Good Reporting on Race, Genes, and Health Outcomes

We here at Biopolitical Times are deeply concerned by how the media discusses racial disparities in health and the growing tendency to reduce unequal health outcomes to presumed yet unverified genetic differences between races. That's why it's important to point out when journalists show a healthy amount of skepticism about such claims, and today's award goes to Washington Post HealthDay reporter Ed Edelson.

Edelson wrote a piece this week in response to a study recently published in Archives of Internal Medicine showing that Blacks with asthma are much more likely than other races to visit emergency rooms or be hospitalized. The kicker is in their conclusion:

Even in a health care setting that provides uniform access to care, black race was associated with worse asthma outcomes, including a greater risk of [emergency department] visits and hospitalizations. This association was not explained by differences in [socio-economic status], asthma severity, or asthma therapy. These findings suggest that genetic differences may underlie these racial disparities.

This troubling move - finding health outcome differences between races, controlling for a handful of variables, and suggesting that genes are the cause without actually studying them - happens all too often in biomedical research. This isn't to say that our genetic endowments don't affect our heath. Rather, it's to point out the ease with which medical researchers give credence to the long discredited idea that there are meaningful biological differences between races - particularly in research where genes aren't even studied.

Edelson provides a balanced review of this study by quoting Dr. Lauren Smith at length:

But the reality is not that simple, said Dr. Lauren Smith, an associate professor of pediatrics at Boston University. She led a larger study two years ago that found that socioeconomics played a big role in asthma management when income fell well below the poverty line.

The San Francisco researchers said they adjusted for socioeconomic factors, "but even when one looks at such factors, there are differences that often go unincorporated because they are not easy to handle," Smith said. "Housing quality, segregation in the neighborhood, these are things that generally are not accounted for when you control for socioeconomic status. And the experience of race is complicated, and the measures you have to look at socioeconomic status generally are broad."

Those factors mean that "a genetic explanation needs to pass a high bar to come to that conclusion," Smith said.

Keep up the good work, Ed.