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Morse-Karzen B, Lee JW, Stone PW, Shang J, Chastain A, Dick AW, Glance LG, Quigley DD. Post-Acute Care Trends and Disparities After Joint Replacements in the United States, 1991-2018: A Systematic Review. J Am Med Dir Assoc 2024:105149. [PMID: 39009064 DOI: 10.1016/j.jamda.2024.105149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVE To review evidence on post-acute care (PAC) use and disparities related to race and ethnicity and rurality in the United States over the past 2 decades among individuals who underwent major joint replacement (MJR). DESIGN Systematic review. SETTING AND PARTICIPANTS We included studies that examined US PAC trends and racial and ethnic and/or urban vs rural differences among individuals who are ≥18 years with hospitalization after MJR. METHODS We searched large academic databases (PubMed, CINAHL, Embase, Web of Science, and Scopus) for peer-reviewed, English language articles from January 1, 2000, and January 26, 2022. RESULTS Seventeen studies were reviewed. Studies (n = 16) consistently demonstrated that discharges post-MJR to skilled nursing facilities (SNFs) or nursing homes (NHs) decreased over time, whereas evidence on discharges to inpatient rehab facilities (IRFs), home health care (HHC), and home without HHC services were mixed. Most studies (n = 12) found that racial and ethnic minority individuals, especially Black individuals, were more frequently discharged to PAC institutions than White individuals. Demographic factors (ie, age, sex, comorbidities) and marital status were not only independently associated with discharges to institutional PAC, but also among racial and ethnic minority individuals. Only one study found urban-rural differences in PAC use, indicating that urban-dwelling individuals were more often discharged to both SNF/NH and HHC than their rural counterparts. CONCLUSIONS AND IMPLICATIONS Despite declines in institutional PAC use post-MJR over time, racial and minority individuals continue to experience higher rates of institutional PAC discharges compared with White individuals. To address these disparities, policymakers should consider measures that target multimorbidity and the lack of social and structural support among socially vulnerable individuals. Policymakers should also consider initiatives that address the economic and structural barriers experienced in rural areas by expanding access to telehealth and through improved care coordination.
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Affiliation(s)
- Bridget Morse-Karzen
- Center for Health Policy, Columbia University School of Nursing, New York, NY, USA
| | - Ji Won Lee
- Center for Health Policy, Columbia University School of Nursing, New York, NY, USA.
| | - Patricia W Stone
- Center for Health Policy, Columbia University School of Nursing, New York, NY, USA
| | - Jingjing Shang
- Center for Health Policy, Columbia University School of Nursing, New York, NY, USA
| | - Ashley Chastain
- Center for Health Policy, Columbia University School of Nursing, New York, NY, USA
| | | | - Laurent G Glance
- The RAND Corporation, RAND Health, Boston, MA, USA; Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine, Rochester, NY, USA
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2
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Schwäble Santamaria A, Grassi M, Meeusen JW, Lieske JC, Scott R, Robertson A, Schiffer E. Performance of Nuclear Magnetic Resonance-Based Estimated Glomerular Filtration Rate in a Real-World Setting. Bioengineering (Basel) 2023; 10:717. [PMID: 37370648 DOI: 10.3390/bioengineering10060717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/25/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
An accurate estimate of glomerular filtration rate (eGFR) is essential for proper clinical management, especially in patients with kidney dysfunction. This prospective observational study evaluated the real-world performance of the nuclear magnetic resonance (NMR)-based GFRNMR equation, which combines creatinine, cystatin C, valine, and myo-inositol with age and sex. We compared GFRNMR performance to that of the 2021 CKD-EPI creatinine and creatinine-cystatin C equations (CKD-EPI2021Cr and CKD-EPI2021CrCys), using 115 fresh routine samples of patients scheduled for urinary iothalamate clearance measurement (mGFR). Median bias to mGFR of the three eGFR equations was comparably low, ranging from 0.4 to 2.0 mL/min/1.73 m2. GFRNMR outperformed the 2021 CKD-EPI equations in terms of precision (interquartile range to mGFR of 10.5 vs. 17.9 mL/min/1.73 m2 for GFRNMR vs. CKD-EPI2021CrCys; p = 0.01) and accuracy (P15, P20, and P30 of 66.1% vs. 48.7% [p = 0.007], 80.0% vs. 60.0% [p < 0.001] and 95.7% vs. 86.1% [p = 0.006], respectively, for GFRNMR vs. CKD-EPI2021CrCys). Clinical parameters such as etiology, comorbidities, or medications did not significantly alter the performance of the three eGFR equations. Altogether, this study confirmed the utility of GFRNMR for accurate GFR estimation, and its potential value in routine clinical practice for improved medical care.
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Affiliation(s)
| | - Marcello Grassi
- Department of Research and Development, Numares AG, 93053 Regensburg, Germany
| | - Jeffrey W Meeusen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - John C Lieske
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
| | - Renee Scott
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Andrew Robertson
- Department of Research and Development, Numares AG, 93053 Regensburg, Germany
| | - Eric Schiffer
- Department of Research and Development, Numares AG, 93053 Regensburg, Germany
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3
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Mueller K, Balthazar MS, Hamilton JB, Kimble LP. Integrating the Social Determinants of Health Into Prelicensure Nursing Pharmacology. J Nurs Educ 2023; 62:175-179. [PMID: 36881892 PMCID: PMC10448450 DOI: 10.3928/01484834-20230109-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND Nursing organizations have called for the incorporation of social determinants of health (SDOH) throughout nursing school curricula. Guidance is needed regarding best practices to integrate SDOH into pharmacology courses in prelicensure nursing programs. METHOD Using Emory University's School of Nursing SDOH framework to guide curriculum innovation, pharmacology faculty identified three pharmacology-centric SDOH topics: race-based medicine and pharmacogenomics, pharmacy deserts, and lack of diversity in clinical trials. These three SDOH topics were incorporated into preestablished pharmacology content. RESULTS Faculty integrated SDOH into pharmacology courses with heavy science content, and students were receptive to open discussion of SDOH topics. CONCLUSION The integration of SDOH into a prelicensure nursing pharmacology course across multiple cohorts of students was feasible, and student feedback was positive. Faculty faced several challenges, including time constraints. Additional and ongoing training is needed to support the integration of SDOH into nursing curricula. [J Nurs Educ. 2023;62(3):175-179.].
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Royal CD. Science, Society, and Dismantling Racism. Health Equity 2023; 7:38-44. [PMID: 36744232 PMCID: PMC9892922 DOI: 10.1089/heq.2022.29023.cro] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
As a foundational pillar of the Truth, Racial Healing & Transformation framework, Narrative Change involves reckoning with our historical and current realities regarding "race" and racism, uprooting dominant narratives that normalize injustice and sustain oppression, and advancing narratives that promote equity and collective liberation. Narrative Change is vital to creating communal recognition and appreciation of the interconnectedness and equality of all humans and dismantling the ideology and structures of racial hierarchy. Telling new or more truthful and complete stories must include improving our understanding and messaging about what race is and what it is not as well as the relationship between race and racism. Ideas about the existence of biological human races have long been discredited by scientists and scholars in various fields. Yet, false beliefs about natural and fixed biological differences within the human species persist in some scientific studies, in aspects of health care, and in the political and legal architectures of the United States and other countries, thereby reproducing and maintaining social hierarchies. Efforts to eradicate racism and its pernicious effects are limited in their potential for sustained positive transformation unless simultaneous endeavors are undertaken to reframe people's thinking about the very concept of race. This brief provides an overview of the origins of racial hierarchy, distinguishes between biological concepts of race and socially defined race, reviews perspectives on the meanings and uses of race, and describes ongoing and potential efforts to address prevailing misunderstandings about race and racism.
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Affiliation(s)
- Charmaine D.M. Royal
- Departments of African and African American Studies, Biology, Global Health and Family Medicine and Community Health and Duke Center for Truth, Racial Healing & Transformation, Duke University, Durham, North Carolina, USA
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Braxton C, Begian-Lewis KM, Marback R, Fritz H. Pain, No Gain?: A Narrative Analysis Exploring the Accounts of Older African American Patients and Their Discussion of Pain Management Related to Chronic Illness. RHETORIC OF HEALTH & MEDICINE 2023; 6:217-240. [PMID: 38362507 PMCID: PMC10868708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Drawing from interviews conducted as part of a study of older African Americans with multimorbidity, we argue how various forms of racism work together to shape communication between doctors and patients. By focusing on what patients say about pain, we highlight patient descriptions of their relationships with pain management, their interactions with healthcare providers, and how they navigate understanding their chronic conditions. Our documentation of patient experience with stigmas and biases suggests what is needed for more empathetic and effective communication within the doctor and patient relationship. We conclude by using the interview data to propose addressing racial inequality in health care in the United States through educational reform and training initiatives grounded in rhetorical research.
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Affiliation(s)
| | | | | | - Heather Fritz
- Associate Professor and Founding Director of the Pacific Northwest University of Health Sciences School of Occupational Therapy
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Falzarano C, Lofton T, Osei-Ntansah A, Oliver T, Southward T, Stewart S, Andrisse S. Nonalcoholic Fatty Liver Disease in Women and Girls With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2022; 107:258-272. [PMID: 34491336 DOI: 10.1210/clinem/dgab658] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Indexed: 12/15/2022]
Abstract
CONTEXT Nonalcoholic fatty liver disease (NAFLD) describes a spectrum of liver damage due to excessive hepatic lipid accumulation. Recent research has demonstrated a high prevalence of NAFLD in women with polycystic ovary syndrome (PCOS). RESULTS Strong associations independent of body mass index (BMI) have been found between high androgen levels characteristic of PCOS, as well as insulin resistance, and the presence of NAFLD in these women, suggesting that these factors contribute to liver injury more significantly than obesity. Current studies indicate the occurrence of NAFLD in normal weight women with PCOS in addition to the commonly researched women who are overweight and obese. While the majority of studies address NAFLD in adult, premenopausal women (ages 25-40 years), the occurrence of NAFLD in young and adolescent women has gone largely unaddressed. Research in this field lacks diversity; a majority of studies either focus on populations of White women or are missing demographic information entirely. CONCLUSIONS Future studies should include larger, more racially and ethnically inclusive populations and particular attention should be paid to how excess androgens and insulin resistance contribute to the increased risk of NAFLD seen in women with PCOS of varying weights, ages, and ethnicities. OBJECTIVE AND METHODS Here, we review NAFLD in women with PCOS with subsections focused on the impact of hyperandrogenism, BMI, insulin resistance and age. Most notably, we present the most up-to-date racially and ethnically diverse worldwide prevalence of NAFLD in women with PCOS compared with women without PCOS (51.56% vs 29.64%, P < .001, respectively).
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Affiliation(s)
- Claire Falzarano
- Howard University College of Medicine, Physiology and Biophysics, Washington, DC, 20059, USA
| | - Taylor Lofton
- Howard University College of Medicine, Physiology and Biophysics, Washington, DC, 20059, USA
| | - Adjoa Osei-Ntansah
- Howard University College of Medicine, Physiology and Biophysics, Washington, DC, 20059, USA
| | - Trinitee Oliver
- Howard University College of Medicine, Physiology and Biophysics, Washington, DC, 20059, USA
| | - Taylor Southward
- Howard University College of Medicine, Physiology and Biophysics, Washington, DC, 20059, USA
| | - Salim Stewart
- Howard University College of Medicine, Physiology and Biophysics, Washington, DC, 20059, USA
| | - Stanley Andrisse
- Howard University College of Medicine, Physiology and Biophysics, Washington, DC, 20059, USA
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7
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Pierce P, Felver L. Visualizing diversity: the Oregon Health & Science University Educational Use Photo Diversity Repository. J Med Libr Assoc 2021; 109:472-477. [PMID: 34629977 PMCID: PMC8485945 DOI: 10.5195/jmla.2021.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Health science education needs images that represent both the diversity of patients served and the diversity of its students and clinicians. To begin to address this need, a nurse educator and librarian collaborated to launch the Oregon Health & Science University (OHSU) Educational Use Photo Diversity Repository. This online resource provides educators of health professional students with access to photos of pathophysiological conditions in skin of various colors so their students can increase their awareness of issues related to health and diversity and prepare themselves for more effective clinical work with their future patients. Case Presentation The OHSU Educational Use Photo Diversity Repository became a university-wide project, leveraging the thoughts of an image advisory board, clinicians, faculty members, administrators, and students. Key considerations were given to the workflows used to submit photos as well as the controlled vocabulary for submitting images. The repository was started with photos already in existence, with future plans to have images taken specifically for the repository. Conclusions This repository is playing an important role as OHSU and the health sciences in general reflect on the role of systemic racism in health care and clinical education. Negotiating issues of consent, patient health information, and privacy around using different technologies to take photos is a complex and ongoing process. The repository provides opportunities for closely examining these processes and creating improvements that result in more equitable education.
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Affiliation(s)
- Pamela Pierce
- , Digital Scholarship and Repository Librarian, Oregon Health & Science University, Portland, OR
| | - Linda Felver
- , Associate Professor, OHSU School of Nursing, Oregon Health & Science University, Portland, OR
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Hochman A. Janus-faced race: Is race biological, social, or mythical? AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 175:453-464. [PMID: 33135802 DOI: 10.1002/ajpa.24169] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/13/2020] [Accepted: 10/10/2020] [Indexed: 01/29/2023]
Abstract
As belief in the reality of race as a biological category among U.S. anthropologists has fallen, belief in the reality of race as a social category has risen in its place. The view that race simply does not exist-that it is a myth-is treated with suspicion. While racial classification is linked to many of the worst evils of recent history, it is now widely believed to be necessary to fight back against racism. In this article, I argue that race is indeed a biological fiction, but I critique the claim that race is socially real. I defend a form of anti-realist reconstructionism about race, which says that there are no races, only racialized groups-groups mistakenly believed to be races. I argue that this is the most attractive position about race from a metaphysical perspective, and that it is also the position most conductive to public understanding and social justice.
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Affiliation(s)
- Adam Hochman
- Department of Philosophy, Faculty of Arts, Macquarie University, Macquarie Park, New South Wales, Australia
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9
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Hubbard AR, Monnig LA. Using Anthropological Principles to Transform the Teaching of Human "Difference" and Genetic Variation in College Classrooms. SCIENCE & EDUCATION 2020; 29:1541-1565. [PMID: 33078044 PMCID: PMC7557306 DOI: 10.1007/s11191-020-00164-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
Exposure to information about genetics is at an all-time high, while a full understanding of the biocultural complexity of human difference is low. This paper demonstrates the value of an "anthropological approach" to enhance genetics education in biology, anthropology, and other related disciplines, when teaching about human differences such as race/ethnicity, sex/gender, and disability. As part of this approach, we challenge educators across social and natural sciences to critically examine and dismantle the tacit cultural assumptions that shape our understanding of genetics and inform the way we perceive (and teach about) human differences. It calls on educators from both social and natural science disciplines to "de-silo" their classrooms and uses examples from our biological anthropology and sociocultural anthropology classrooms, to demonstrate how educators can better contextualize the "genetics" of human difference in their own teaching. Numerous opportunities to transform our teaching exist, and we are doing a disservice to our students by not taking these critical steps.
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Affiliation(s)
- Amelia R. Hubbard
- Department of Sociology and Anthropology, Wright State University, 270 Millett Hall, 3640 Col. Glenn Hwy, Dayton, OH 45435 USA
| | - Laurel A. Monnig
- Department of Sociology and Anthropology, Wright State University, 270 Millett Hall, 3640 Col. Glenn Hwy, Dayton, OH 45435 USA
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10
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Bentley GR. Don't blame the BAME: Ethnic and structural inequalities in susceptibilities to COVID-19. Am J Hum Biol 2020; 32:e23478. [PMID: 32677326 PMCID: PMC7404609 DOI: 10.1002/ajhb.23478] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/20/2022] Open
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DeMello AS, Yang Y, Schulte J, Wolf DA, Holcomb JB, Bless B, DeMeter K, Wade CE, Drake SA. Learning from suicide deaths in Harris County, Texas. DEATH STUDIES 2020; 46:745-755. [PMID: 32536264 DOI: 10.1080/07481187.2020.1776790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examined individual and community demographic characteristics surrounding suicides in one of the most populous counties in the United States. We paired medical examiner records with U.S. Census data and analyzed them using geospatial software. The majority of decedents were non-Hispanic, white males who died primarily of gunshot wounds. Salient age characteristics included interpersonal violence and depression among ages younger than 40. Despite lower incomes and education levels, areas with higher population density and racial/ethnic minorities had fewer suicides. Additional research should address depression among males and the elderly, interpersonal violence, firearm access, and culture.
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Affiliation(s)
- Annalyn S DeMello
- The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, USA
| | - Yijiong Yang
- The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, USA
| | | | - Dwayne A Wolf
- Harris County Institute of Forensic Sciences, Medical Examiner Investigations Division, Houston, Texas, USA
| | - John B Holcomb
- Department of Surgery, Division of Acute Care Surgery, University of Alabama, Birmingham, Alabama, USA
| | - Bethany Bless
- Harris County Institute of Forensic Sciences, Medical Examiner Investigations Division, Houston, Texas, USA
| | - Kaeleigh DeMeter
- Harris County Institute of Forensic Sciences, Medical Examiner Investigations Division, Houston, Texas, USA
| | - Charles E Wade
- McGovern School of Medicine, Center for Translational Injury Research, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Stacy A Drake
- Texas A&M University, College of Nursing, Center of Excellence in Forensic Nursing, Houston, Texas, USA
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12
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Roth WD, Yaylacı Ş, Jaffe K, Richardson L. Do genetic ancestry tests increase racial essentialism? Findings from a randomized controlled trial. PLoS One 2020; 15:e0227399. [PMID: 31995576 PMCID: PMC6988910 DOI: 10.1371/journal.pone.0227399] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/13/2019] [Indexed: 11/18/2022] Open
Abstract
Genetic ancestry testing is a billion-dollar industry, with more than 26 million tests sold by 2018, which raises concerns over how it might influence test-takers' understandings of race. While social scientists argue that genetic ancestry tests may promote an essentialist view of race as fixed and determining innate abilities, others suggest it could reduce essentialist views by reinforcing a view of race as socially constructed. Essentialist views are a concern because of their association with racism, particularly in its most extreme forms. Here we report the first randomized controlled trial of genetic ancestry testing conducted to examine potential causal relationships between taking the tests and essentialist views of race. Native-born White Americans were randomly assigned to receive Admixture and mtDNA tests or no tests. While we find no significant average effect of genetic ancestry testing on essentialism, secondary analyses reveal that the impact of these tests on racial essentialism varies by type of genetic knowledge. Within the treatment arm, essentialist beliefs significantly declined after testing among individuals with high genetic knowledge, but increased among those with the least genetic knowledge. Additional secondary analysis show that essentialist beliefs do not change based on the specific ancestries reported in test-takers' results. These results indicate that individuals' interpretations of genetic ancestry testing results, and the links between genes and race, may depend on their understanding of genetics.
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Affiliation(s)
- Wendy D. Roth
- Department of Sociology, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Şule Yaylacı
- Department of Sociology, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
- Institute for European Studies, University of British Columbia, Vancouver, BC, Canada
| | - Kaitlyn Jaffe
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Lindsey Richardson
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
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Bell HS, Odumosu F, Martinez-Hume AC, Howard HA, Hunt LM. Racialized Risk in Clinical Care: Clinician Vigilance and Patient Responsibility. Med Anthropol 2019; 38:224-238. [PMID: 29912575 PMCID: PMC6298860 DOI: 10.1080/01459740.2018.1476508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Racial/ethnic identity is contingent and arbitrary, yet it is commonly used to evaluate disease risk and treatment response. Drawing on open-ended interviews with patients and clinicians in two US clinics, we explore how racialized risk is conceptualized and how it impacts patient care and experience. We found that racial/ethnic risk was a common but poorly defined construct for both patients and clinicians, who intermingled concepts of genetics, biology, behavior, and culture, while disregarding historical or structural context. We argue that racializing risk embodies social power in marked and unmarked bodies, reinforcing inequality along racial lines and undermining equitable health care.
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Affiliation(s)
- Hannah S Bell
- a Department of Anthropology , Michigan State University , East Lansing , Michigan , USA
| | - Funmi Odumosu
- a Department of Anthropology , Michigan State University , East Lansing , Michigan , USA
| | - Anna C Martinez-Hume
- a Department of Anthropology , Michigan State University , East Lansing , Michigan , USA
| | - Heather A Howard
- a Department of Anthropology , Michigan State University , East Lansing , Michigan , USA
| | - Linda M Hunt
- a Department of Anthropology , Michigan State University , East Lansing , Michigan , USA
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14
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Torres JB. Race, Rare Genetic Variants, and the Science of Human Difference in the Post‐Genomic Age. TRANSFORMING ANTHROPOLOGY 2019. [DOI: 10.1111/traa.12144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Jada Benn Torres
- Genetic Anthropology and Biocultural Studies Laboratory Department of Anthropology Vanderbilt University Nashville TN 37235
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15
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Nelson SC, Yu JH, Wagner JK, Harrell TM, Royal CD, Bamshad MJ. A content analysis of the views of genetics professionals on race, ancestry, and genetics. AJOB Empir Bioeth 2019; 9:222-234. [PMID: 30608210 DOI: 10.1080/23294515.2018.1544177] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Over the past decade, the proliferation of genetic studies on human health and disease has reinvigorated debates about the appropriate role of race and ancestry in research and clinical care. Here we report on the responses of genetics professionals to a survey about their views on race, genetics, and ancestry across the domains of science, medicine, and society. Through a qualitative content analysis of free-text comments from 515 survey respondents, we identified key themes pertaining to multiple meanings of race, the use of race as a proxy for genetic ancestry, and the relevance of race and ancestry to health. Our findings suggest that for many genetics professionals the questions of what race is and what race means remain both professionally and personally contentious. Looking ahead as genomics is translated into the practice of precision medicine and as learning health care systems offer continued improvements in care through integrated research, we argue for nuanced considerations of both race and genetic ancestry across research and care settings.
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Affiliation(s)
- Sarah C Nelson
- a Institute for Public Health Genetics , University of Washington
| | - Joon-Ho Yu
- b Department of Pediatrics , University of Washington
| | - Jennifer K Wagner
- c Center for Translational Bioethics & Health Care Policy , Geisinger Health System
| | | | - Charmaine D Royal
- d Department of African & African American Studies , Duke University
| | - Michael J Bamshad
- b Department of Pediatrics , University of Washington.,e Department of Genome Sciences , University of Washington
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