One point about faith healers cannot be overemphasized: They kill people. Convinced that they are cured when they are not, they may be dissuaded from seeking legitimate medical help that could save their lives. For example, many kinds of cancer are now treatable, if treatment begins early enough…. How many of the largely elderly and poor members of [a typical faith healer's] audience go home to great pain and even die because they have thrown away the medicine that was really treating their health problems?…In many states, laws covering child abuse and neglect contain specific religious exemptions. These permit a parent to withhold medical treatment from a child if the parent is a member of a religious group that believes in the power of faith healing or in the power of prayer to heal. Such exemptions have resulted in the death of many children whose lives could have been saved by legitimate medical treatment.3
GO DEEPER…
Brenneman, Richard J. Deadly Blessings: Faith Healing on Trial. Amherst, NY: Prometheus Books, 1990.
Randi, James. The Faith Healers. Amherst, NY: Prometheus Books, 1989.
Sloan, Richard P. Blind Faith: The Unholy Alliance of Religion and Medicine. New York: St. Martin's Griffin, 2008.
How accurate can “race” be in determining genetic links to disease and health conditions when the definition of race is one that eludes most researchers?
—From the report Geneticizing Disease: Implications for Racial Health Disparities
In 1998, the American Anthropological Association (AAA) issued a formal statement on the concept of race. It opens with these words:
In the United States both scholars and the general public have been conditioned to viewing human races as natural and separate divisions within the human species based on visible physical differences. With the vast expansion of scientific knowledge in this century, however, it has become clear that human populations are not unambiguous, clearly demarcated, biologically distinct groups.1
The AAA's statement goes on to explain that there is more diversity within racial groups than there is between them. It also points out that humans have mated whenever and wherever they came into contact throughout prehistory and history and that this “continued sharing of genetic materials has maintained all of humankind as a single species.” The AAA communicated it loud and clear: Traditional racial groups such as “black” and “white” are not natural or consistent biological categories. Races are cultural categories of our own design. We invented divisions between people and then proceeded to blame nature for it. While the AAA's important statement is direct and readily available to anyone, there is a significant problem with it: Virtually no one read it. Including, it seems, many medical doctors and drug company executives, because currently there are hundreds of race-based drugs in development at major pharmaceutical companies. Many scientists warn that this is a mistake that could have severe consequences for patients.
What's wrong with racialized healthcare? The more personal and precisely targeted a drug is, the better it should work, proponents say. So why not race-based medicine? It seems logical that a drug engineered for black people would work better for a black person, for example, than a drug designed for anyone and everyone, right?
No. Drugs designed and prescribed according to race are not a good idea. It's a terrible idea for the simple reason that race groups are nowhere near the biologically distinct and unique subsets of humanity that most people think they are. The last thing you want is to be prescribed a drug based on some doctor's spontaneous assumptions about your current genetic makeup and your ancestry stretching back several thousand years, all based on how you look or identify yourself culturally. No one can glance at another human being and know such things with certainty. Consider Barack Obama; he self-identifies as “black” or “African American” and, based on his appearance, people who have been encultured to think in line with traditional American race rules would identify him as such. Imagine, however, if he was not the president of the United States and instead was some relatively unknown lawyer. What would a doctor probably assume his race to be? “Black” or “African American,” most likely. While this may be culturally accurate, it would be far off the mark biologically. And if Obama took a drug specifically designed and tested for African Americans—who knows?—it could be ineffective or even harmful to him. The reason Obama's genome would likely be significantly different from most African Americans is because they derive their recent African ancestry from West Africa. Obama's recent African ancestry comes from his father, who was an East African Kenyan. Ironically, it is his recent African ancestry that puts the most genetic distance between Obama and most other African Americans. His “white” mother is likely the closest kinship tie that he shares with African Americans because that population has high levels of recent white European ancestry too. The reason for this is because East Africans and West Africans are not nearly as closely related as many people assume.
Africa is our oldest home, “the cradle of humanity,” and our species has lived there longer than anywhere else. This is why Africans today are the most genetically diverse population. It's also why thinking of all dark-skinned Africans as simply “black people” that fit within a single biological race is nonsense scientifically—and risky when it comes to medicine. Obama may have skin color that is similar to many other African Americans, but this does not justify lumping him in with them when it comes to the serious business of prescribing drugs that were designed based on genetic and ancestral factors. The same applies to all of us. No doctor can know the complexities of your genome and ancestry stretching back across thousands of years by simply looking at you or noting which box you checked on a form.
In my experience discussing the concept of race in a formal setting or casual conversation, the question of “racial diseases” comes up virtually every time. It seems that most people are under the impression that many diseases afflict one race and not others and that this proves both the existence of races as well as the need for racialized medicine. The reality, however, is that commonly cited examples such as sickle-cell disease as a “black person's disease” and Tay-Sachs as a “Jewish disease” are not proof of anything. Sickle-cell disease is not a “black disease.” Many black people are in no danger of it and many non-black people are in danger of it. Sickle-cell trait is the result of people in some regions undergoing evolutionary adaptations in the presence of the malarial protozoa over thousands of years. It has nothing to do with our illogical concept of race. “Sickle-cell is a disease of populations originating from areas with a high incidence of malaria,” states race researcher Kenan Malik. “Some of these populations are black, some are not. The sickle-cell gene is found in equatorial Africa, parts of southern Europe, southern Turkey, parts of the Middle East, and much of central India. Most people, however, only know that African Americans suffer disproportionately from the trait. And, given popular ideas about race, they automatically assume that what applies to black Americans also applies to all blacks and only to blacks. It is the social imagination, not the biological reality, of race that turns sicklecell into a black disease.”2
Sickle-cell disease is a problem for many Hispanic people, people in northwest India and people throughout the Mediterranean region, many of whom have light-colored skin. “The label ‘black disease,’ however, rendered the distribution of sickle cell anemia invisible in other populations, leading to erroneous understanding of the geographical distribution of the underlying genetic variants,” writes Charles N. Rotimi in Nature Genetics. “This is one reason why many people, including physicians, are unaware that the town of Orchomenos in central Greece has a rate of sickle-cell anemia that is twice that of African Americans and that black South Africans do not carry the sickle-cell trait.”3
Similarly, Tay-Sachs should not be thought of as a “Jewish disease” because it is also a problem for non-Jewish French Canadians. False perception often trumps reality when it comes to race, and this is a mistake no one should be willing to tolerate in healthcare.
“We know race is a terrible proxy for genotype,” explains biological anthropologist Jonathan Marks. “The most relevant examples would be something like a drug working in 75 percent of Africans but 25 percent of Asians. First, within each category, there will have to be huge variation, patterned the way we know human diversity is patterned: the African Ethiopians are more likely to cluster with the Asian Pakistanis than with the African Ghanaians. So the continental average value is hardly of use. More importantly, the drug won't work in 25 percent of Africans—and might sicken them—and will work in 25 percent of Asians [who won't receive its benefits because it won't be given to them]. What I'm getting at is that the test has to be made at the individual genotype level; prescribing a drug based on the census category of the patient is a medically very bad idea.”4
Dr. Marks is correct, of course. Races as biological categories of humans are far too illogical, inconsistent, and untrustworthy to base things as important as medical diagnoses and treatments on. I certainly don't want a doctor looking at me, seeing a “white man,” and making her decisions accordingly. My personal history could be a lot more complicated than that. Like it is for most people, my family history blurs after only a few generations and becomes a total mystery after six or seven. If I have no idea who the majority of my ancestors are, I know my doctor doesn't. What we need is not racialized medicine but individualized medicine. Fortunately, it's on the way. In 2003, the US government produced a rough draft of a human genome for about $2.7 billion (1991 dollars).5 By 2010, a genome could be sequenced for a few thousand dollars (though most companies charge a lot more to do it). Soon, experts predict, the cost will be less than $1,000.6 That's great; in the meantime, however, be weary if offered medical treatment that is based on race. Ask to be viewed by your doctor as a unique individual with an ambiguous ancestry spanning many thousands of years—because that is precisely who you are.
It is important to understand that rejecting the existence of biological race categories and criticizing racialized medicine does not mean that race has no place in discussions about health and healthcare. Cultural race groups are real and meaningful because we made them so. They can have deadly biological consequences and therefore can't be ignored. “Black” or “Native American” may be nonsense as biological categories, for example, but they still have to be considered because membership to a group can sometimes have very serious health consequences. This is because people often are treated differently, make unique choices, or experience different environmental conditions (stress, toxins, nutrition, violence, and so on) as a direct result of belonging to a particular cultural race group. This can cause confusion on the issue of race for the general public and many doctors because racial health disparities do exist within some societies. This leads some people to conclude that biological race is the cause, when in reality cultural race is to blame. The Pima Indians are a good example of this.
Nearly half of the adult Pima Indians in Arizona have type 2 diabetes, one of the highest rates in the world. No doubt it would be automatic for many people to see this as a biological race problem in need of a biological race solution, perhaps a race-based drug. But hold on, there is a community of Pima Indians just across the border in Mexico, and they have a type 2 diabetes rate of approximately 7 percent.7 This is essentially one population of people, with the same ancestry, split into two by an imaginary line. If race is all about kinship and ancestry, then it makes no sense that this could be a racial problem in need of a racial solution. Clearly there is something about living conditions on one side of the border (diet perhaps?) that created this health disparity. The Pima Indians in Arizona don't need a new pill designed and marketed for their “biological race.” What they need to do is address whatever it is within their specific culture or environment that is causing the high diabetes rate.
Another example of a health problem that can be misinterpreted easily is the relatively low birthweight of black babies born in the United States compared with white babies born in the United States. Low birthweight is a serious matter, as it corresponds with many health risks for infants. But where many might reflexively imagine a biological race problem in need of a race-based cure, a long-term study of the problem points directly to social causes. Researchers found that black African women who had immigrated to America had babies that were the same weight as white American babies. But the daughters of these African women who grew up in America later had babies that weighed, on average, half a pound less than white babies. Furthermore, the researchers discovered that infants born to black Caribbean women who had immigrated to America weighed more than the babies of black women who had been born in the United States. If this problem were tied to biological race, then it would not spare black women from Africa and the Caribbean. It seems clear that there is something about living your entire life as a black woman in America that puts your infant at a relatively high risk of low birthweight. This is a cultural challenge.8
The fact that biological race categories do not exist in a consistent or logical sense means that we cannot safely rely on them to diagnose and treat people with health problems. Cultural race groups may be relevant and important to determining the best course of action to help people in some cases. But it's vital that we keep it clear in our minds that there is a difference between biological race and cultural race. The lay concept of race can easily trick us into making false assumptions about our genes, ancestry, and medical needs. For this reason, belief in biological races clearly has no place in a doctor's office, in hospitals, or in the development of drugs.
GO DEEPER…
Books
Graves, Joseph L. The Emperor's New Clothes: Biological Theories of Race at the Millennium. Piscataway, NJ: Rutgers University Press, 2003.
Harrison, Guy P. Race and Reality: What Everyone Should Know about Our Biological Diversity. Amherst, NY: Prometheus Books, 2010.
Montagu, Ashley. Man's Most Dangerous Myth: The Fallacy of Race. Lanham, MD: AltaMira Press, 1997.
Other Sources
Unnatural Causes…Is Inequality Making Us Sick? www.unnaturalcauses.org/media_and_documents.php.
Vaccines can be credited with saving approximately nine million lives a year worldwide. A further sixteen million deaths a year could be prevented if effective vaccines were deployed against all potentially vaccine-preventable diseases. In all, vaccines have brought seven major human diseases under some degree of control: smallpox, diphtheria, tetanus, yellow fever, whooping cough, polio, and measles.
—UNICEF
I’m feeling uneasy as the nurse prepares the syringe. Not that my precious little baby daughter or anyone else would ever know it. I'm upbeat, all smiles and jokes on the outside. But there is no denying the resentment smoldering within. I'm bothered because I'm trapped in a time period when the best medical science can do is stab my baby with a sharp piece of metal in order to get disease-preventing vaccines into her little body. Of course, I suppose I should be grateful that I'm not stuck in the time before vaccines. That was when half the children never made it to the age of five. I rub my daughter's head and force a smile as the nurse jabs a needle into her. “There, sweetheart, all done.”
I can't remember if it was the DPT shot (for diphtheria, pertussis, tetanus) or MMR (for measles, mumps, rubella) that she received that day. I do, however, recall feeling troubled by more than just her temporary pain. It was 2002, and as a journalist who reads science news incessantly and often writes about science topics, I was well aware of the growing concerns and protests over vaccines. I understood that the claims of an autism-vaccine link were unproven, but I watch talk shows on TV too. I had heard the claims from mothers, some tearful and some enraged, that vaccines were responsible for their children's autism. I know the difference between anecdotes and credible scientific studies. I also know the difference between a Hollywood celebrity and a scientist. Still, I found it impossible to forget those passionate warnings when it was my child about to get the shot. “What if they're right
? What if there really is something wrong with vaccines and the scientists just haven't figured it out yet? What if I am about to make the biggest mistake of my life? What if I let this happen and it condemns my little girl to a diminished life?”
Fortunately, I reacted to the scary questions in my head by thinking. Emotions are wonderful; I love them. But when it comes to important decisions, I prefer analysis and reason to hunches and fears. I may have felt the possible threat of an autism-vaccine link, but I knew the reality of how vaccines protect children. There is no doubt that vaccines save the lives of millions of children each year and prevent many millions more from having to suffer through painful illnesses. I want my children to be on that side of the fence. How could I possibly send my daughter out into a dangerous world without protecting her from known killers such as measles and diphtheria? In the end, I decided it is far safer to go with the known and the proven over the unknown and the unproven—especially when my daughter's safety is the issue. A few celebrities and one or two renegade doctors don't match up favorably against the world's top epidemiologists. There are no guarantees, of course, but it would have been reckless and irresponsible of me to withhold a very important protection from my child based on unproven claims.
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