Health

Health through "the lens of race"

By C. Gerald Fraser, Our Correspondent

Are disparities in health between blacks and whites due merely to one race's inherent fitness or another's unhealthiness?

No, and its time to discard notions of a genetic link between race and health, says Harold Freeman, M.D., a noted surgeon and former head of the North General Hospital in Harlem, New York's famed and troubled Black district.

The "unequal burdens of disease have more to do with class, culture and social injustice" - in other words the stress of being Black in a racist world - he told a meeting in New York of experts and journalists writing on issues in genetics

Speaking to the Gene Media Forum, Freeman, an African American who is chair of the President's Cancer Panel and associate of the National Institutes of Health, explained his reasoning. "Race does not exist, and yet it does exist. It doesn't exist from a scientific and biological point of view, but it does exist from a social, political point of view. And in our society we see, value and behave toward each other through this powerful lens of race."

Freeman said, "Class is a powerful determinant of what happens to people. Poverty causes negative human events-- groups of people who are disproportionately poor will have more negative events".

Culture is another determinant of health. And by culture "I mean people who have a similar communication system, similar social environment, traditions, lifestyle, attitude and behavior, world view. Culture is not equal to race. You'll find many cultures within a so-called race, and culture may go across race."

What causes the "unequal burden of disease," Freeman said were socio-economic status, culture, and social injustice, historically and today.

For example, many studies reported in the "New England Journal of Medicine," he said, "indicate that race is a determinant of how people get treated." A national study done in war veteran's hospitals, he said, indicated that when black males presented symptoms of chest pains that may indicate coronary disease or risk for death from heart disease they were less likely than white males to receive thorough evaluations.

There is, he said, "a huge difference" between blacks and whites getting referred for kidney transplants "even when the economics are the same." And, similarly, studies have shown that in Los Angeles and Atlanta emergency rooms. Hispanic and black men with long bone fractures are less likely to be treated with pain relief medicines.

"We need to look at what I call the meaning of the lens of race," Freeman said. "How people see each other. Health professionals seeing patients and patients seeing care givers. In my view, he concluded: "Race is a powerful factor in determining how we see each other, value each other, and behave toward each other even when people do not intend harm."

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