Racism In Health Care

Most of you came across my content through my Instagram that highlights my yoga journey, but you may not know that I am also a Nurse Scientist and Professor. I actually spent several years working as a Nurse Practitioner and seeing patients. Now, I spend my days teaching students and performing academic research studies on sleep. 

In addition to sleep, I have a huge passion for social justice. I educate my readers to improve the health outcomes of vulnerable populations. On my blog, I’ll discuss topics like racism in medicine and what its implications are.

In this post, I’ll be discussing:

• How race ties in with the Human Genome Project
• Race as a social construct
• Racial disparities are secondary to racism and not race

Let’s start out by diving into the Human Genome Project.

Human Genome Project

In 2003, an international scientific research collaboration called the Human Genome Project was completed. Their goal was to sequence the human genome. The human genome is a set of base pairs and nucleic acid sequences making up your DNA and the 23 chromosome pairs in your cells. While the Human Genome Project resulted in the complete sequencing of 3.2 billion base pairs, there were other conclusions from the study.

The Human Genome Project demonstrates that there are more genetic variations within a given “racial category” than between them. This shows that two unrelated human beings with very different external appearances from a different “racial category” are actually more alike than two individuals from the same “racial category.” 

If you take any two individuals, they share 99.9% of their DNA, and 0.1% varies between each other. And that 0.1%? Well, 95.7% of the human genetic variation (so 95.7% of the 0.1%) occurs between individuals within the same continental group. When we study our DNA, the results reveal that race isn’t real in a biological sense. There’s no “race chromosome.” 

As fascinating as these findings from the Human Genome Project are, scientists from fields such as Evolutionary Biology and Anthropology had already been stressing the lack of scientific basis in race categorization for decades prior.

So where did race originate from?

Race Is a Social Construct

We’re all a part of the human race. Humanity is itself a race. However, during colonization and the slave trade, the human race was split into categories based on skin color. But skin color has more to do with the geography of your ancestors than it does your DNA. Your skin will be darker if your ancestors were born closer to the equator to protect your skin from the sun’s UV rays – like a natural protective sunscreen.

Documented use of the word “race” exists as early as the 1500’s. However, it was a word rarely ever used and an idea interchangeable with terms such as “type” or “sort”. 

The use of the word race to classify large segments of human beings originated in 1758 with a Swedish taxonomist by the name of Carl von Linne who classified human beings into the following categories:

• Europeans – ‘fair, gentle, acute, inventive, governed by laws’
• Amerians – ‘copper-coloured, obstinate, content free, regulated by customs’
• Asiatics – ‘sooty, severe, haughty, covetous, governed by opinions’
• Africans – ‘black, crafty, indolent, negligent, governed by caprice’

In 1775, a German anthropologist by the name of Johann Blumenbach presented his own race categories:

• Caucasian – coined based on the belief that the Caucasus mountains produced the most beautiful race of men
• Mongolian
• Ethiopian
• American
• Malay

While some insist race is a biological construct, the Human Genome Project, other scientific research studies, and history reveal that race is a social construct. This social construct was developed for the sole purpose of justifying colonization and the slave trade. Positioning Europeans or Caucasians a the top of an invented societal hierarchy allowed slave traders, colonizers, and their supporters to absolve themselves of any guilt they otherwise might have experienced at kidnapping, enslaving, pillaging, raping, and slaughtering their fellow human beings.

By the 1800s, there were three racial categories used in the United States:

• Black
• White 
• Mulatto

You’ll see in this graphic from the United States Census that the way the country defines race has changed from the 1700s to today. In fact, it appears that each race reported has changed every year except for white. Between 1790 and 1952, the naturalization of a foreigner to the United States was primarily for “free white persons.” Racial prerequisites for court decisions and naturalization defined the boundaries of whiteness and race. 

To emphasize the social construct of racism, some ethnicities that are not considered white (like those of Mexican descent) were considered white under the United States census in the 20th century. And up until the 1950s, the United States census could look at a person and decide what race they thought the person was and mark it down as such. 

The example of the United States census is just one example that shows that race is not biological. Race is a social construct.

But what about racial disparities?

Racial Disparities Are Secondary to Racism

Racial disparities are the incongruities and imbalances between the treatment of racial groups which includes housing options, societal treatment, and economic status. Racial disparities are secondary to racism and not race. The color of your skin doesn’t put you at a greater or lesser risk of a disease biologically. So why is race used in medical research? 

Dorothy Roberts, JD a professor at the University of Pennsylvania’s Africana Studies Department, gives an example in an interview with NPR.

“Black patients who have the symptoms of cystic fibrosis aren’t diagnosed because doctors see it as a white disease.”

Dorothy Roberts, JD

This is dangerous as it can lead doctors, scientists, and medical professionals treating a patient to believe that each race has different genes from the others.

Racist policies impact the distribution of wealth and resources. These policies are the cause of health disparities and other disparities such as education, incarceration, and wealth. Several racist policies were signed in the New Deal by Franklin D. Roosevelt during the Great Depression. These government policies created housing codes that would determine which banks could give housing loans to people based on their race. It was extremely hard for a Black family to be given a loan compared to a white family. Real-estate is the primary driver of wealth in America, so this deeply hurt Black communities. 

Now how does this affect health?

Due to urban planning that benefited richer white neighborhoods, Blacks, Indigenous peoples, and people of color are more likely to live closer to industrial plants that release toxic by-products and fumes, homes with toxic paint and undrinkable water, and live further away from grocery stores with fresh produce. This leads to higher incidents of health issues like cancer and asthma.  

Be The Change

While I addressed race and racial disparities, I just scratched the surface of racism in health care. This blog post serves as an introduction. I’ll continue to write and educate you about racism in health care. I also hope to inspire you to educate yourself and take action. We can take action to help eradicate racism in our health care system.

What are your thoughts about racism in health care? Share with me in the comments below.