You want your doctor to treat you as an individual. But clinical practice is warped by dubious—and sometimes outright dangerous— ideas about raceby Angela Saini / June 10, 2019 / Leave a comment
When I was pregnant some years ago, a friend of mine—a doctor at a busy London hospital—told me that South Asian women tend to give birth earlier than other women. That passing comment was enough for me to begin cheerfully planning around the likelihood that my baby’s arrival was more imminent than I had thought. I prepared the nursery ahead of time. I confidently told my brother-in-law, who was visiting from overseas, that his nephew would be born long before he had to return home. In the event, my son came two weeks late and my brother-in-law missed the birth.
I recalled this when I started researching the use of race in medicine. I remembered how unquestioningly I had accepted my friend’s assertion. This wasn’t just because I trusted her medical expertise, but also because it slotted neatly into a wider story we have been told: that certain ethnicities and racial groups have different propensities to illness, from diabetes to heart disease to schizophrenia. These assumptions have been creeping into diagnostics and drug evaluation for years, in different ways. But they are assumptions which, as my own pregnancy taught me, can often be misleading. Indeed, in some circumstances, fatal.
On the surface, there are of course average physical differences between populations, most obviously in skin colour and facial features. A handful of inherited diseases also show up in higher frequencies in certain communities than in others: the serious blood condition sickle cell, for example, occurs at greater rates in black Americans than white Americans. There are those who also like to point to the possibility of deeper variations, including in “build.” Reviewing Kenya’s phenomenal success in long-distance athletics a few years ago, the Atlantic’s Max Fisher speculated that the local population’s shape, lungs and muscles might give them some “genetic” edge.
But the truth is more complex than it might seem. Scientific reality almost always defies our crude categories of race, which are themselves byproducts of recent human history. Yet claims about “racial difference” reflect and reinforce the widespread belief that race matters in some deeper, visceral way. On far-right websites, I have seen supposed medical differences cited as positive proof of this. Yet most of the apparent differences are illusions, which…