgical intensive care unit stays. Contrary to our hypothesis, race was not associated with rapid readmission or mortality of critically ill patients. Factors independently associated with rapid readmission were mechanical ventilation beyond 29 days and disposition to an acute rehabilitation or skilled nursing facility. Further studies are required to ascertain whether these factors are generalizable or idiosyncratic to our institution.
    Full-text · Article · Jan 2009 · Heart & lung: the journal of critical care
  • [Show abstract] [Hide abstract]
    ABSTRACT: This purpose of this paper is to review the literature on racial/ethnic disparities in the utilization and quality of care and the proposed explanations for these differences. First, the literature on racial/ethnic disparities in medical treatment is reviewed briefly with the goal of providing a sense of the range of procedures and conditions on which these disparities occur. Then, the possible role of physician/provider, patient, and health care system factors in contributing to these disparities is reviewed. Finally, suggestions for new or expanded directions for research in each of these three areas are given. The goal of the paper is to identify factors that might be particularly amenable to the type of research done by health psychologists.
    No preview · Article · Feb 2009 · Journal of Behavioral Medicine
Show more