Changes for page The Existence of Race

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72	72	Biologically real racial differences are particularly evident in health and disease profiles. Certain genetic diseases or medical conditions are far more prevalent in some races than others, underscoring the practical importance of biological race in medicine:
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74		-* Blood Groups and Transfusions: Blood type frequencies vary by ethnicity, and *some rare blood antigens are found only in specific racial groups*. According to the American Red Cross, *“there are more than 600 known antigens, and some are unique to specific racial and ethnic groups.”{{footnote}} https://www.redcrossblood.org/donate-blood/blood-types/diversity/african-american-blood-donors.html#:~:text=,patient%20with%20sickle%20cell%20disease{{/footnote}} For patients with conditions like sickle cell disease who need frequent transfusions, finding a compatible blood match often requires a donor of the same racial background./foot For example, U-negative blood (a rare type) is found almost exclusively in people of African descent. The Red Cross and other blood services therefore emphasize the need for racially diverse blood donors so that all patients can find well-matched units. This is a clear-cut case where race is literally a factor in saving lives – a purely social construct would not correlate with immunohematology, but in reality, one’s ancestry (race) predicts one’s blood antigen profile.
	74	+* Blood Groups and Transfusions: Blood type frequencies vary by ethnicity, and *some rare blood antigens are found only in specific racial groups*. According to the American Red Cross, *“there are more than 600 known antigens, and some are unique to specific racial and ethnic groups.”{{footnote}} https://www.redcrossblood.org/donate-blood/blood-types/diversity/african-american-blood-donors.html#:~:text=,patient%20with%20sickle%20cell%20disease{{/footnote}} For patients with conditions like sickle cell disease who need frequent transfusions, finding a compatible blood match often requires a donor of the same racial background.{{footnote}} https://www.redcrossblood.org/donate-blood/blood-types/diversity/african-american-blood-donors.html#:~:text=,patient%20with%20sickle%20cell%20disease{{/footnote}} For example, U-negative blood (a rare type) is found almost exclusively in people of African descent. The Red Cross and other blood services therefore emphasize the need for racially diverse blood donors so that all patients can find well-matched units.{{footnote}} https://www.redcrossblood.org/donate-blood/blood-types/diversity/african-american-blood-donors.html#:~:text=,patient%20with%20sickle%20cell%20disease{{/footnote}} This is a clear-cut case where race is literally a factor in saving lives – a purely social construct would not correlate with immunohematology, but in reality, one’s ancestry (race) predicts one’s blood antigen profile.
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76		-* Sickle Cell Disease & Malaria Adaptation: *Sickle cell anemia* is often cited in discussions of race and genetics. This serious genetic blood disorder is most common in those of African descent (also in parts of the Middle East and India). In the U.S., over 100,000 individuals (mostly African-Americans) have sickle cell disease. The reason is evolutionary: the sickle-cell mutation provides resistance to malaria, a disease historically endemic in Africa. Carriers of one sickle allele are less likely to die from malaria (an adaptive advantage in malarial regions), but inheriting two copies causes anemia. Thus, the high frequency of the sickle cell gene in Africans (and some South Asians) is a result of natural selection – a genetic adaptation to the environment. This example shows race-linked genetic traits can have functional consequences. Other malaria-protective genetic variants (like G6PD deficiency and thalassemias) are prevalent in Mediterranean, African, or Southeast Asian racial groups, but rare in those from non-malarial regions, illustrating how different populations evolved different solutions to the same problem (malaria).
	76	+* Sickle Cell Disease & Malaria Adaptation: *Sickle cell anemia* is often cited in discussions of race and genetics. This serious genetic blood disorder is most common in those of African descent (also in parts of the Middle East and India). In the U.S., over 100,000 individuals (mostly African-Americans) have sickle cell disease.{{footnote}} https://www.redcrossblood.org/donate-blood/blood-types/diversity/african-american-blood-donors.html#:~:text=More%20than%20100%2C000%20individuals%20in,blood%20transfusions%20throughout%20their%20lifetime{{/footnote}} The reason is evolutionary: the sickle-cell mutation provides resistance to malaria, a disease historically endemic in Africa. Carriers of one sickle allele are less likely to die from malaria (an adaptive advantage in malarial regions), but inheriting two copies causes anemia. Thus, the high frequency of the sickle cell gene in Africans (and some South Asians) is a result of natural selection – a genetic adaptation to the environment. This example shows race-linked genetic traits can have functional consequences. Other malaria-protective genetic variants (like G6PD deficiency and thalassemias) are prevalent in Mediterranean, African, or Southeast Asian racial groups, but rare in those from non-malarial regions, illustrating how different populations evolved different solutions to the same problem (malaria).
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78		-* Lactose Intolerance: The ability to digest lactose (the sugar in milk) after infancy is governed by genetic variants in the *LCT* gene, and it varies dramatically among races due to past dietary regimes. Lactase persistence (continued production of lactase enzyme into adulthood) evolved in populations with a long history of dairy farming. It is very high in Northern Europeans (and some pastoralist African groups), but low in East Asians, many Africans, and indigenous Americans. In the United States, only about 15% of adult Caucasians are lactose intolerant, whereas roughly 85% of African-Americans and 90+% of Asian-Americans are lactose intolerant. In East Asia and many African and Native American groups, the majority of adults experience some degree of lactose intolerance (with symptoms like bloating when consuming fresh milk). This stark difference is clearly genetic and tied to race/ancestry – it has nothing to do with skin color, but with millennia of evolutionary adaptation to cattle domestication. The lactase persistence allele common in Europeans is essentially absent in East Asians, for example. Such facts demonstrate that human races differ in metabolic and digestive traits in line with their traditional diets.
	78	+* Lactose Intolerance: The ability to digest lactose (the sugar in milk) after infancy is governed by genetic variants in the *LCT* gene, and it varies dramatically among races due to past dietary regimes. Lactase persistence (continued production of lactase enzyme into adulthood) evolved in populations with a long history of dairy farming. It is very high in Northern Europeans (and some pastoralist African groups), but low in East Asians, many Africans, and indigenous Americans. In the United States, only about 15% of adult Caucasians are lactose intolerant, whereas roughly 85% of African-Americans and 90+% of Asian-Americans are lactose intolerant.{{footnote}} https://gi.org/topics/lactose-intolerance-in-children/#:~:text=Approximately%2015,of%20lactose%20intolerance%20is{{/footnote}} In East Asia and many African and Native American groups, the majority of adults experience some degree of lactose intolerance (with symptoms like bloating when consuming fresh milk).{{footnote}} https://gi.org/topics/lactose-intolerance-in-children/#:~:text=Approximately%2015,of%20lactose%20intolerance%20is{{/footnote}} This stark difference is clearly genetic and tied to race/ancestry – it has nothing to do with skin color, but with millennia of evolutionary adaptation to cattle domestication. The lactase persistence allele common in Europeans is essentially absent in East Asians, for example. Such facts demonstrate that human races differ in metabolic and digestive traits in line with their traditional diets.
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80		-* Drug Response and Medical Reactions: Ancestry can influence how patients respond to certain medications. For instance, some heart medications (like ACE inhibitors) are on average *less effective* in black patients than in white patients, leading to the development of BiDil (a heart failure drug combination) that was specifically tested and approved for African-American patients. Another example: the adverse reaction Stevens-Johnson syndrome is associated with a particular HLA allele that is far more common in people of Southeast Asian ancestry – prompting genetic screening for at-risk Asian patients before prescribing certain drugs (like carbamazepine). Additionally, the tolerable doses of drugs metabolized by specific liver enzymes can vary by race, because the frequency of enzyme variants (CYP450 family, etc.) differs. In short, race/ancestry is a useful proxy for certain genetic profiles relevant to healthcare. The U.S. FDA and medical practitioners increasingly recognize that a patient’s racial or ethnic background can be a valuable piece of information in diagnosis and treatment, precisely because it correlates with underlying genetic factors affecting health.
	80	+* Drug Response and Medical Reactions: Ancestry can influence how patients respond to certain medications. For instance, some heart medications (like ACE inhibitors) are on average *less effective* in black patients than in white patients, leading to the development of BiDil (a heart failure drug combination) that was specifically tested and approved for African-American patients. Another example: the adverse reaction Stevens-Johnson syndrome is associated with a particular HLA allele that is far more common in people of Southeast Asian ancestry – prompting genetic screening for at-risk Asian patients before prescribing certain drugs (like carbamazepine). Additionally, the tolerable doses of drugs metabolized by specific liver enzymes can vary by race, because the frequency of enzyme variants (CYP450 family, etc.) differs. In short, race/ancestry is a useful proxy for certain genetic profiles relevant to healthcare.{{footnote}} https://www.researchgate.net/publication/26756268_Is_Homo_sapiens_polytypic_Human_taxonomic_diversity_and_its_implications#:~:text=Finally%20the%20implications%20of%20this,save%20lives%20in%20the%20future{{/footnote}} The U.S. FDA and medical practitioners increasingly recognize that a patient’s racial or ethnic background can be a valuable piece of information in diagnosis and treatment, precisely because it correlates with underlying genetic factors affecting health.
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82		-* Disease Susceptibilities: Different races show differing patterns of disease prevalence. For example, hypertension and type-2 diabetes rates are notably higher in some populations (e.g., African-Americans have higher hypertension prevalence than whites in the U.S.), likely due to a combination of genetic predispositions and environmental factors. Prostate cancer is another example – it has a significantly higher incidence and mortality in men of African descent worldwide compared to other groups, suggesting genetic risk factors play a role. Meanwhile, osteoporosis is more common in people of European and Asian descent and relatively less common in Africans (consistent with the higher bone density in black populations). Skin cancers are very rare in darkly pigmented races but common in light-pigmented groups under strong sunlight. Each of these disparities has a biological component tied to race.
	82	+* Disease Susceptibilities: Different races show differing patterns of disease prevalence. For example, hypertension and type-2 diabetes rates are notably higher in some populations (e.g., African-Americans have higher hypertension prevalence than whites in the U.S.), likely due to a combination of genetic predispositions and environmental factors. Prostate cancer is another example – it has a significantly higher incidence and mortality in men of African descent worldwide compared to other groups, suggesting genetic risk factors play a role. Meanwhile, osteoporosis is more common in people of European and Asian descent and relatively less common in Africans (consistent with the higher bone density in black populations).{{footnote}} https://www.amren.com/archives/back-issues/october-1999/#:~:text=higher%20mineral%20content,in%20blacks%20than%20in%20whites{{/footnote}} {{footnote}} https://www.amren.com/archives/back-issues/october-1999/#:~:text=Blacks%20have%20more%20lean%20body,years%20sooner%20than%20white%20children{{/footnote}} Skin cancers are very rare in darkly pigmented races but common in light-pigmented groups under strong sunlight. Each of these disparities has a biological component tied to race.
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84		-A dramatic illustration was given by former U.S. Surgeon General David Satcher: as of around 2000, *black infants in America were 2.5 times more likely to die in their first year than white infants*. While some of this difference is socioeconomic, studies have found that even after accounting for factors like income and access to care, racial gaps in infant mortality and other health outcomes persist. The cause is not fully understood – hypotheses range from chronic stress of discrimination to possible genetic or bio-social factors. The AR (American Renaissance) source cynically noted that it’s hard to attribute an excess death rate in *newborns* to social racism, hinting that biological differences (e.g. lower birth weight, different maturation rates, etc.) might be involved. While that interpretation is controversial, the raw facts of health disparities underscore that human populations are *not identical in health profile*, and some differences may stem from inherited traits. Modern medicine is actively studying such differences to better tailor treatments and preventive measures to diverse populations.
	84	+A dramatic illustration was given by former U.S. Surgeon General David Satcher: as of around 2000, *black infants in America were 2.5 times more likely to die in their first year than white infants.{{footnote}} https://www.amren.com/archives/back-issues/october-1999/#:~:text=This%20difference%20is%20often%20ascribed,be%20caused%20by%20one%20of{{/footnote}} While some of this difference is socioeconomic, studies have found that even after accounting for factors like income and access to care, racial gaps in infant mortality and other health outcomes persist. The cause is not fully understood – hypotheses range from chronic stress of discrimination to possible genetic or bio-social factors. The AR (American Renaissance) source cynically noted that it’s hard to attribute an excess death rate in *newborns* to social racism, hinting that biological differences (e.g. lower birth weight, different maturation rates, etc.) might be involved. While that interpretation is controversial, the raw facts of health disparities underscore that human populations are *not identical in health profile*, and some differences may stem from inherited traits. Modern medicine is actively studying such differences to better tailor treatments and preventive measures to diverse populations.
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86	86	## Evolved Differences Beyond Skin Color##
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