Examining Race-Based Medicine
Jerry Adler, senior editor for Newsweek, examines research into the genetic differences between racial groups in a recent opinion piece for the magazine. According to Adler, the question of "what, if any, are the significant genetic differences between racial groups ... that we use to define 'race'" was "virtually a closed question in academia" for decades. However, medical researchers lately have been collecting data on differences in health risks and drug responses for various groups, according to Adler.
In addition to BiDil -- the first FDA-approved drug to treat heart failure specifically for blacks -- a recent Pharmacogenomics Journal study "counted up nine clinical trials around the world studying diseases or treatments in groups defined by race or gender or both, including chronic hepatitis B in blacks and Hispanics and respiratory syncytial virus in Native American infants," Adler writes.
A report of a conference attended by medical ethicists, geneticists and legal scholars "urges researchers to tread carefully in designing, carrying out and reporting studies that involve racial categories," Adler writes. Timothy Caulfield -- a professor of health law at the University of Alberta, who convened the conference -- believes that race as a social construct is not very useful biologically. For instance, according to Caulfield, descendents of Nigeria are very different from those of Kenya, even though they are both physically categorized as black, Adler writes.
Caulfield also is concerned that even if such distinctions are made in research, once that research "gets in the hands of drug manufacturers, there's going to be slippage ... marketers want to sell to the broadest possible categories."
However, Adler says "that very tendency runs counter to another significant trend in medicine." He writes, "The research that has allowed us to parcel out racial differences by ancestry will eventually outstrip even those categories, and identify specific vulnerabilities and drug reactions in the genomes of individuals." Adler says, "We will no longer be white or Asian or African, or even Northern European, Ashkenazi, Japanese or East African; we will be who we are, each one of us," concluding, "And the sooner we reach that point, the better" (Adler, Newsweek, 1/12).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Weekly Health Disparities Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Weekly Health Disparities Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.