> The blood thinner clopidogrel, or Plavix, doesn't work in the 75 percent of Pacific Islanders whose bodies don't produce the enzyme required to activate the drug. For them, taking the medication is like taking a placebo.
> People with epilepsy who are of Asian descent are supposed to get genetic testing before being prescribed the seizure medication carbamazepine, because the drug can damage the skin and internal organs of patients with a certain gene variant.
> And, says Oh, "African-Americans and Puerto Ricans don't respond as well to some of the most common asthma controller medications, and that's really a tragedy since these two groups are the most affected by asthma in the United States."
One big reason why this happen is there are more clinical trials for white people than there are of other races. One of the reason for this that I got from her is that other races aren't lining up in numbers to go through clinical trials and that there should be more out reach in educating.
Race does not exist... therefore there won't be a genetic difference in average outcomes between different people groups. It is useful to think of variation from person-to-person but it is impossible to make comparisons between ethnic groups/races because no substantive differences exist among the various human populations. Probably the study results you reference are a result of different environments...
Race is often shorthand for ethnicity, and it's true that to a certain extent different ethnic groups have genetic differences of medical relevance. While variation within groups is generally larger than that between groups, that doesn't mean ethnicity is medically useless as data point. Classic examples are among those the OP listed. The most visible are probably lactose tolerance (significantly more common in Europe and cattle-herding populations) and alcohol dehydrogenase (also know as Alcohol Flush Reaction). There are many others and we're likely to find many more.
Medically important genetic differences between ethnicities exist, but it's important to note the limits of this analysis. Usually these are fairly low-level traits, i.e. different enzyme activity, and it's critical not not over-extend the logic to more complex emergent traits such as intelligence or others where clean biochemical links are suspect. Saying a certain set of constraints changed the way certain enzymes work in a given population is not the same as saying this group is better than another group.
"it's true that to a certain extent different ethnic groups have genetic differences of medical relevance."
It's just plain true.
"While variation within groups is generally larger than that between groups"
That line is for the big traits, like intelligence, strength, etc. Those are made up of many, many genes, and I've even seen a couple of recent articles that suggest the answer to the question "which genes affect intelligence?" may well be "all of them". When it comes to specific genes, though, the incidences can be correlated very strongly to ethnicities/races.
If you're having trouble squaring that with your political pieties, bear in mind that it's actually all correlations, not causations. The real cause of the genes an individual has is their literal ancestry (i.e., not their "race" but their exact ancestry, the exact humans and indeed even the exact genes carried by the relevant eggs and sperms), and it isn't that surprising that that correlates strongly with something else that is very tied to ancestry. But really, it's a separate process.
There is a de-novo genetic mutation my wife has. She didn't get it from either of her parents. (You know what I mean.) The races of all the individuals involved have nothing to do with the fact that one of our children also has it and one does not.
It's sort of important that we not freak out about "races" showing up in medicine; is it more important that people get correct medical treatment and live better lives and at times just plain live even if we can only use a crude tool for a while, or that our particular delicate political beliefs be left unchallenged? I know which I choose.
Huh? In medical contexts I've always understood race as a person's genetic background and ethnicity as a person's cultural background. The two often don't align as many might expect: an adopted child, for example, could be racially South Asian but ethnically French because they speak French, enjoy French food and culture, perceive their self as French, etc.
That's maybe true but in that case also quite incomplete and doesn't actually conflict with my point. Ethnicity is a readout of where that person grew up, those cultural touchtones reflect that you have a bunch of people living in the same geographical area. These people scramble their genes together, but because they're in the same area, they would naturally begin to diverge genetically from those in other areas.
You're right that ethnicity and the common definitions of race (i.e. skin tone, hair color/texture, dominant facial features) don't always correlate as well as expected, but that doesn't stop it from being used that way. Another example in addition to yours would be someone who is north african and someone who is south african may have quite different tolerance to lactose because of different prevalences of cattle herding in those regions of the world (Lactose tolerance arises very quickly when humans raise cattle). Still an outside observer would label them both "Black", despite their ethnicities and genetic makeups being different.
In short, ethnicity/race/genetics are all correlates but not absolutes. You have to do a follow-up test, you have to be careful in your assumptions or you'll make a mistake.
> I've always understood race as a person's genetic background and ethnicity as a person's cultural background
I've heard that maybe once every 20 years. It just isn't the way the language is used. It may not be anyone's fault, but the conflation is the way it is AFAIK.
Are you sure you mean ethnicity? My understanding is ethnicity refers to things like language, perhaps nationality, regional culture, etc. I have friends who have the same ethnicity as myself: we speak the same language, eat the same foods, share the same culture, etc. but 100% of their ancestors up to their parents are from Samoa. So, it would seem that they would be affected by medical things that are specific to Pacific Islanders even though their ethnicity is not Pacific Islander.
I don’t get what you are trying to claim here. There are well known differences between races (e.g. lactose tolerance) that are minor but medically relevant.
And that the racial categories used politically and socially don't always map cleanly to genetic categories used by scientists (thus "75 percent of Pacific Islanders" rather than 100%).
But in some (carefully defined) cases they get close.
I apologize for not making it clear that I intended this to be a parody illustrating the absurdity of a certain POV when carried to its logical extreme (most POVs are incorrect when carried to an extreme).
After further thought, I should have added an /s at the end or better yet not posted at all. My apology for the dishonesty to anyone who took this literally.
This is ridiculous sorry. As an example, thalassemia is common (>20% carrier rate) in South and Southeast asia. Many thalassemia carriers will present as mildly anemic. In asia, the doctors will often test for thalassemia first, because taking iron if you carry thalassemia and have mild anemia as a result, can cause permanent injury. Sometimes, pregnant women are told to take iron, and develop hemochromatosis, which puts both them and the baby at risk of major complications.
I meant this comic to be a somewhat tongue-in-cheek parody of positions I have seen people take, which I intended the ellipses to hint at. Clearly there are some genetic differences between populations.
Who brainwashed you bro? Are you trying to say ethnicity doesn't exist? There won't be genetic differences (and physical non-genetic differences) between different groups? This is how far leftist propaganda has gone :(
EDIT: and typical that I get downvoted without reason for merely suggesting that it is silly to claim that ethnicity doesn't exist (which is how the parent is using the word 'race').
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When I first started evaluating research, I was able to deconstruct studies and show why they were bad left and right. I thought I was so smart, but then when I started trying to do my own research it became obvious that we operate under the same limitations as everyone else -- how do we design the best imperfect study given the limitations of money, time, people, and geography?
In that context, I think this study is great. It is always true that the results of a study in a narrow group do not extrapolate to a larger group and it is good to be aware. However, that doesn't mean it can't generate hypotheses for a larger group (which can then be studied). The researchers likely would not have had the pull to generate an equivalent amount of data and follow-up data for a world-wide population, but I'm glad they did the best they could rather than spend their day posting criticisms on HackerNews.
"The cohort’s leaders recruit babies born at the Guangzhou Women and Children’s Medical Center. Only families planning to live in the southern Chinese city for a long time have been recruited"
Limited ethnic and geographical selection of participants means this 'slew' of data will likely be less valuable than this article lets on. Helpful to that immediate area? yes.
If it’s applicable to 20% - 30% of people for whom we previously didn’t have medical studies on, this could prove a boon to medicine. In addition for the vast majority of things this is applicable to 100% of people.
I have to say, the impressive scale of this data collection probably means it will still have some uses. And for Chinese health & medicine, it's simply a massive deal, if everything was done correctly.
It's commonly given to women who have had repeat miscarriages, like my wife. However, her doctor also prescribes it after birth for women with PPD, because it has been shown to alleviate the symptoms, and I imagine that if my wife were to present with that, she would be put on it.
It's also common to give it to women who have short luteal phases and want to conceive.
It is common in the US and Canada to use progesterone during early gestation for IVF pregnancies, to support the endometrium after embryo implantation.
These sorts of broad cohort studies wind up being enormously useful. The Scandinavian study keeps returning good results even today.
I would, mildly speculatively, hazard that enormous cost overruns are permissible and acceptable to the tune of 1000% if we could execute a similar cohort study in the entire United States for 30-50 years. The wealth of knowledge they can reveal is absolutely astounding and informs post/ante/neo-natal care to the point of redefining key practices.
> The blood thinner clopidogrel, or Plavix, doesn't work in the 75 percent of Pacific Islanders whose bodies don't produce the enzyme required to activate the drug. For them, taking the medication is like taking a placebo.
> People with epilepsy who are of Asian descent are supposed to get genetic testing before being prescribed the seizure medication carbamazepine, because the drug can damage the skin and internal organs of patients with a certain gene variant.
> And, says Oh, "African-Americans and Puerto Ricans don't respond as well to some of the most common asthma controller medications, and that's really a tragedy since these two groups are the most affected by asthma in the United States."