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Does Race Play a Factor in Health?

Does Race Play a Factor in Health?


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Dr. Kim Mulvihill ReportingWe know that many factors influence our risk of getting some diseases, everything from our diet to how much we exercise. But could your race also be a factor? It's an intriguing, but controversial question.

When we talk about race, genetics, and medical science, for many people it brings up uncomfortable memories. Memories of Nazi experiments in World War II, or the Tuskegee experiment in the US when African Americans with Syphilis were left untreated to see how the disease would affect them.

So it's no wonder that scientists all too often shy away from the subject, but that reluctance could be hurting people like 12-year old Chad Houston.

Chad has sickle cell anemia. It's an inherited disorder in which red blood cells become distorted causing intense pain.

Chad Houston, Sickle cell patient "Sometimes it's like excruciating, it really hurts bad, but sometimes it’s dull.”

An estimated 80-thousand Americans suffer from the disease, the vast majority of them African Americans. Sickle cell anemia is just one of a number of diseases where a person's ethnicity seems to play a role in determining their risk.

Doctor Michael Lenoir is the president of the ethnic health institute.

Dr. Michael Lenoir, Ethnic Health Institute: "There are also some diseases that are more common in other ethnic groups: diabetes in Latinos, Hepatitis C in Asian populations."

But just how big a role does race play in health? It's a question with big implications. If race is important, failing to take it into account when doing medical studies could hurt patients like Chad by delaying discovery of new drugs or new approaches to treating their disease.

But like anything to do with race there are no easy answers. Researchers involved in the human genome project say you cannot tell from a person's DNA, the basic blueprint for our bodies, what race they are. They say making medical decisions based on what a person looks like is just bad science. And yet there is evidence that race does, at least on some level, influence health.

Doctors Esteban Burchard and Elad Ziv are researchers at UC San Francisco. They say it is increasingly clear that different races are at different risks for different diseases.

Dr. Esteban Burchard, UCSF Internal medicine specialist: "Here at San Francisco General it was demonstrated that metabolism rates for nicotine, or byproducts of nicotine, vary by racial groups and that could have major implications for different rates of emphysema, different rates of lung cancer and so forth."

Some studies suggest race not only influences the diseases we get, but also how we respond to treatments. For instance, not only are African Americans more likely than whites to get asthma, but they are less likely to benefit from the most commonly prescribed medications.

Dr. Michael Lenoir: "It's pretty clear that African Americans don't respond the same way to Albuterol, which is a very common bronchodilator. They don't get as much of a change in the size of the airway and in many instances have side effects."

Similarly African Americans with high blood pressure do not respond as well to beta blocker medications as whites; nor do those with Hepatitis C respond to interferon as well as whites.

But could these differences be due to something other than race? How much are disease and response to treatments influenced by culture, diet or socio-economic class? And how do you even sort through those elements to get at the truth?

Part of the problem may be that we don't know what role race plays because we haven't really studied it. Most clinical trials do not include enough people of color to determine if certain medications work just as well in say Asians as they do in whites.

Dr. Burchard: "We don't know where we are at or how important the or what the relative importance of race and ethnicity is, but just because we don't know does not mean we should exclude it and gloss over it."

They say we have to overcome our sense of discomfort in discussing race, genetics and medicine. Only by fully exploring the issue will we know what, if any, role race plays in our health. There's a lot more at stake than just academic bragging rights. Just ask people like Chad.

Doctors Burchard and Ziv say the argument over race and health is at the same level that the argument over gender and health was in the 1970's; and that only by including more communities of color in medical studies can we decipher the role that race plays in health.

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