Smoking Trajectories Among Monoracial and Biracial Black Adolescents and Young Adults

Posted in Articles, Health/Medicine/Genetics, Media Archive, Social Work, United States on 2014-07-13 07:02Z by Steven

Smoking Trajectories Among Monoracial and Biracial Black Adolescents and Young Adults

Journal of Drug Issues
Published online before print: 2014-07-11
DOI: 10.1177/0022042614542511

Trenette T. Clark, Assistant Professor of Social Work
University of North Carolina, Chapel Hill

Anh B. Nguyen, Cancer Prevention Fellow
Science of Research and Technology Branch (SRTB)
Behavioral Research Program (BRP)
National Cancer Institute, Rockville, Maryland

Emanuel Coman
University of North Carolina, Chapel Hill

Cigarette-smoking trajectories were assessed among monorace Blacks, Black–American Indians, Black–Asians, Black–Hispanics, and Black–Whites. We used a subsample of nationally representative data obtained from the National Longitudinal Study of Adolescent Health (Add Health). The sample consisted of adolescents who were in Grades 7 to 12 in 1994, and followed across four waves of data collection into adulthood. Wave 4 data were collected in 2007-2008 when most respondents were between 24 and 32 years old. Respondents could report more than one race/ethnicity. Poisson’s regression was used to analyze the data. We found distinct smoking trajectories among monorace and biracial/ethnic Blacks, with all groups eventually equaling or surpassing trajectories of Whites. The age of cross-over varied by gender for some subgroups, with Black–American Indian males catching up earlier than Black–American Indian females. Black–White females smoked on more days than monorace Black females until age 26 and also smoked more than Black–White males between ages 11 and 29 years. Black–Hispanic males smoked on more days than Black–Hispanic females from ages 11 to 14. The results of the interaction tests also indicated different smoking trajectories across socioeconomic status (SES) levels among White, Black, and Black–White respondents. Significant heterogeneity was observed regarding smoking trajectories between monorace and biracial/ethnic Blacks. Knowledge of cigarette-smoking patterns among monorace and biracial/ethnic Black youth and young adults extends our understanding of the etiology of tobacco use and may inform interventions.

Read or purchase the article here.

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Medicating Race: Heart Disease and Durable Preoccupations with Difference by Anne Pollock (review)

Posted in Articles, Book/Video Reviews, Health/Medicine/Genetics, History, Media Archive on 2014-07-11 06:52Z by Steven

Medicating Race: Heart Disease and Durable Preoccupations with Difference by Anne Pollock (review)

Bulletin of the History of Medicine
Volume 88, Number 2, Summer 2014
pages 393-395
DOI: 10.1353/bhm.2014.0025

Lundy Braun, Professor of Pathology and Laboratory Medicine; Africana Studies
Brown University, Providence, Rhode Island

Anne Pollock, Medicating Race: Heart Disease and Durable Preoccupations with Difference (Durham: Duke University Press, 2012).

Science and technology studies (STS) scholar Anne Pollock’s Medicating Race uses the lens of “durable preoccupations” to explore the racialization of different categories of heart disease from the early twentieth century when cardiology emerged as a medical specialty. The book is a useful reminder that the intense and sometimes vitriolic debate over BiDil, a medication for heart failure and the first race-based drug, is but one moment—though a very public one—in a long history of the mobilization of race in cardiology. Drawing on rich and varied sources, including archival materials, scientific articles, interviews, and professional conferences, Pollock extends prior analyses of BiDil to examine the intersection of race with the numerous epistemological debates that characterize the history of heart disease. Why, Pollock asks, has race proved so resilient in the history of heart disease, despite relentless critique?

This deeply theorized account tracks “epistemologically eclectical” racial preoccupations as they travel among the social worlds of science, the clinic, and the pharmaceutical industry. Weaving together three main themes—the role of heart disease research in constituting Americanness, the persistence of racial categorization throughout this history, and the social and political dimensions of health disparities activism—Pollock argues that the durability of race in theories of heart disease is a dynamic biosocial process enmeshed in ambiguous and changing classifications of both disease and race and the persistence of unequal access to power, resources, and treatment. As Pollock writes, “Preoccupations with racial differences always exceed the data itself” (p. 19).

Beginning with early twentieth-century beliefs about infectious etiologies of heart disease, racial discourses shaped the emergence and professionalization of cardiology in complex ways. So deeply entrenched were ideas of syphilitic heart disease in blacks, for example, that Booker T. Washington’s death from arteriosclerosis in 1915 remained a matter of dispute until the 2000s. For African American physicians committed to providing medical care to their neglected communities, engagement with black heart disease also provided them with access to the modern technologies of scientific medicine, albeit limited. As others have shown with diseases such as tuberculosis and cancer, discourses of modernity, stress, and civilization were central to the whitening of coronary heart disease by midcentury.

Particularly fascinating is Pollock’s detailed examination of the complicated relationship between the famed Framingham Heart Study organized in 1948 and the Jackson Heart Study organized in 2000. Framingham researchers constructed their population as both white and normal through changing coding practices, categorizations, computerization, and data analysis, all of which cohered to produce hypertension as a distinct disease category. Modeled on Framingham, the Jackson Heart Study recruited only self-identified blacks, constructing a population that was simultaneously representative and different. Unlike the Framingham investigators, the Jackson investigators incorporated the social dimensions of health disparities, in addition to lifestyle and genetics, into the study design. In chapter 3, Pollock traces the complexity of social processes that produced African American hypertension as a distinctive disease category—and the consequent emergence of the category of African American itself as a risk factor for heart disease. Moving to “durable preoccupations” in contemporary race science in later chapters, Medicating Race analyzes the debates about the salt-slavery hypothesis of hypertension, thiazide diuretics, and BiDil.

While arguing throughout the book for careful attention to biology in any constructivist analysis, for this reader Pollock underestimates the consequences of genetic essentialism and market imperatives in medicine. Yet, in making explicit the tensions in democracy embedded in the historical debates over black heart disease, this book provides fresh insight into a key aspect of the dilemma of difference: when and how to use race in contemporary research. Despite at least a decade of careful social and scientific scrutiny, the academic and public debate about race and race science is not, nor can it be, settled as long as race remains such a salient marker of inequality in U.S. society.

This theoretically sophisticated book does an excellent job of making many familiar STS concepts relevant to medical history. Placing current arguments over race and heart disease in a broad historical context, Pollock adds valuable nuance to the historiography of race and heart disease and their material-semiotic natures. For all its semiotic ambiguity, heart…

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Mexico boasts a staggering genetic diversity, study shows

Posted in Caribbean/Latin America, Health/Medicine/Genetics, Media Archive, Mexico on 2014-07-02 01:45Z by Steven

Mexico boasts a staggering genetic diversity, study shows

Los Angeles Times
2014-06-12

Geoffrey Mohan

SHARELINES

▼ DNA offers a nuanced answer to what it means to be Mexican
▼ Ancient genetic signal survived conquest in Mexico
▼ Latino and Hispanic labels don’t do justice to Mexico’s genome

Writers, artists and historians have long pondered what it means to be Mexican. Now science has offered its answer, and it could change how medicine uses racial and ethnic categories to assess disease risk, testing and treatment..

The broadest analysis of the Mexican genome ever undertaken reveals a nation of staggering genetic diversity, where European conquest only thinly masks the ancestral DNA of Native Americans, and where some populations remain as distinct from one another as Europeans are from Chinese, according to findings published Thursday in the journal Science.

Forty researchers, who share Latino heritage as well as professional qualms over the significance of ethnic and racial categories, teamed up across borders to analyze more than 1 million variations in the building blocks of DNA. They examined more than 500 samples collected in Mexico’s remote Indian villages and polyglot cities, and from Mexican Americans in California.

“Because these populations are so rich, so genetically differentiated, you can’t just lump them all in,” said lead investigator Carlos Bustamante, a population geneticist and co-director of Stanford University’s Center for Computational, Evolutionary and Human Genomics. “You really have to embrace that diversity and think about doing medical genetic studies on a very large scale.”

To illustrate their point, the researchers compared their new genetic data with the results of lung function tests for children in Mexico City and Latinos in the San Francisco Bay Area. They discovered that pulmonary function varied in ways that were mirrored in DNA. It was as if someone with a fraction of Maya ancestry had lungs that were 10 years older than someone with a bit of northern indigenous heritage…

…Researchers not involved in the study, however, caution that correlations between disease risk and ancestry may not have much of a genetic basis at all. In many cases, they might mask socioeconomic or environmental factors — where and how you live.

The suggestion that differences in DNA are responsible for observed differences in lung capacity “is an enormous leap,” said UC Berkeley sociologist Troy Duster, who has written extensively on the intersection of race, biology and public policy.

Lundy Braun, an Africana studies professor at Brown University who studies the intersection of race and medicine, said medicine’s focus on genetics may be overshadowing other avenues of research.

“The effects of social class on lung function have been largely ignored in favor of the focus on race and ethnic difference,” she said.

Braun and Duster worry that such genomic studies may unwittingly lend legitimacy to widely discredited ideas about racial disparities.

“There is always lurking danger that this kind of research, which emphasizes the genetic structure of ethnic and racial groups, fuels the notion that the biology or genetics of those groups explains their condition,” Duster said…

Read the entire article here.

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Implications of Genetic Diversity in Mexico

Posted in Articles, Caribbean/Latin America, Health/Medicine/Genetics, Media Archive, Mexico on 2014-07-01 01:13Z by Steven

Implications of Genetic Diversity in Mexico

Biopolitical Times
Center for Genetics and Society
2014-06-25

Pete Shanks

The category Latino is a valid cultural artifact, and often self-identified. But it’s not really a race in any modern sense of the term, and the genetic evidence surely shows that it is far too broad a grouping to be scientifically appropriate without serious qualification. Yet it is used, even in some current peer-reviewed papers.

One that does not use the term is an article published in Science this month on the genetics of Mexico. The country’s population is large and ethnically, linguistically, geographically, economically and culturally diverse. It is also genetically complex, and this article by a large and distinguished team of scientists provides new details. It also suggests some important implications for genomic research and likely for personalized medicine in general:

The genetics of Mexico recapitulates Native American substructure and affects biomedical traits

The study included 511 Native Mexican individuals from 20 indigenous groups, and 500 mestizo (mixed-race) individuals from ten states; nearly a million SNPs were analyzed for each. The variation was striking…

Read the entire article here.

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Infectious Fear: Politics, Disease, and the Health Effects of Segregation

Posted in Books, Health/Medicine/Genetics, History, Monographs, Social Science, United States on 2014-06-30 21:06Z by Steven

Infectious Fear: Politics, Disease, and the Health Effects of Segregation

University of North Carolina Press
May 2009
328 pages
36 illus., 5 tables, notes, bibl., index
6.125 x 9.25
Paper ISBN: 978-0-8078-5934-6

Samuel Kelton Roberts Jr., Associate Professor of History; Assistant Professor of Sociomedical Sciences
Columbia University, New York

For most of the first half of the twentieth century, tuberculosis ranked among the top three causes of mortality among urban African Americans. Often afflicting an entire family or large segments of a neighborhood, the plague of TB was as mysterious as it was fatal. Samuel Kelton Roberts Jr. examines how individuals and institutions—black and white, public and private—responded to the challenges of tuberculosis in a segregated society.

Reactionary white politicians and health officials promoted “racial hygiene” and sought to control TB through Jim Crow quarantines, Roberts explains. African Americans, in turn, protested the segregated, overcrowded housing that was the true root of the tuberculosis problem. Moderate white and black political leadership reconfigured definitions of health and citizenship, extending some rights while constraining others. Meanwhile, those who suffered with the disease—as its victims or as family and neighbors—made the daily adjustments required by the devastating effects of the “white plague.”

Exploring the politics of race, reform, and public health, Infectious Fear uses the tuberculosis crisis to illuminate the limits of racialized medicine and the roots of modern health disparities. Ultimately, it reveals a disturbing picture of the United States’ health history while offering a vision of a more democratic future.

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People from Mexico show stunning amount of genetic diversity

Posted in Articles, Caribbean/Latin America, Health/Medicine/Genetics, Media Archive, Mexico on 2014-06-16 13:58Z by Steven

People from Mexico show stunning amount of genetic diversity

Science
2014-06-12

Lizzie Wade, Latin America Correspondent

Imagine if people from Kansas and California were as genetically distinct from each other as someone from Germany is from someone from Japan. That’s the kind of remarkable genetic variation that scientists have now found within Mexico, thanks to the first fine-scale study of human genetic variation in that country. This local diversity could help researchers trace the history of the country’s different indigenous populations and help them develop better diagnostic tools and medical treatments for people of Mexican descent living all over the world.

The team has done a “tremendous job” of creating a “blueprint of all the genetic diversity in Mexico,” says Bogdan Pasaniuc, a population geneticist at the University of California (UC), Los Angeles, who was not involved in the research…

…When the team analyzed the genomes of 511 indigenous individuals from all over Mexico, they found a striking amount of genetic diversity. The most divergent indigenous groups in Mexico are as different from each other as Europeans are from East Asians, they report online today in Science. This diversity maps onto the geography of Mexico itself. The farther away ethnic groups live from each other, the more different their genomes turn out to be.

But most people in Mexico or of Mexican descent these days are not indigenous but rather mestizo, meaning they have a mixture of indigenous, European, and African ancestry. Do their genomes also vary by what region of Mexico they come from, or has all that local variation been smoothed out by centuries of different groups meeting, mixing, and having babies?…

Read the entire article here.

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Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population

Posted in Articles, Health/Medicine/Genetics, Media Archive on 2014-06-13 22:34Z by Steven

Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population

Journal of the American Academy of Dermatology
Available online: 2014-06-11
DOI: 10.1016/j.jaad.2014.05.023

Steven Y. He, BS
Department of Dermatology
University of California, San Francisco

Charles E. McCulloch, PhD
Department of Epidemiology and Biostatistics
University of California, San Francisco

W. John Boscardin, PhD
Department of Epidemiology and Biostatistics; Department of Medicine
University of California, San Francisco

Mary-Margaret Chren, MD
Department of Dermatology
University of California, San Francisco

Eleni Linos, MD, MPH, DrPH
Department of Dermatology
University of California, San Francisco

Sarah T. Arron, MD, PhD
Department of Dermatology
University of California, San Francisco

Background

Fitzpatrick skin phototype (FSPT) is the most common method used to assess sunburn risk and is an independent predictor of skin cancer risk. Because of a conventional assumption that FSPT is predictable based on pigmentary phenotypes, physicians frequently estimate FSPT based on patient appearance.

Objective

We sought to determine the degree to which self-reported race and pigmentary phenotypes are predictive of FSPT in a large, ethnically diverse population.

Methods

A cross-sectional survey collected responses from 3386 individuals regarding self-reported FSPT, pigmentary phenotypes, race, age, and sex. Univariate and multivariate logistic regression analyses were performed to determine variables that significantly predict FSPT.

Results

Race, sex, skin color, eye color, and hair color are significant but weak independent predictors of FSPT (P < .0001). A multivariate model constructed using all independent predictors of FSPT only accurately predicted FSPT to within 1 point on the Fitzpatrick scale with 92% accuracy (weighted kappa statistic 0.53).

Limitations

Our study enriched for responses from ethnic minorities and does not fully represent the demographics of the US population.

Conclusions

Patient self-reported race and pigmentary phenotypes are inaccurate predictors of sun sensitivity as defined by FSPT. There are limitations to using patient-reported race and appearance in predicting individual sunburn risk.

Read or purchase the article here.

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Race: A Starting Place

Posted in Articles, Health/Medicine/Genetics, Media Archive on 2014-06-09 02:48Z by Steven

Race: A Starting Place

Virtual Mentor: American Medical Association Journal of Ethics
Volume 16, Number 6 (June 2014)
pages 472-478

Brooke A. Cunningham, MD, PhD

Health status, access to and quality of care, and numerous social factors associated with health vary across racial groups. Many applaud the collection and use of race data to identify and monitor progress in addressing health disparities. The National Institutes of Health (NIH) requires and the Food and Drug Administration (FDA) recommends the collection of race data in clinical research; the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act provided financial incentives for health systems to collect race information through the Medicare and Medicaid Electronic Health Record Incentive Program (i.e., “meaningful use” of electronic health records); and the 2010 Patient Protection and Affordable Care Act (ACA) mandated that the Department of Health and Human Services establish standards for race and ethnicity data collection. Yet, in the face of increasing amounts of “race data,” we have created few opportunities for discussing “what race measures.” Some journals require authors to explain how race is conceptualized and collected in their studies, but the requirement is not standardized and rarely met. Thus, race and racial data are frequently interpreted in conflicting ways. This article seeks to provide an overview of race as a foundation for an improved understanding of the relationship between race and health.

Many challenges await those who wish to consider the role of race in health outcomes critically. Careful consideration of race requires identifying and setting aside much tacit knowledge about race—those ideas that come easily, are taken for granted, and simply seem right. Although “race…appears obvious, intuitive, and in need of no special knowledge to discuss or analyze…[u]sing race in biomedical contexts requires great care and expertise”. Such an approach is difficult because from childhood we learn the ways that racial groups are supposed to differ from one another. Frequently the lesson has been that differences between the races are intrinsic or inherited, and those beliefs have justified discrimination against members of racial minority groups. Finally, it seems that, to many, newer understandings of race that have emerged from the social sciences seem less scientific, less reliable, and more political than the biological or genetic explanations that they seek to unseat…

…Racial categories vary across the world. Thus, identical twins separated and raised in different countries could end up identifying their race differently. Similarly, were we able to send a person back through time, his or her race might change. Social scientists point to this variation in racial categories across time and space to argue that race is a social construct. Further support for the fluidity of race also comes from recent studies that show that some people report membership in different races at different times in their lives. The race that one selects often depends upon one’s current social position…

Read the entire article here in HTML or PDF format.

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The Color Of Health: Skin Color, Ethnoracial Classification, And Discrimination In The Health Of Latin Americans

Posted in Articles, Brazil, Caribbean/Latin America, Health/Medicine/Genetics, Media Archive, Mexico, Social Science on 2014-06-02 19:00Z by Steven

The Color Of Health: Skin Color, Ethnoracial Classification, And Discrimination In The Health Of Latin Americans

Social Science & Medicine
Available online: 2014-06-01
DOI: 10.1016/j.socscimed.2014.05.054

Krista M. Perreira, Professor of Public Policy and Associate Dean Office for Undergraduate Research
University of North Carolina, Chapel Hill

Edward E. Telles, Professor of Sociology
Princeton University, Princeton, New Jersey

Highlights

  • Uses newly collected data on 4921 adults from Brazil, Columbia, Mexico, and Peru
  • Examines multiple measures of race/ethnicity and their associations with health
  • Finds significant skin-color gradients in self-reported health.
  • Finds significant skin-color gradients in class-based discrimination and low SES.
  • SES and class-based discrimination largely account for disparities in health by skin color.

Latin America is one of the most ethnoracially heterogeneous regions of the world. Despite this, health disparities research in Latin America tends to focus on gender, class and regional health differences while downplaying ethnoracial differences. Few scholars have conducted studies of ethnoracial identification and health disparities in Latin America. Research that examines multiple measures of ethnoracial identification is rarer still. Official data on race/ethnicity in Latin America are based on self-identification which can differ from interviewer-ascribed or phenotypic classification based on skin color. We use data from Brazil, Columbia, Mexico, and Peru to examine associations of interviewer-ascribed skin color, interviewer-ascribed race/ethnicity, and self-reported race/ethnicity with self-rated health among Latin American adults (ages 18-65). We also examine associations of observer-ascribed skin color with three additional correlates of health – skin color discrimination, class discrimination, and socio-economic status. We find a significant gradient in self-rated health by skin color. Those with darker skin colors report poorer health. Darker skin color influences self-rated health primarily by increasing exposure to class discrimination and low socio-economic status.

Read or purchase the article here.

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Things to Know When Talking About Race and Genetics

Posted in Anthropology, Articles, Health/Medicine/Genetics, Media Archive on 2014-05-19 02:35Z by Steven

 

Things to Know When Talking About Race and Genetics

Psychology Today
2014-05-13

Agustín Fuentes, Professor of Anthropology
University of Notre Dame

On May 5th, 2014, I shared the platform in a webinar debate with Nicholas Wade (former NYTimes Science Writer) about his new book “A Troublesome Inheritance – A discussion on genes, race and human history.” The debate was sponsored by the American Anthropological Association.

Wade’s assertions in the book (and our discussion) are that Humans are divided into genetically identified “continental races” and that there are significant differences in genetically based social behaviors between these “races” as a result of the last 50,000 years of human evolution.

Wade argues that social scientists are covering up these ideas and claims that a true discussion on race is repressed by most academics out of political correctness. These points were also made by Charles Murray in a laudatory review of Wade’s book in the Wall Street Journal. They are both wrong.

I am an academic and I love to talk about the data on race, so do many of my colleagues. The scientific data on human genetic variation and human evolution refute the claims there are multiple biological races in humans today and in the debate I offered articles, datasets, and work by biologists, geneticists, evolutionary theorists and even anthropologists to demonstrate this. Unfortunately, in such discussions the bulk of data, and its complexity, are too often ignored.

Avoiding direct challenge is a common tactic by people trying to use select slices of genetic data to “prove” that there are multiple biological races in humans today. This is a problem because dialogue on such an important topic should be encouraged and as open minded as possible, but it must also be accurately informed by the science of human biology. So here is a mini-primer on what we what we know about human genetics to help such a discussion (see the bibliography at the bottom of this post for very good articles on the topic)…

…5) Nearly all the genetic variation in our entire species is found in populations just in Africa, with most of the variation found in all populations outside of Africa making up a small subset of that variation…

…Given these facts, here is the key argument you need to remember: While different populations vary in some of the .1% of the genome, the way this variation is distributed does not map to biological races, either by continent or otherwise.

For example, when you compare people from Nigeria, Western Europe and Beijing you do get some patterned differences…but these specific groups do not reflect the entire continental areas of Africa, Europe, and Asia (the proposed “continental races” of African, Caucasian and Asian). There are no genetic patterns that link all populations in just Africa, just Asia or just Europe to one another to the exclusion of other populations in other places. If you compare geographically separated populations within the “continental” areas you get the same kind of variation as you would between them. Comparing Nigerians to Western Europeans to people from Beijing gives us the same kind of differences in variation patterns as does comparing people from Siberia, Tibet and Java, or from Finland, Wales and Yemen, or even Somalia, Liberia and South Africa— and none of these comparisons demonstrates “races.”…

Read the entire article here.

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