Race and Ethnicity

An analysis based on assumptions of an underlying structure of racism would emphasise the influence of racist immigration laws on the genetic variation in a community. For example, do laws restricting rights of British Moslems to marriage partners from the Indian Sub-Continent effectively narrow the gene pool of potential partners in communities practising consanguinity? An anti-racist analysis would also address the interplay of racism and class in education, housing and employment in determining material life chances and thereby the material basis to the situational relevancy of genetic information.

Moreover, it would be unwise not to consider that the ascription of genetic risk to ra-cialized groups may engender stigma in a way in which such information appears not to in the white population (Watson et al, 1992; Burn, 1993) particularly as one such historical example apparently exists (Stamatoyannopoulos, 1974). Although in the case of beta-tha-lassaemia and a Pakistani Moslem community in Britain stigma is not socially constructed, this is because of very specific cultural factors, namely that the pattern of consanguinity in marriage means that to ascribe stigma would be to stigmatize one's own family (Darr, 1990). Indeed, where genetic information disturbs the one valued social role open to black women living in poverty, namely raising children, genetic information relating to sickle cell may be rejected or blurred (Hill, 1994). Apolitical economy analysis also reveals implications for racial discrimination. Firstly, the manufacture of pharmaceutical drugs, such as desferrioxamine for beta-thalassaemia major, in the countries of the North raises a specific instance of the general exploitation of financially poorer countries by multinational drugs companies (Melrose, 1982). Secondly, haemoglobinopathies are carried by nearly 5% of the population globally (WHO, 1994), but since most of these are in developing countries venture capital is more likely to support research into the genetic basis of heart disease and cancers. Thirdly, the South Asian diaspora to five continents may mean there are extended families who have independently in several countries discovered their familial genetic status by the unexpected birth of a child with a haemoglobin disorder.

Anti-racist approaches would also be critical of explanations which cited lack of cultural understandings for failure to assimilate or act upon genetic information. Such authors have criticized the 'ethnic' culturalist approach in medicine and health education for failing to acknowledge racism; for portraying ethnic groups as homogenous and for construing minority ethnic cultures as deviant, deficient and resistant to change (Pearson, 1986 & 1989; Ahmad, 1994 & 1996). Moreover, material and structural factors may apply differentially between different ethnic groups; be experienced in differing ways and to differing degrees by the mediation of culture; and culture may itself be forged in the historical and social context of material factors (Smaje, 1996). Such is the case of low income families caring for a child with sickle cell in the US, where "...the strong cultural norm of motherhood among low income black women mitigates against easy acceptance of reproductive implications of having sickle cell trait." (Hill, 1994, p. 68).

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