Thinking critically about race and ethnicity in biomedical research

By Bradley Kawano.

As a senior at Occidental College, I had the privilege to hear Rev. William Barber deliver a speech on race and the political divide in the U.S. Speaking about our politics, he asserted that we could not avoid the problem of race. Instead, we must confront it head-on. In science, we face a similar issue. Racial health disparities exist. Racial justice requires us to understand these disparities and eliminate them. Yet, bioethicists regularly debate what role, if any, race should play in biomedical research. Like our politics, I think that we need to confront the use of race in scientific research, particularly in biomedical research, head-on.

To find answers to these problems, I have taken undergraduate and graduate-level courses on the philosophy of race. My professors, Clair Morrissey and Robert Brandon, encouraged critical engagement with a range of ideas including race eliminativism, cladistic race concepts, and of course social constructionism. Thus, people like Sally Haslanger, Jonathan Kaplan, Lisa Gannett, and Quayshawn Spencer have deeply influenced how I think about race. However, it is Catherine Lee’s work that is most central to my critiques. Briefly, Lee has found that biomedical scientists under-theorize what race is and use race in an unreflective way. This limits our ability to think about the causes of racial health disparities and potential solutions.

Unfortunately, I have also noticed that most debates on race and science center on a Black-White dichotomy. This dichotomy leaves out racial groups, like my own, whose presence should complicate how we think about race. This led me to qualitatively analyze a relatively novel study comparing the progression of cardiovascular disease in South Asians to other groups in the U.S.: the Mediators of Atherosclerosis among South Asians Living in America (MASALA) study. This turned out to be a fruitful case to investigate how a group of scientists used race, ethnicity, and ancestry to study cardiovascular health disparities between South Asians, White, Black, Hispanic, and Chinese Americans.

Ultimately, I want this research to be a springboard to think about how scientists can use race responsibly. Certainly, race is an important concept for scientists to track and study racial health disparities. In fact, it was biomedical researchers who identified the cardiovascular health disparity between South Asians and other populations. And even if we could definitively prove that this disparity is the result of structural inequities as opposed to genetic differences, we would still need biomedical researchers to demonstrate how those structural inequities translate into biological health disparities.

However, I think we should also insist that scientists be more critical about their use of race. What assumptions do they make when picking out their study population? What limitations do those assumptions introduce? How should they interpret their findings, especially when those findings focus on genetic and molecular differences between the groups? How should they present and disseminate their findings to the public? Scientists should not take race and racial groups for granted. And by extension, we should be equally critical about attempts to replace race with ethnicity and ancestry.

Race is not off-limits for scientists. Instead, it is a complicated idea that they need to approach more critically than they used to.

 

Paper title: Constructing a South Asian Cardiovascular Disease: A Qualitative Analysis on How Researchers Study Cardiovascular Disease in South Asians

Author: Bradley Kawano

Affiliations: Duke University School of Medicine

Competing interests: The author has no competing interests to disclose.

Social media accounts of post author: @BradleyKawano

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