Mixed Race Studies

If doctors and clinical educators rigorously analyze algorithms that include race correction, they can judge, with fresh eyes, whether the use of race or ethnicity is appropriate. In many cases, this appraisal will require further research into the complex interactions among ancestry, race, racism, socioeconomic status, and environment. Much of the burden of this work falls on the researchers who propose race adjustment and on the institutions (e.g., professional societies, clinical laboratories) that endorse and implement clinical algorithms. But clinicians can be thoughtful and deliberate users. They can discern whether the correction is likely to relieve or exacerbate inequities. If the latter, then clinicians should examine whether the correction is warranted. Some tools, including eGFR and the VBAC calculator, have already been challenged; clinicians have advocated successfully for their institutions to remove the adjustment for race.^43,44 Other algorithms may succumb to similar scrutiny.⁴⁵ A full reckoning will require medical specialties to critically appraise their tools and revise them when indicated.

Darshali A. Vyas, Leo G. Eisenstein, and David S. Jones, “Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms,” The New England Journal of Medicine, Volume 2020, Number 383, 882. https://dx.doi.org/10.1056/NEJMms2004740.

Race and ethnicity highlights:

• The White population remained the largest race or ethnicity group in the United States, with 204.3 million people identifying as White alone. Overall, 235.4 million people reported White alone or in combination with another group. However, the White alone population decreased by 8.6% since 2010.
• The Two or More Races population (also referred to as the Multiracial population) has changed considerably since 2010. The Multiracial population was measured at 9 million people in 2010 and is now 33.8 million people in 2020, a 276% increase.
• The “in combination” multiracial populations for all race groups accounted for most of the overall changes in each racial category.
• All of the race alone or in combination groups experienced increases. The Some Other Race alone or in combination group (49.9 million) increased 129%, surpassing the Black or African American population (46.9 million) as the second-largest race alone or in combination group.
• The next largest racial populations were the Asian alone or in combination group (24 million), the American Indian and Alaska Native alone or in combination group (9.7 million), and the Native Hawaiian and Other Pacific Islander alone or in combination group (1.6 million).
• The Hispanic or Latino population, which includes people of any race, was 62.1 million in 2020. The Hispanic or Latino population grew 23%, while the population that was not of Hispanic or Latino origin grew 4.3% since 2010.

It is important to note that these data comparisons between the 2020 Census and 2010 Census race data should be made with caution, taking into account the improvements we have made to the Hispanic origin and race questions and the ways we code what people tell us.

United States Census Bureau, “2020 Census Statistics Highlight Local Population Changes and Nation’s Racial and Ethnic Diversity,” Release Number CB21-CN.55, August 12, 2021. https://www.census.gov/newsroom/press-releases/2021/population-changes-nations-diversity.html.

How scientists are subtracting race from medical risk calculators

Science Magazine
2021-07-22

Jyoti Madhusoodanan
Portland, Oregon

Anuj Shrestha

To pediatrician Nader Shaikh, the rhythm of treating babies running high fevers is familiar. After ruling out the obvious colds and other common viruses, he must often thread a catheter into a months-old baby to draw a urine sample and check for a urinary tract infection (UTI). “You have to hold the baby down, the baby’s crying, the mother is usually crying too,” says Shaikh, who works at the University of Pittsburgh. “It’s traumatic.”

UTIs, although relatively rare in children under age 2, carry a high risk of kidney damage in this group if left untreated. Often, the only symptom is a high fever. But high fevers can also signal a brain or blood infection, or a dozen other illnesses that can be diagnosed without a urine sample. To help clinicians avoid the unnecessary pain and expense of catheterizing a shrieking infant, Shaikh and his colleagues developed an equation that gauges a child’s risk of a UTI based on age, fever, circumcision status, gender, and other factors—including whether the child is Black or white. Race is part of the equation because previous studies found that—for reasons that aren’t clear—UTIs are far less common in Black children than in white ones.

The UTI algorithm is only one of several risk calculators that factor in race, which doctors routinely use to make decisions about patients’ care. Some help them decide what tests to perform next or which patients to refer to a specialist. Others help gauge a patient’s lung health, their ability to donate a liver or kidney, or which diabetes medicines they need.

In the past few years, however, U.S. doctors and students reckoning with racism in medicine have questioned the use of algorithms that include race as a variable. Their efforts gained momentum thanks to the Black Lives Matter movement. In August 2020, a commentary published in The New England Journal of Medicine (NEJM) highlighted the use of race in calculators as a problem “hidden in plain sight.” It’s widely agreed that race is a classification system designed by humans that lacks a genetic basis, says Darshali Vyas, a medical resident at Massachusetts General Hospital and co-author on the paper. “There’s a tension between that [understanding] and how we see race being used … as an input variable in these equations,” Vyas says. “Many times, there’s an assumption that race is relevant in a biological sense.”…

Read the entire article here.

Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms

The New England Journal of Medicine
Volume 2020, Number 383
pages 874-882
2020-08-27 (published on 2020-06-17, at NEJM.org.)
DOI: 10.1056/NEJMms2004740

Darshali A. Vyas, M.D., Resident Physician
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
Harvard University, Cambridge, Massachusetts

Leo G. Eisenstein, M.D., Resident Physician
New York University Langone Medical Center, New York, New York

David S. Jones, M.D., Ph.D., A. Bernard Ackerman Professor of the Culture of Medicine
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts

Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics and could be clinically useful.¹ Others held that any small benefit was outweighed by potential harms that arose from the long, rotten history of racism in medicine.² Weighing the two sides, the accompanying Perspective article concluded that though the concept of race was “fraught with sensitivities and fueled by past abuses and the potential for future abuses,” race-based medicine still had potential: “it seems unwise to abandon the practice of recording race when we have barely begun to understand the architecture of the human genome.”³

The next year, a randomized trial showed that a combination of hydralazine and isosorbide dinitrate reduced mortality due to heart failure among patients who identified themselves as black. The Food and Drug Administration granted a race-specific indication for that product, BiDil, in 2005.⁴ Even though BiDil’s ultimate commercial failure cast doubt on race-based medicine, it did not lay the approach to rest. Prominent geneticists have repeatedly called on physicians to take race seriously,^5,6 while distinguished social scientists vehemently contest these calls.^7,8

Our understanding of race and human genetics has advanced considerably since 2003, yet these insights have not led to clear guidelines on the use of race in medicine. The result is ongoing conflict between the latest insights from population genetics and the clinical implementation of race. For example, despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice. One subtle insertion of race into medicine involves diagnostic algorithms and practice guidelines that adjust or “correct” their outputs on the basis of a patient’s race or ethnicity. Physicians use these algorithms to individualize risk assessment and guide clinical decisions. By embedding race into the basic data and decisions of health care, these algorithms propagate race-based medicine. Many of these race-adjusted algorithms guide decisions in ways that may direct more attention or resources to white patients than to members of racial and ethnic minorities…

Read the entire in PDF or HTML format.

Becoming American in Creole New Orleans, 1896–1949

Louisiana State University Press
July 2021
224 pages
5.50 x 8.50 inches
no illustrations
Hardcover ISBN: 9780807175477

Darryl Barthé Jr., Lecturer in History
Dartmouth College, Hanover, New Hampshire

Extensive scholarship has emerged within the last twenty-five years on the role of Louisiana Creoles in the eighteenth and early nineteenth centuries, yet academic work on the history of Creoles in New Orleans after the Civil War and into the twentieth century remains sparse. Darryl Barthé Jr.’s Becoming American in Creole New Orleans moves the history of New Orleans’ Creole community forward, documenting the process of “becoming American” through Creoles’ encounters with Anglo-American modernism. Barthé tracks this ethnic transformation through an interrogation of New Orleans’s voluntary associations and social sodalities, as well as its public and parochial schools, where Creole linguistic distinctiveness faded over the twentieth century because of English-only education and the establishment of Anglo-American economic hegemony.

Barthé argues that despite the existence of ethnic repression, the transition from Creole to American identity was largely voluntary as Creoles embraced the economic opportunities afforded to them through learning English. “Becoming American” entailed the adoption of a distinctly American language and a distinctly American racialized caste system. Navigating that caste system was always tricky for Creoles, who had existed in between French and Spanish color lines that recognized them as a group separate from Europeans, Africans, and Amerindians even though they often shared kinship ties with all of these groups. Creoles responded to the pressures associated with the demands of the American caste system by passing as white people (completely or situationally) or, more often, redefining themselves as Blacks.

Becoming American in Creole New Orleans offers a critical comparative analysis of “Creolization” and “Americanization,” social processes that often worked in opposition to each another during the nineteenth century and that would continue to frame the limits of Creole identity and cultural expression in New Orleans until the mid-twentieth century. As such, it offers intersectional engagement with subjects that have historically fallen under the purview of sociology, anthropology, and critical theory, including discourses on whiteness, métissage/métisajé, and critical mixed-race theory.

2020 Census Statistics Highlight Local Population Changes and Nation’s Racial and Ethnic Diversity

United States Census Bureau
2021-08-12
Release Number CB21-CN.55

U.S. Census Bureau Delivers Data for States to Begin Redistricting Efforts

AUG. 12, 2021 — The U.S. Census Bureau today released additional 2020 Census results showing an increase in the population of U.S. metro areas compared to a decade ago. In addition, these once-a-decade results showed the nation’s diversity in how people identify their race and ethnicity.

“We are excited to reach this milestone of delivering the first detailed statistics from the 2020 Census,” said acting Census Bureau Director Ron Jarmin. “We appreciate the public’s patience as Census Bureau staff worked diligently to process these data and ensure it meets our quality standards.”

These statistics, which come from the 2020 Census Redistricting Data (Public Law 94-171) Summary File, provide the first look at populations for small areas and include information on Hispanic origin, race, age 18 and over, housing occupancy and group quarters. They represent where people were living as of April 1, 2020, and are available for the nation, states and communities down to the block level.

The Census Bureau also released data visualizations, America Counts stories, and videos to help illustrate and explain these data. These resources are available on the 2020 Census results page. Advanced users can access these data on the FTP site…

…Race and ethnicity highlights:

• The White population remained the largest race or ethnicity group in the United States, with 204.3 million people identifying as White alone. Overall, 235.4 million people reported White alone or in combination with another group. However, the White alone population decreased by 8.6% since 2010.
• The Two or More Races population (also referred to as the Multiracial population) has changed considerably since 2010. The Multiracial population was measured at 9 million people in 2010 and is now 33.8 million people in 2020, a 276% increase.
• The “in combination” multiracial populations for all race groups accounted for most of the overall changes in each racial category…

Read the entire news release here.

Black Puritan, Black Republican: The Life and Thought of Lemuel Haynes, 1753-1833

Oxford University Press
2002-12-12
248 pages
9.04 x 6.84 x 0.9 inches
Hardcover ISBN: 978-0195157178
DOI: 10.1093/0195157176.001.0001

John Saillant, Professor of English and History
Western Michigan University, Kalamazoo, Michigan

In the second half of the eighteenth century, British and American men and women began criticizing the slave trade and slavery as violations of the principles of Christianity, natural rights, and political security. A black spokesman for abolitionism was Lemuel Haynes (1753–1833), one of the first African Americans to publish. Haynes served as a minuteman in the American War of Independence and began writing against the slave trade and slavery in the 1770s. After ordination in a Congregational church, he assumed a pulpit in Rutland, Vermont, where he became a leading controversialist, defender of the theology of Jonathan Edwards, and interpreter of republican ideology. He was dismissed from his pulpit in 1818, because his affiliation to the Federalist Party and his opposition to the War of 1812 offended his congregation. The last 15 years of his life were characterized by pessimism about the ability of Americans of the early republic to defeat racism as well as by a defense of Puritanism, which he believed could guide the creation of a free, harmonious, and integrated society.

Table of Contents

• Introduction
• 1. A Further Liberty in 1776
• 2. Republicanism Black and White
• 3. The Divine Providence of Slavery and Freedom
• 4. Making and Breaking the Revolutionary Covenant
• 5. American Genesis, American Captivity

‘The Vice President’s Black Wife’: New Book by IU History Professor

Bloom Magazine
Bloomington, Indiana
2021-04-28

Peter Dorfman

Blue Spring Farm, where Julia lived. This is the last standing slave building on the property, likely used as a kitchen. Courtesy photo

Dr. Amrita Chakrabarti Myers regards her work as an academic focused on slavery and Black women’s history as a “labor of recovery.” Her subjects, many illiterate, left little behind.

Myers’ second book, The Vice President’s Black Wife: The Untold Life of Julia Chinn, due out in 2022, focuses on the life of Julia Chinn, an enslaved woman in the early 1800s, on the Kentucky estate of Richard Mentor Johnson. Chinn had two children by Johnson, to whom she was married for 23 years. Because Chinn was Black, the marriage was not legal, but Johnson publicly treated her as his spouse. Chinn was literate, and Johnson put her in charge of the plantation (including oversight of the enslaved laborers) when he was away from home. “She was his wife in every sense,” Myers asserts…

Read the entire article here.

How I Learned to Love Myself as a Black Jew

alma.
2020-06-16

Aviva Davis
Oakland, California

While I am so proud to be a queer Jewish woman of color, it has taken an excruciating amount of work to reach this point.

As a child, I always knew I was Black, but I didn’t know what that meant for me as an individual. I certainly didn’t know how my Blackness intersected with my other identities, including my Jewishness. I didn’t even realize, when one of my friends asked me how I could believe in God but not Jesus, that my religion and my race were informing her question.

Cut to almost 10 years later, and I’m coming out of the closet. I am Black, I am Jewish, I am queer, and on top of all that, I’m a woman, too. Someone once said I decided to play the game of life on “Expert Mode.” I couldn’t help but laugh at such an accurate analogy, because although I am so proud to be a queer Jewish woman of color, it has taken an excruciating amount of work to reach this point and fully love myself…

Read the entire article here.