BIOETHNIC CONSCRIPTION: Genes, Race, and Mexicana/o Ethnicity in Diabetes Research

Ethico-racial positioning in campaigns for COVID-19 research and vaccination featuring public figures

This article analyses a set of videos which featured public figures encouraging racially minoritised people in the UK to take the COVID-19 vaccine or get involved in related research. As racially targeted health communication has both potentially beneficial and problematic consequences, it is important to examine this uniquely high-profile case. Using a purposive sample of 10 videos, our thematic content analysis aimed to reveal how racially minoritised people were represented and the types of concerns about the vaccine that were expressed. We found representations of racialised difference that centred on 'community' and invoked shared social experiences. The expressed concerns centred on whether ethnic difference was accounted for in the vaccine's design and development, plus the overarching issue of trust. Our analysis adopts and develops the concept of 'racialisation'; we explore how 'mutuality' underpinned normative calls to action ('ethico-racial imperatives') and how the videos 'responsibilised' racially minoritised people. We discuss two points of tension in this case: the limitations for addressing the causes of mistrust and the risks of reductivism that accompanied the ambiguous notion of community. Our analysis develops scholarship on racialisation in health contexts and provides public health practitioners with insights into the socio-political considerations of racially targeted communications.

On the persistence of race: Unique skulls and average tissue depths in the practice of forensic craniofacial depiction

The (re-)surfacing of race in forensic practices has received plenty of attention from STS scholars, especially in connection with modern forensic genetic technologies. In this article, I describe the making of facial depictions based on the skulls of unknown deceased individuals. Based on ethnographic research in the field of craniofacial identification and forensic art, I present a material-semiotic analysis of how race comes to matter in the face-making process. The analysis sheds light on how race as a translation device enables oscillation between the individual skull and population data, and allows for slippage between categories that otherwise do not neatly map on to one another. The subsuming logic of race is ingrained - in that it sits at the bases of standard choices and tools - in methods and technologies. However, the skull does not easily let itself be reduced to a racial type. Moreover, the careful efforts of practitioners to articulate the individual characteristics of each skull provide clues for how similarities and differences can be done without the effect of producing race. Such methods value the skull itself as an object of interest, rather than treat it as a vehicle for practicing race science. I argue that efforts to undo the persistence of race in forensic anthropology should focus critical attention on the socio-material configuration of methods and technologies, including data practices and reference standards.

Genetic syncretism: Latin American forensics and global indigenous organizing

In the 1970s, Latin America became a global laboratory for military interventions, the cultivation of terror, and ideological and economic transformation. In response, family groups and young scientists forged a new activist forensics focused on human rights, victim-centered justice, and state accountability, inaugurating new forms of forensic practice. We examine how this new form of forensic practice centered in forensic genetics has led to a critical engagement with Indigeneity both within and outside the lab. Drawing on ethnographic fieldwork with human rights activists and forensic scientists in Argentina, Guatemala and Mexico, this paper examines the relationship between forensic genetics, Indigenous organizing, and human rights practice. We offer the concept of ‘genetic syncretism’ to attend to spaces where multiple and competing beliefs about genetics, justice, and Indigenous identity are worked out through (1) coming together in care, (2) incorporation, and (3) ritual. Helping to unpack the uneasy and incomplete alliance of Indigenous interests and forensic genetic practice in Latin American, genetic syncretism offers a theoretical lens that is attentive to how differentials of power embedded in colonial logics and scientific practice are brokered through the coming together of seemingly incompatible beliefs and practices.

The limits of personalization in precision medicine: Polygenic risk scores and racial categorization in a precision breast cancer screening trial

Population-based genomic screening is at the forefront of a new approach to disease prevention. Yet the lack of diversity in genome wide association studies and ongoing debates about the appropriate use of racial and ethnic categories in genomics raise key questions about the translation of genomic knowledge into clinical practice. This article reports on an ethnographic study of a large pragmatic clinical trial of breast cancer screening called WISDOM (Women Informed to Screen Depending On Measures of Risk). Our ethnography illuminates the challenges of using race or ethnicity as a risk factor in the implementation of precision breast cancer risk assessment. Our analysis provides critical insights into how categories of race, ethnicity and ancestry are being deployed in the production of genomic knowledge and medical practice, and key challenges in the development and implementation of novel Polygenic Risk Scores in the research and clinical applications of this emerging science. Specifically, we show how the conflation of social and biological categories of difference can influence risk prediction for individuals who exist at the boundaries of these categories, affecting the perceptions and practices of scientists, clinicians, and research participants themselves. Our research highlights the potential harms of practicing genomic medicine using under-theorized and ambiguous categories of race, ethnicity, and ancestry, particularly in an adaptive, pragmatic trial where research findings are applied in the clinic as they emerge. We contribute to the expanding literature on categories of difference in post-genomic science by closely examining the implementation of a large breast cancer screening study that aims to personalize breast cancer risk using both common and rare genomic markers.

What is the alcohol, tobacco, and other drug prevalence among culturally and linguistically diverse groups in the Australian population? A national study of prevalence, harms, and attitudes

In Australia, one in three people are born overseas, and one in five households speak languages other than English. This study explores substance use prevalence, related harms, and attitudes among these large groups in the population. Analysis was conducted using cross-sectional data (N = 22, 696) from the 2013 National Drug Strategy Household Survey. General linear model and binary logistic regression were used to assess substance use and harms, using stabilized inverse propensity score weighting to control for potential confounding variables. Between culturally and linguistically diverse populations and the population born in Australia, United Kingdom, or New Zealand who speak only English at home, there is no statistically significant variation in the likelihood of current smoking; using analgesics, tranquilizers, or sleeping pills; or administering drugs via injection. Culturally diverse populations are less likely to drink alcohol or use cannabis or methamphetamines. No difference between these two major groups in the population is observed in substance-related abuse from strangers; but culturally diverse respondents are less likely to report substance-related abuse from known persons. Lower substance use prevalence is not observed among people from culturally diverse backgrounds who have mental health issues. Australian-, UK-, or New Zealand-born respondents who speak only English at home are more likely to oppose drug and tobacco policies, including a range of harm reduction policies. We discuss the practical and ethical limitations of this major Australian data set for examining the burden of drug-related harms experienced by specific migrant populations. Avenues for potential future research are outlined.

Fluid Drugs: Revisiting the Anthropology of Pharmaceuticals

This review discusses a growing body of scholarship at the intersection of anthropology and science and technology studies (STS) that examines how drugs are rendered efficacious in laboratories, therapeutic settings, and everyday lives. This literature foregrounds insights into how commercial interests and societal concerns shape the kinds of pharmaceutical effects that are actualized and how some efficacies are blocked in response to moral concerns. The work brought together here reveals how regulatory institutions and health policy makers seek to stabilize pharmaceutical actions while, on the front lines of care, pharmacists, health workers, and users tinker with dosages and indications to tailor pharmaceutical actions to specific circumstances. We show that there is no pure (pharmaceutical) object that precedes its socialization. Pharmaceuticals are not “discovered”; they are made and remade in relation to shifting contexts. This review outlines five key areas of ethnographic and STS research that examines such fluid drugs.

Consuming DNA: The Good Citizen in the Age of Precision Medicine

The convergence of increasingly efficient high-throughput genetic sequencing technology and ubiquitous Internet use has fueled the proliferation of companies that provide direct-to-consumer (DTC) personal genetic information. The emergence of consumer genetics reflects several shifts in the governance of genetic testing and management of human genetic data. This article discusses DTC genetics as a case study of neoliberalism and contemporary transformations in medicine that construe disease and its management through economic rationalities. At stake are shifts in subjectivities from “patient” to “consumer” and the meaning of being a “good citizen” in the context of precision medicine. Engaging concepts of biopower, biosociality, and biovalue in the public consumption of genetic information, this article analyzes DTC genetics and its effect on social connection, identity, and modes of participation in the production of biomedical knowledge and the management of health and risk.

Geneticizing Ethnicity and Diet: Anti-doping Science and Its Social Impact in the Age of Post-genomics

While gene doping and other technological means of sport enhancement have become a topic of ethical debate, a major outcome from genomic research in sports is often linked to the regulation of doping. In particular, researchers within the field of anti-doping science, a regulatory science that aims to develop scientific solutions for regulating doped athletes, have conducted genomic research on anabolic-androgenic steroids. Genomic knowledge on anabolic-androgenic steroids, a knowledge base that has been produced to improve doping regulation, has caused the ‘geneticization’ of cultural objects such as ethnic identities and dietary habits. Through examining how anti-doping genomic knowledge and its media representation unnecessarily reify cultural objects in terms of genomics, I argue that Ethical, Legal, and Social Implications (ELSI) research programs in human enhancement should include the social impacts of anti-doping science in their discussions. Furthermore, this article will propose that ELSI scholars begin their academic analysis on anti-doping science by engaging with the recent ELSI scholarship on genomics and race and consider the regulatory and political natures of anti-doping research.

Ethnicity in Dutch health research: situating scientific practice

OBJECTIVE

A growing body of work is examining the role health research itself plays in the construction of 'ethnicity.' We discuss the results of our investigation as to how the political, social, and institutional dynamics of the context in which health research takes place affect the manner in which knowledge about ethnicity and health is produced.

DESIGN

Qualitative content analysis of academic publications, interviews with biomedical and health researchers, and participant observation at various conferences and scientific events.

RESULTS

We identified four aspects related to the context in which Dutch research takes place that we have found relevant to biomedical and health-research practices. Firstly, the 'diversity' and 'inclusion' policies of the major funding institution; secondly, the official Dutch national ethnic registration system; a third factor was the size of the Netherlands and the problem of small sample sizes; and lastly, the need for researchers to use meaningful ethnic categories when publishing in English-language journals.

CONCLUSIONS

Our analysis facilitates the understanding of how specific ethnicities are constructed in this field and provides fruitful insight into the socio-scientific co-production of ethnicity, and specifically into the manner in which common-sense ethnic categories and hierarchies are granted scientific validity through academic publication and, are subsequently, used in clinical guidelines and policy.

Accounting for Complexity: Gene-environment Interaction Research and the Moral Economy of Quantification

Scientists now agree that common diseases arise through interactions of genetic and environmental factors, but there is less agreement about how scientific research should account for these interactions. This paper examines the politics of quantification in gene-environment interaction (GEI) research. Drawing on interviews and observations with GEI researchers who study common, complex diseases, we describe quantification as an unfolding moral economy of science, in which researchers collectively enact competing ''virtues.'' Dominant virtues include molecular precision, in which behavioral and social risk factors are moved into the body, and ''harmonization,'' in which scientists create large data sets and common interests in multisited consortia. We describe the negotiations and trade-offs scientists enact in order to produce credible knowledge and the forms of (self-)discipline that shape researchers, their practices, and objects of study. We describe how prevailing techniques of quantification are premised on the shrinking of the environment in the interest of producing harmonized data and harmonious scientists, leading some scientists to argue that social, economic, and political influences on disease patterns are sidelined in postgenomic research. We consider how a variety of GEI researchers navigate quantification's productive and limiting effects on the science of etiological complexity.

Between (Racial) Groups and a Hard Place: An Exploration of Social Science Approaches to Race and Genetics, 2000-2014

As the social sciences expand their involvement in genetic and genomic research, more information is needed to understand how theoretical concepts are applied to genetic data found in social surveys. Given the layers of complexity of studying race in relation to genetics and genomics, it is important to identify the varying approaches used to discuss and operationalize race and identity by social scientists. The present study explores how social scientists have used race, ethnicity, and ancestry in studies published in four social science journals from 2000 to 2014. We identify not only how race, ethnicity, and ancestry are classified and conceptualized in this growing area of research, but also how these concepts are incorporated into the methodology and presentation of results, all of which structure the discussion of race, identity, and inequality. This research indicates the slippage between concepts, classifications, and their use by social scientists in their genetics-related research. The current study can assist social scientists with clarifying their use and interpretations of race and ethnicity with the incorporation of genetic data, while limiting possible misinterpretations of the complexities of the connection between genetics and the social world.

Building the genomic nation: 'Homo Brasilis' and the 'Genoma Mexicano' in comparative cultural perspective

This article explores the relationship between genetic research, nationalism and the construction of collective social identities in Latin America. It makes a comparative analysis of two research projects--the 'Genoma Mexicano' and the 'Homo Brasilis'--both of which sought to establish national and genetic profiles. Both have reproduced and strengthened the idea of their respective nations of focus, incorporating biological elements into debates on social identities. Also, both have placed the unifying figure of the mestizo/mestiço at the heart of national identity constructions, and in so doing have displaced alternative identity categories, such as those based on race. However, having been developed in different national contexts, these projects have had distinct scientific and social trajectories: in Mexico, the genomic mestizo is mobilized mainly in relation to health, while in Brazil the key arena is that of race. We show the importance of the nation as a frame for mobilizing genetic data in public policy debates, and demonstrate how race comes in and out of focus in different Latin American national contexts of genomic research, while never completely disappearing.

País de gordos/país de muertos: Obesity, death and nation in biomedical and forensic genetics in Mexico

This article provides a comparison between genomic medicine and forensic genetics in Mexico, in light of recent depictions of the nation as a 'país de gordos' (country of the fat) and a 'país de muertos' (country of the dead). We examine the continuities and ruptures in the public image of genetics in these two areas of attention, health and security, focusing especially on how the relevant publics of genetic science are assembled in each case. Publics of biomedical and forensic genetics are assembled through processes of recruitment and interpellation, in ways that modulate current theorizations of co-production. The comparison also provides a vista onto discussions regarding the involvement of genetics in regimes of governance and citizenship and about the relationship between the state and biopower in a context of perceived health crisis and war-like violence.

Pharmacogenomics, human genetic diversity and the incorporation and rejection of color/race in Brazil

Public funding for research on the action of drugs in countries like the United States requires that racial classification of research subjects should be considered when defining the composition of the samples as well as in data analysis, sometimes resulting in interpretations that Whites and Blacks differ in their pharmacogenetic profiles. In Brazil, pharmacogenomic results have led to very different interpretations when compared with those obtained in the United States. This is explained as deriving from the genomic heterogeneity of the Brazilian population. This article argues that in the evolving field of pharmacogenomics research in Brazil there is simultaneously both an incorporation and rejection of the US informed race-genes paradigm. We suggest that this must be understood in relation to continuities with national and transnational history of genetic research in Brazil, a differently situated politics of Brazilian public health and the ongoing valorization of miscegenation or race mixture by Brazilian geneticists as a resource for transnational genetic research. Our data derive from anthropological investigation conducted in INCA (Brazilian National Cancer Institute), in Rio de Janeiro, with a focus on the drug warfarin. The criticism of Brazilian scientists regarding the uses of racial categorization includes a revision of mathematical algorithms for drug dosage widely used in clinical procedures around the world. Our analysis reveals how the incorporation of ideas of racial purity and admixture, as it relates to the efficacy of drugs, touches on issues related to the possibility of application of pharmaceutical technologies on a global scale.

Race and ancestry in the age of inclusion: technique and meaning in post-genomic science

This article examines how race and ancestry are taken up in gene-environment interaction (GEI) research on complex diseases such as heart disease, diabetes, and cancer. Using 54 in-depth interviews of 33 scientists and over 200 hours of observation at scientific conferences, we explore how GEI researchers use and interpret race, ethnicity, and ancestry in their work. We find that the use of self-identified race and ethnicity (SIRE) exists alongside ancestry informative markers (AIMs) to ascertain genetic ancestry. Our participants assess the utility of these two techniques in relative terms, downplaying the accuracy and value of SIRE compared to the precision and necessity of AIMs. In doing so, we argue that post-genomic scientists seeking to understand the interactions of genetic and environmental disease determinants actually undermine their ability to do so by valorizing precise characterizations of individuals' genetic ancestry over measurement of the social processes and relations that differentiate social groups.

Homogeneity and heterogeneity as situational properties: producing--and moving beyond?--race in post-genomic science

In this article, we explore current thinking and practices around the logics of difference in gene-environment interaction research in the post-genomic era. We find that scientists conducting gene-environment interaction research continue to invoke well-worn notions of racial difference and diversity, but use them strategically to try to examine other kinds of etiologically significant differences among populations. Scientists do this by seeing populations not as inherently homogeneous or heterogeneous, but rather by actively working to produce homogeneity along some dimensions and heterogeneity along others in their study populations. Thus we argue that homogeneity and heterogeneity are situational properties--properties that scientists seek to achieve in their study populations, the available data, and other aspects of the research situation they are confronting, and then leverage to advance post-genomic science. Pointing to the situatedness of homogeneity and heterogeneity in gene-environment interaction research underscores the work that these properties do and the contingencies that shape decisions about research procedures. Through a focus on the situational production of homogeneity and heterogeneity more broadly, we find that gene-environment interaction research attempts to shift the logic of difference from solely racial terms as explanatory ends unto themselves, to racial and other dimensions of difference that may be important clues to the causes of complex diseases.

The epigenome and nature/nurture reunification: a challenge for anthropology

Recognition among molecular biologists of variables external to the body that can bring about hereditable changes in gene expression or cellular phenotypes has reignited nature/nurture discussion. These epigenetic findings may well set off a new round of somatic reductionism because research is confined largely to the molecular level. A brief review of the late nineteenth-century formulation of the nature/nurture concept is followed by a discussion of the positions taken by Boas and Kroeber on this matter. I then illustrate how current research into Alzheimer's disease uses a reductionistic approach, despite epigenetic findings in this field that make the shortcomings of reductionism clear. In order to transcend the somatic reductionism associated with epigenetics, drawing on concepts of local biologies and embedded bodies, anthropologists can carry out research in which epigenetic findings are contextualized in the specific historical, socio/political, and environmental realities of lived experience.

Tuberculosis is a threshold: the making of a social disease in post-Soviet Georgia

In this article I use Margaret Lock's concept of local biology as a standpoint to view tuberculosis as a threshold where distinctions between social and biological aspects of disease are negotiated. I conceptualize tuberculosis as a threshold in two ways: first as a passageway, and second as a space for navigating the limits of tolerance to therapeutics. The article is based on ethnographic research about responses to tuberculosis in post-Soviet Georgia. I focus on how health professionals and patients make claims to social aspects of illness by recuperating historical examples for tuberculosis treatment as a moral commitment to society, and in the context of emergent patient-centered treatment services.

Troubling "environments": postgenomics, Bajan wheezing, and Lévi-Strauss

Postgenomics is intended to move beyond the search for genes to explore disease as a result of genes interacting with their environment, revealing how they have relevance for health. This addition of environment confers genomic research with new cultural life, making it relevant to public health discourse, government interventions, and health disparities. Drawing on ethnographic research following an American genetics of asthma study conducted in Barbados, I explore the ways environment gets construed by the multiple communities involved-U.S. researchers, Bajan officials, medical practitioners, and patient participants. I draw on Lévi-Strauss to argue that plural competing environments give mana to the American postgenomic project as intervention on racial injustice, household practices, pollution, and other aspects of asthma.

Multiple environmental chemical exposures to lead, mercury and polychlorinated biphenyls among childbearing-aged women (NHANES 1999-2004): Body burden and risk factors

BACKGROUND

Lead, mercury and polychlorinated biphenyls (PCBs) are neurotoxicants with intergenerational health consequences from maternal body burden and gestational exposures. Little is known about multiple chemical exposures among childbearing-aged women.

OBJECTIVES

To determine the percentage of women aged 16-49 of diverse races and ethnicities whose body burdens for all three xenobiotics were at or above the median; to identify mixed exposures; and to describe those women disproportionately burdened by two or more of these chemicals based on susceptibility- and exposure-related attributes, socioeconomic factors and race-ethnicity.

METHODS

Secondary data analysis of National Health and Nutrition Examination Survey (1999-2004).

RESULTS

The best-fit logistic regression model without interactions contained 12 variables. Four risk factors associated with body burden were notable (P≤0.05). An exponential relationship was demonstrated with increasing age. Any fish consumption in past 30 days more than doubled the odds. Heavy alcohol consumption increased the relative risk. History of breastfeeding reduced this risk. These women were more likely to have two xenobiotics at or above the median than one. More than one-fifth of these childbearing-aged women had three xenobiotic levels at or above the median.

CONCLUSIONS

These findings are among the first description of US childbearing-aged women's body burden and risk factors for multiple chemical exposures. This study supports increasing age, any fish consumption and heavy alcohol consumption as significant risk factors for body burden. History of breastfeeding lowered the body burden. Limited evidence was found of increased risk among minority women independent of other risk factors.

Diabetes and Culture

Diabetes and its many manifestations articulate well with the four-field approach in anthropology, providing an almost seamless example of the relationship between human biology, behavior, society, and culture in both the past and the present tense. In general, publications on diabetes and culture echo Enlightenment philosophies on change and progress that posit the increasing prevalence of diabetes as a “crisis in human relations” ( Bendix 1967 , p. 302) for which culture plays a significant role. The undermining of racial approaches due to what now appears to be diabetes-without-borders has also directed anthropological research into the contingent temporal frameworks of history. The recent attention to society and the social production of the disease may portend the end of culture in research on diabetes and culture.

"Os charruas vivem" nos Gaúchos: a vida social de uma pesquisa de "resgate" genético de uma etnia indígena extinta no Sul do Brasil

Este artigo explora a articulação entre uma pesquisa de ancestralidade genética e a construção social de identidades étnicas no Rio Grande do Sul. Isso é feito através da análise da vida social de um projeto de pesquisa conduzido por pesquisadores da Universidade Federal do Rio Grande do Sul (UFRGS). Tal investigação estabeleceu a continuidade genética entre a população Gaúcha contemporânea e os presumidamente extintos Charrua, uma etnia indígena que vivia na região do Pampa do estado. Ao longo do desenvolvimento do projeto de pesquisa, a ideia de continuidade genética passou por diferentes configurações, a depender de contextos específicos, sendo afirmada com diferentes níveis de certeza. A presente análise enfoca as condições sociais e genéticas que possibilitaram o estabelecimento de tal continuidade, assim como a afirmação da especificidade genética dos Gaúchos. Finalmente, são explorados os impactos sociais dessa pesquisa, em particular as suas articulações com construções de uma identidade regional diferenciada.

What are our AIMs? Interdisciplinary Perspectives on the Use of Ancestry Estimation in Disease Research

BACKGROUND

Ancestry estimation serves as a tool to identify genetic contributions to disease but may contribute to racial discrimination and stigmatization. We sought to understand user perspectives on the benefits and harms of ancestry estimation to inform research practice and contribute to debates about the use of race and ancestry in genetics.

METHODS

Key informant interviews with 22 scientists were conducted to examine scientists' understandings of the benefits and harms of ancestry estimation.

RESULTS

Three main perspectives were observed among key informant scientists who use ancestry estimation in genetic epidemiology research. Population geneticists self identified as educators who controlled the meaning and application of ancestry estimation in research. Clinician-researchers were optimistic about the application of ancestry estimation to individualized risk assessment and personalized medicine. Epidemiologists remained ambivalent toward ancestry estimation and suggested a continued role for race in their research.

CONCLUSIONS

We observed an imbalance of control over the meaning and application of ancestry estimation among disciplines that may result in unwarranted or premature translation of ancestry estimation into medicine and public health. Differences in disciplinary perspectives need to be addressed if translational benefits of genetic ancestry estimation are to be realized.

Organized ambivalence: when sickle cell disease and stem cell research converge

OBJECTIVE

This article analyzes sickle cell patient families' responses to stem cell transplant recruitment efforts. It identifies key dynamics that explain why sickle cell patient families are not undergoing stem cell transplants at the rate of other patient populations. It challenges the conventional focus on 'African-American distrust' as a set of attitudes grounded in collective memories of past abuses and projected on to current initiatives, by examining the sociality of distrust produced daily in the clinic and reinforced in broader politics of health investment.

DESIGN

It draws upon a two-year multi-sited ethnography of a US-based stem cell research and cures initiative. Fieldwork included participant observation in a state stem cell agency, a publicly-funded stem cell transplant program, a sickle cell clinic, and semi-structured, open-ended interviews with caregivers and stem cell research stakeholders, all of which were subject to qualitative analysis.

FINDINGS AND IMPLICATIONS

This paper finds ambivalence-in-action structured by three contextual strands: therapeutic uncertainties of the clinic, institutionalized conflation of healthcare and medical research, and political contests over scientific and medical investments. The paper posits that organized ambivalence is an analytic alternative to individualized notions of distrust and as a framework for implementing more participatory research initiatives that better account for the multiple uncertainties characteristic of regenerative medicine.

Different differences: the use of 'genetic ancestry' versus race in biomedical human genetic research

This article presents findings from our ethnographic research on biomedical scientists' studies of human genetic variation and common complex disease. We examine the socio-material work involved in genome-wide association studies (GWAS) and discuss whether, how, and when notions of race and ethnicity are or are not used. We analyze how researchers produce simultaneously different kinds of populations and population differences. Although many geneticists use race in their analyses, we find some who have invented a statistical genetics method and associated software that they use specifically to avoid using categories of race in their genetic analysis. Their method allows them to operationalize their concept of 'genetic ancestry' without resorting to notions of race and ethnicity. We focus on the construction and implementation of the software's algorithms, and discuss the consequences and implications of the software technology for debates and policies around the use of race in genetics research. We also demonstrate that the production and use of their method involves a dynamic and fluid assemblage of actors in various disciplines responding to disciplinary and sociopolitical contexts and concerns. This assemblage also includes particular discourses on human history and geography as they become entangled with research on genetic markers and disease.We introduce the concept of'genome geography' to analyze how some researchers studying human genetic variation'locate' stretches of DNA in different places and times. The concept of genetic ancestry and the practice of genome geography rely on old discourses, but they also incorporate new technologies, infrastructures, and political and scientific commitments. Some of these new technologies provide opportunities to change some of our institutional and cultural forms and frames around notions of difference and similarity. Nevertheless, we also highlight the slipperiness of genome geography and the tenacity of race and race concepts.

Hyperdiagnostics: postcolonial utopics of race-based biomedicine

The expansion of biomedical research into countries outside the United States and Western Europe is positing new biological links between populations based on race. This expansion includes six international projects occurring in Barbados, premised on the idea that the population is genetically representative of other black people. Based on ethnographic research tracking one such study, a genetics of asthma project, this article explores the ways Caribbean meanings of ethnicity and illness are reworked as Barbadian state medical practitioners become involved in facilitating the international genetics research on race and disease. As the state attempts to participate in an imagined future of genetic medicine, the hyperspecificity of genetic technologies create new medical meanings of race and disease. These changes rely on a paradoxical response by medical practitioners toward the high technology American genetic research as both authoritative and inapplicable, creating unexpected etiologies of illness and ethnicity.

The logic of identity and resemblance in culturally appropriate health care

Greater diversity in the health care workforce is frequently proposed as a means of addressing health disparities between minority and majority populations in the USA by improving health care access and quality for minority groups. ‘Culturally appropriate’ health care programs that include ethnic resemblance between physician and patient are emerging as new technologies of knowledge and power in a wide range of health care settings. Based on participant-observation research and interviews with patients and health care providers at a federally funded New England clinic, this article uses theories of cultural identity supported by ethnographic examples to examine arguments in favor of patient—provider resemblance. While ethnic identity is often assumed to incorporate cultural expertise or competence, in practice, developing and maintaining such expertise is the result of repeated performances developed in part through didactic trainings described herein. Claims for the efficacy of patient—provider resemblance in addressing disparities in quality of care mobilize notions of specificity, difference and recognition that both depend on and construct racialized ethnic identities. Proposed as a means to expand access to health care, resemblance programs nonetheless perpetuate segregation in health care by relying on minority health care providers to care for the minority poor. Both patients and health care providers I interviewed perceived benefits associated with ethnic resemblance, yet also articulated critiques of the essentialized notions of identity that render ethnicity automatically efficacious. Following Laclau, I argue that an exclusive focus on physician—patient resemblance constructs ethnicity as ‘mere particularity’ and in so doing helps to obscure the relations of power and inequality that produce the very health disparities that resemblance is meant to solve.