Mistreating Health Inequities: - PowerPoint Presentation

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Mistreating Health Inequities:The New Biopolitics of Race, Health & Justice

Dorothy RobertsSlide2

D.Roberts, UPennSlide3

111 “excess” deaths of black women in Chicago in 2005

Almost

one-half of annual black breast cancer deathsD.Roberts, UPennSlide4

Black and White Breast Cancer Mortality Rates, Chicago, 1980-2005

Age-Adjusted Female Breast Cancer Mortality for Chicago, Per 100,000 Population

38.1

37.4

41.4

19.2

D.Roberts, UPennSlide5

I believe one of the great truths to emerge from this triumphant expedition inside the human genome is that , in genetic terms, all human beings, regardless of race, are more than 99.9% the same. June 26, 2000

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The Scientific Invention of RaceD.Roberts, UPennSlide7

The Tuskegee Experiment, 1932-1972D.Roberts, UPennSlide8

North Carolina Eugenics Board, 1933-1973D.Roberts, UPennSlide9

Nicholas Wade, NY Times, July 20, 2001“Scientists planning the next phase of the human genome project are being forced to confront a treacherous issue: the genetic differences between human races.D.Roberts, UPennSlide10

“An explosive new account of the genetic basis of race and its role in the human story.”D.Roberts, UPennSlide11

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A New Biopolitics of RaceNew racial science defines race as genetic grouping.Biotechnology and pharmaceutical industries develop race-specific products.Racial inequality & state violence persist in supposedly “post racial” society.D.Roberts, UPennSlide13

“Genome Study Points to Adaptation in Early African-Americans,” Nicholas Wade, Jan. 2, 2012HARSH NEW WORLD Slaves in Georgia, circa 1850. A new environment apparently brought genetic change. D.Roberts, UPennSlide14

“[C]ertain disease-causing variant genes became more common in African-Americans after their ancestors reached American shores—perhaps because they conferred greater, offsetting benefits.”D.Roberts, UPennSlide15

Infant mortality rate for blacks increased from 1.6 times to 2.3 times rate for whites since 1950s.D.Roberts, UPennSlide16

Test the hypothesis that “black race independent of other factors increases the risk of extreme preterm birth and its frequency of recurrence.”

Zachary

A.-F. Kistka, et al., “Racial Disparity in the Frequency of Recurrence of Preterm Births,” American Journal of Obstetrics & Gynecology

196 (2007): 131.e1. D.Roberts, UPennSlide17

Findings “suggest a probable genetic component that may underlie the public health problem presented by the racial disparity in preterm birth.”D.Roberts, UPennSlide18

Nicholas Bakalar, “Study Points to Genetics in Disparities in Preterm Births,” New York Times, February 27, 2007, F5.

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Overall birthweight distribution for infants of US-born white women and African-born women almost identical.Black women born in US experienced higher rates of very low birthweight.Richard David & James Collins Jr., Disparities in Infant Mortality: What’s Genetics Got to Do With It? A JPH 97 (2007): 1191-1197.D.Roberts, UPennSlide20

“Our findings were not readily explained by any genetic mechanism but rather suggested that negative effects of minority status are cumulative through the life course from fetus to childbearing women.”D.Roberts, UPennSlide21

Race-specific MedicineD.Roberts, UPennSlide22

D.Roberts, UPenn

“Observed

racial disparities in mortality and therapeutic response rates in black patients may be due in part to ethnic differences in the underlying pathophysiology of heart failure"

Nitromed

March 2001 press

releaseSlide23

“We’re using self-identified race as a surrogate for genetic markers.”

Dr. Steve Nissen, chair FDA advisory committeeD.Roberts, UPennSlide24

A pharmacogenomic drug?“Representing a step toward the promise of personalized medicine.” FDA News Release, 6/23/05“On the leading edge of the emerging field of race-based pharmacogenomics.” NYT Mag, 10/10/04

D.Roberts, UPennSlide25

D.Roberts, UPenn

BiDil as remedy for medical wrongs against African Americans

“

for whom treatment has been denied and deferred for 400 years.”Slide26

“the strategic use of race as a genetic category to obtain patent protection and drug approval” Jonathan Kahn, Hamline University

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False Equation 0.1 % genetic difference = race

unequal health outcomes

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Embodying RacismD.Roberts, UPennSlide29

Colorblind Social Policy “The way to stop discrimination on the basis of race is to stop discriminating on the basis of race.” Chief Justice John Roberts, Parents Involved in Community Schools v. Seattle School District No. 1 (2007)

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Social race is the phenomenon constructionists have in mind…. Biological race, however, is what BiDil’s developers are concerned with – that is, race as ancestry. Sally

Satel

(2004) D.Roberts, UPennSlide31

We talk a lot about diversity in the United States, as long as we wink and smile that this diversity is not real …. But in some aspects of our humanity, it is very real, and such differences can have huge consequences in everything from sports performance to success in the classroom. Jon Entine (2007)

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Twisted Logic Racial differences are real at the molecular level, but merely constructed in society

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“A DATE WITH DNA”NYTimes, Sept. 2008D.Roberts, UPennSlide34

Apple & Facebook pay for egg freezingApple & Facebook offer to pay female employees D.Roberts, UPennSlide35

Gang-Banging May Be GeneticBy Associated Press, June 17, 2009Slide36

Wrong DirectionSocial hierarchies are facts of nature that require private technological fixes & punitive controls.D.Roberts, UPennSlide37

A more just society would be a healthier one D.Roberts, UPenn