Women and Health Research Ethical and Legal Issues of Including Women in Clinical Studies: Volume 2: Workshop and Commissioned Papers (1994) / Chapter Skim
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18 Racial Differentials in Medical Care: Implications for Research on Women
18 Racial Differentials in Medical Care: Implications for Research on Women
Pages 174-191
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From page 174... ...
It will focus primarily on African Americans. The report is divided into four sections.
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From page 175... ...
He used skin color, stature, end physique as the criteria for racial designation. Over 200 years later, in 1950, W.S.
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Anthropologist Fatimah Jackson in a 1992 article about the use of race and ethnicity as biological constructs attributes this trend to a growing recognition by her colleagues of "the difficulty of making valid taxonomic assessments in longlived, sexually reproducing, socially complex, and highly mobile species such as Homo sapiens."9 The traditional medical and public health view has been to interpret race as a biological and genetic category. This frequently takes He form of attributing observed differences in health status to inherent putatively "racial" characteristics.
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From page 178... ...
"The publication of health statistics in racial tenns," he states, "assumes that white unskilled workers have more in common with white lawyers, for example, than with black unskilled workers."'2 Criticism of the application of the biological model to medicine and public also focuses on the notion that race, that is, skin color, is an accurate measure of the biological differences between human beings. As Richard Cooper has pointed out: To classify on the basis of skin color arbitrarily assigns primary importance to that characteristic and forces all others to be ignored.
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From page 179... ...
Its findings suggested that no benefit would be gained from early AZT therapy in African Americans and Limos. Later studies repudiated this conclusion.~9 The complexities in analyzing racial variations are seen in the VA study.
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These are questions that must be addressed as programs are developed to include more women of color in research programs. The many unanswered questions regarding racial differences in medical research mandates more precision in the use ofthe term and the development of strategies to include more people of color in clinical studies.
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From page 181... ...
Id 1932 Raymond Pearl, one of the major proponents of the health hypothesis, alleged that black women's contraceptive use was lower than that oftheir white counterparts because "the negro generally exercises less prudence and foresight than white people do in all sexual matters."23 The authors of a 1958 book on childbirth and abortion also emphasized the perceived racial differences in reproductive behavior. They wrote: Insofar as reproductive behavior is concerned, the .
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Close historical examination of the lives of African American women reveals images that sharply contrast to the previously accepted view. Jessie Rodrique has discovered that a nationwide, grass roots bird control movement operated in the black community in the years before World War II.
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From page 183... ...
Race is also seen in these investigations as a definable genetic category. Additional studies have concluded thy Hispanic women are also less susceptible to the disorder than white women.36 One author has suggested that as Mexican Americans and African Americans are "relativelyprotected" that they "may benefit less from prophylactic theories."37 The literature on Asians is contradictory with studies presenting them as both less and more susceptible.38 Race and ethnicity, however, do not over immunity to osteoporosis.
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From page 184... ...
The challenge before us is to attempt to understand and confront the historically based realities behind these sentiments. The Tuskegee Syphilis Study symbolizes for many African Americans the racism that pervades American institutions, including the medical profession.39 It is often used to demonsb~e why African Americans should not cooperate with medical researchers.
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From page 186... ...
For example, a 1990 survey conducted by the Soothed Christian Leadership Conference found that 35 percent of the 1,056 black church members who responded believed that AIDS was a form of genocide.43 The Tuskegee Syphilis Study is presented as evidence of the government's genocidal policies toward African Americans. A lasting legacy of the study is that it demonsb~es to many African Americam why they should not trust the medical profession.
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From page 187... ...
Only after his experimentation with the slave women proved successful did the physician attempt the procedure on white women volunteers. He found, however, that they could not, or more accurately, would not, withstand the pain and discomfort that the procedure entailed.
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From page 188... ...
: One Natior''s Definition' (University Park: Pennsylvania State University Press, 1991~; Barbara Jean Fields, '~Slavery, Race, and Ideology in the United States of America,"NewLeA Review 181 (1990~: 95-118; Richard Graham, ea., The Idea of Race in Latin America (Austin: University of Texas Press, 1990~; Christopher S Wren, '~South Africa Scraps Law Defining People By Race," New York Times, 18 June 1991.
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From page 189... ...
Levy, Ethnic and Racial Differences in Response to Medicines (Reston, VA: National Pharmaceutical Council, 1993)
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From page 190... ...
36. Richard Bauer and Richard Deyo, "Low Risk of Vertebral Fracture in Mexican American Women," Archives of Internal Medicine 147 (1987~: 1437-1439; Richard Bauer, "Ethnic Differences in Hip Fracture: A Reduced Incidence in Mexican Americans," American Journal of Epidemiology 127 (1988~: 145-149.
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From page 191... ...
Thomas and Sandra Crouse Quinn, "The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV Education and AIDS Risk Education Programs in the Black Community," American Journal of Public Health 81 (1991~: 1499.
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