Thus, returning to the example of glaucoma, it is more important to know a patient’s family history than to assess his or her race.

A dark-skinned, curly-headed person who identifies as African American may, indeed, have much in his or her history and upbringing to justify that identification. But he or she may also have a white grandparent and several Cherokee ancestors. Thus, returning to the example of glaucoma, it is more important to know a patient’s family history than to assess his or her race. And collecting family history ought to mean not only compiling a list of which diseases family members have, but making some attempt to assess common (familial) habits such as diet and life experiences (e.g., first- versus second-generation immigrants, living conditions, or same versus widely varied work experience and geographical locations). Similarly, when the history of passing for white is ignored, those who identify themselves as “white” are assumed to have no ancestral “black blood.” Finally, immigration patterns constantly change. A “black” person walking into a Boston, Massachusetts clinic could easily be the child of a recent immigrant from Ethiopia or Brazil who has a genetic makeup as well as cultural and environmental exposures that differ significantly from the descendents of 19th century US slaves from the western coast of Africa.

Braun L, Fausto-Sterling A, Fullwiley D, Hammonds EM, Nelson A, Quivers W, et al., “Racial Categories in Medical Practice: How Useful Are They?PLoS Medicine, Volume 4, Number 9 (September 2007), pages 1423-1428. http://dx.doi.org/10.1371/journal.pmed.0040271.

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