The Fallacy of Race Based Health
In celebration of Black History Month, the Johnson Center is embarking on a month-long educational campaign on the genetic dispositions of African Americans. Each week, we will explore a different genetic variation commonly seen in Black Americans and explore the potential ramifications. But first, why focus on genomics? Why isn’t simply looking at race enough?
For one, the concept of race is a social construct. Because what does race really mean? Does a white person with South African lineage check the box for ‘African American’? Are Russian Americans categorized as ‘Asian’ or ‘White’? With such broad racial categories, it is impossible to make assumptions about what medical treatment or dosage should be given. Yet, it is frequently the case. The reliance on race within conventional medicine is one of the key problems of the American health care system. The categories are too broad for correct assumptions to be made.
What is race?
The concept of race can be traced back to the 19th-century scientist, Dr. Samuel Morton. Morton collected skulls of people around the world and measured their volume to rank and denote different races. He designated 5 different races and ranked them as such: “whites, East Asians, Southeast Asians, Native Americans, and Blacks.” While the concept of race in America has changed to include more ethnicities, the distinctions between races continue to influence American politics, neighborhoods, and health care.
It was not until the completion of the human genome project mapped out our DNA in 1990 that scientists could begin to explore if the concept of race had any genetic association. What researchers found demonstrated 2 key concepts:
The genome sequencing of all humans is much more similar than previously assumed.
Because everyone has the same collection of genes, albeit, with slightly different versions of them, scientists have been able to trace a complex family tree of all humans
All humans trace back to Africa:
This complex family tree researchers created traces all humans back to the evolution of homo-sapiens in Africa around 300,000 years ago. Homo-sapiens didn’t begin to leave Africa until around 200,000 years had passed, and when they did leave, it was only a small portion of the population. But by then, groups had begun to isolate and develop new genetic differences. And, the longer a genetic group has been separated, the more distinctive tweaks develop in their DNA. Scientists have been able to trace the DNA of modern-day Africans to groups that had been isolated from the main population for far longer than the group that left Africa. African populations such as the Khoe-Sana and the Pygmies were isolated from the population for tens of thousands of years before humans left Africa. This early isolation means that the most deviance between genetic sequencing can be seen between different sects of modern-day Africans, NOT between white and Black people.
All non-Africans in the world today are descended from the several thousand homo-sapiens that left Africa. This small subset of the African population that left took with them only a tiny fraction of the genetic diversity. From there, humans spread throughout the world, and naturally, genetic variations occurred. With the help of natural selection, different populations spread different genetic mutations that most benefited the population. This is why people with ancestry in the Mediterranean are better equipped to handle carbohydrates. This is also why people have different skin colors, a genomic differences of one letter designates how well your skin can handle the sun. Yet, the construct of race is completely reliant on the color of a person’s skin. One genetic variation can label you as Black or white.
The construct of race has no basis to hold weight in how people are treated for an illness. Craig Venter, a pioneer of genome sequencing said, “the concept of race has no genetic or scientific basis.” Genomic medicine is truly the only way to achieve your optimal health. Your health journey should not be based on the color of your skin. At the Johnson Center for Health, we do not use race to conclude the type of treatment you need, we use your DNA. And while race is a misguided construct, DNA doesn’t lie.