Problem of Interest

Equality, Rights, and Education

Problem of Interest

Is Race Based Medicine Constitutional?

What issue am I going to write about?

Is Race-Based medicine constitutional? While nobody expects race to be a key factor in diagnosing patients for many doctors and medical school they’re taught race-based diagnostic tools to determine how certain races take diseases and how to treat them. Because of this we see a medicine race gap, where certain minorities are more likely to suffer than whites who have the same health issues. The issue I am writing about concerns the lack of health urgency for certain ethnic groups and the results of this racial prejudice and stereotyping(Hamblin, 2018).

Race-based medicine is one of the most contentious issues in American pharmaceutical industry and .It has raised many controversies in the American research and development industry in last few years. Some argue that drugs specifically labeled to treat particular racial groups offer an priceless way to fight racial inequalities in health field by solving health related issues of the at-risk populations. Others claim that race-based medicine inappropriately treats race as a biological cause of racial disparities. Since, wide environmental and social factors can provide better solution and explanations.

The issue of the race based medicine became mainstream after the FDA’s 2005 approval of BiDil. This drug became the first drug which was labeled as a racial based medicine in United States of American. this drug was introduced \for the remedy of the African Americans suffering from the heart failure. However, the debate died down within few months due to the ultimate failure of the drug. But, it started a new issue for the American medical industry..

Tradjenta is another example of the race based medicine(Trivedi et al., 2014). This drug was created by the Boehringer Ingelheim Pharmaceuticals and Eli Lilly to provide remedy to the citizens suffering from the Type 2 diabetes. However, results of this medicine have showed that this drug was very successful in treating the African Americans’ blood sugar levels. These results were created after Phase III clinical trial . The press release of the medical department at Boehringer Ingelheim Pharmaceuticals notes:

“African American adults are disproportionately affected by diagnosed diabetes. In the U.S., the risk of diabetes is 77 percent greater for non-Hispanic black adults, when compared to non-Hispanic white adults, with an estimated 18.7 percent (4.9 million) of all non-Hispanic black adults living with the disease”.

John Smith, senior VP at Boehringer Ingelheim was also very happy on the results produced by the drug cure and results .He believed that Tradjenta can offer American blacks adult patients with various other options for the treatment of the diabetes.

Medical experts and media reporters are comparing Tradjenta with the BiDil as both are targeted towards treating the black Americans. It has been recently discovered in the media that Tradjenta had been approved by the FDA for the treatment of the type 2 diabetes in the general Americans. This approval was granted before the the announcement of these race-specific results. However, medical experts believe that this medicine is quite different from the BiDil. Here it should be noted that investigators are looking for race-specific indication from the FDA as it could not win regulatory approval as a race-neutral drug. In spite of many differences between these two drugs ,it has been reported in the media that these both drugs contain somehow similar ingredients. However, media must use these differences to get deeper knowledge of the social determinants of health rather than creating differences among different racial groups of the country.

Why is it an issue?

Race runs deeply throughout all medical practices. It shapes physician’s diagnosis, treatments, prescriptions, and treatment of diseases. This is an issue because race-based medicine leaves patients of color vulnerable to harmful biases and stereotypes. Doctors are supposed to practice evidence-based medicine, but that’s not the case their habits of treating patients by race is a dated and prejudice bias. A wide spread belief that many doctors and medical students are being taught is that ‘black/brown people feel less pain/exaggerate and that they are prone to drug addiction’ based on that stereotype many of those patients are denied pain medications. This happens because of deeply rooted beliefs in medicine that date back to the slavery era, where many physicians like that of Samuel Cartwright whose research, that was conducted on slaves, was tightly linked to justification of slavery. That diagnostic tool is problematic because doctors in the U.S are still using an updated version of Cartwright’s to diagnose patients. Race is a socially constructed concept not biological nor is it genetic as the Human Genome Project proved that. With that said it brings up the question why is that medical care physicians are still using race to treat patients when there is no scientific evidence that race is biological.

To understand this issue better and where these ideas came from we need to look at the history of medicine for minorities. To address health disparities, we need understand why they exist that they’re not due to one single factor. They’re the result of policy decisions we make as a society, they’re due to the environment, health education, insurance and access to care, access to healthy food, and stress.

Why is it important to me?

Race-based medicine is an issue that I care about because it’s an issue that not only is unjust, but it affects the majority of America. It is important to me because it directly impacts my family and I, due to these common prejudices in medicine many minorities are losing their lives. Statistics show that minorities are more likely to die because of certain health issues than whites, and that alone is the results of the bias (Parker-Pope, 2018).

This issue is very important to me as it is also very important for my country. The demographics of USA are changing very fast more than we expected. Since, we have to deal with more diverse and experienced health care units. These health care units are very important for dealing with more diverse population than ever before. Therefore, it is very essential for people like us to understand the differences in disease presentations. African-American are designations for the citizens of the United States descended from West African and sub-Saharan. These designations only began to be used in the 1980s , when the movement of black consciousness began to adopt a policy of union of the entire African diaspora .Another designation considered politically correct is that of the color black (Topol, 2005) . Already the term nigger was the term used before the 60s, with a pejorative connotation.

According to the 2017 census, 40 million Americans declared themselves to be black, African American or Hispanic black. Most African-Americans are descendants of slaves who were brought from Africa to North America and the Caribbean between 1609 and 1807 during the slave trade , most of which arrived in the eighteenth century . The majority came from West Africa and Central Africa. A minority is of recent origin, being immigrants from Africa, the Caribbean, Central America and South America.

Primary and Secondary Sources:

Constitutional Protection Against Racial Discrimination, the fourteenth amendment is supposed to protect its citizens from racial discrimination. Which means doctors practicing race-based medicine are violating the fourteenth amendment.

Who are my two potential addressees?

I would write to the Colorado Department of Health Care Policy and Financing, but I’d also like to write to health care law makers on a national level.

Why do I think writing to them is important?

This is an important issue and I think lawmakers need to understand the real problem with race-based medicine and this totally dependent on my existing outlook and belief regarding race-based medicine. Sociological and legal experts like Dorothy Roberts who is the Professor of Africana Studies, Law & Sociology at the University of Pennsylvania claims that race is not a biological thing that actually creates these health discrepancies. According to her, the real differences and discrepancies are not caused by the genetic difference. Actually, they are caused by the effect of the social inequality on health of the people. This also means that some targeted racial groups like black Americans are facing a high-level risk of suffering diabetes type 2. This type of diabetes is mainly caused by the genetic predispositions of black Americans and this can also be caused due to the system level indifferences of lifestyle and socioeconomic status. Therefore, lawmakers have to understand this issue to make laws on these issues. They also have to understand that race is a social construct which is always defined by lawmakers and legal experts, not biologists or medical experts.

References:

Hamblin, J. (2018). Medicine’s Unrelenting Race Gap. Retrieved from https://www.theatlantic.com/health/archive/2014/12/the-race-problem-in-medicine-race/383613/

Trivedi, A., Nsa, W., Hausmann, L., Lee, J., Ma, A., & Bratzler, D. et al. (2014). Quality and Equity of Care in U.S. Hospitals. New England Journal Of Medicine, 371(24), 2298-2308. doi: 10.1056/nejmsa1405003

Parker-Pope, T. (2018). The Breast Cancer Racial Gap. Retrieved from https://well.blogs.nytimes.com/2014/03/03/the-breast-cancer-racial-gap/

Topol, E. (2005). Cholesterol, racial variation and targeted medicines. Nature Medicine, 11(2), 122-123. doi: 10.1038/nm0205-122