Race, genetics, and their impact on health – Mumbai Mirror

Amongst the various forms of discriminations the world has seen, Apartheid, a system of institutionalised racial segregation practised in South Africa, was one of the worst. I went to medical school with several South African students and the stories of discrimination they told me about were horrifying. Thankfully Apartheid, which was based on white supremacy and lasted more than 40 years, ended in the early 1990s.

I am often asked by my Caucasian friends if I felt discriminated against in the UK because of my brownness. I reply that it may have been true in early 1970s. I remember waiting in line to be served a pint of beer, only to be ignored by the proprietor of the pub. When I had the good fortune of going with a white girl, there was never a problem getting served.

Of course things have changed in the UK, which is today a proudly multicultural country. Overt discrimination of the kind that existed earlier is no longer tolerated. Asian communities especially are a thriving group, eagerly courted by political parties. Today when I go to a pub in London, I find the barmaid waiving me in.

This brings us to the topic of todays column: the role of race in health outcomes. Differences in health status, life expectancy and other indicators in different racial and ethnic groups are well documented. But before we get to that, let me get a somewhat controversial subject out of the way: the dominance of black athletes.

Black athletes enjoy a huge over-representation at the highest level of many sports - from the 100 metres sprint through to the marathon, every single record is currently held by athletes of African origin.

Sir Roger Bannister, who ran the first sub-4-minute mile, said in a speech to the British Association of Advancement of Science in 1995 that heel-bone length, subcutaneous fat and differences in the length of the Achilles tendon may explain the advantage that Africans may have in running sports. A study published in the Journal of Applied Physiology reported that Africans display an enhanced resistance to fatigue while running on a treadmill. There are tens of such studies - many of them controversial - which are beyond the scope of one column.

Coming back to race and health outcomes: Diabetes, for example, is 60 per cent more common among African Americans than white Americans. Black Americans are 2.5 times more likely to suffer limb amputations and 5.5 times likely to suffer from kidney disease because of diabetes.

Blacks in America are more likely to die of asthma than whites and, despite lower tobacco exposure, Blacks are 50 per cent more likely to get lung cancer.

Black Americans suffer twice the risk of stroke than Whites; strokes kill four times more 35- to 54-year-old Blacks than white. Black men have a 40 per cent high cancer death rate, and women 20 per cent higher death rate, than their white counterparts.

The stats for the other major minority group in America - the hispanics - are similarly depressing.

Around 15 years ago, the US FDA controversially approved a drug called BiDil for a single racial-ethnic group - African Americans - for treatment of congestive heart failure. The scientific research leading to BiDils approval tested the drug only in African American populations.

Craig Venter, the famous American biotechnologist who produced the map of the human genome, said it was disturbing to see things categorised in terms of race.

Is race really a surrogate marker for describing human genetic variation? In India genetics and race are certainly considered interchangeable. People still prefer getting married to someone of their own community. One of the major consequence of endogamy - the practice of marrying within the same community - is genetic diseases arising out of a limited gene pool. We would certainly be better off if we looked to widen our gene pool.

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Race, genetics, and their impact on health - Mumbai Mirror