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I continue to hear a genetic relationship between ethnicity and #COVID19 invoked in both explicit and implicit ways among medical colleagues. In this thread I argue, in the race to understand the relationship between #COVIDー19 and ethnicity, we need to look beyond genetics.
It has been 20 yrs since the editors of nature genetics said "The laudable objective to find means to improve the health conditions for all or for specific populations must not be compromised by the use of race or ethnicity as pseudo-biological variables" https://www.nature.com/articles/ng0200_97
Essentially - there is no scientific basis for race, it is a socially constructed phenomenon.
Or as geneticist @AdamRutherford puts it
'race doesn’t exit, racism does' https://www.theguardian.com/science/2015/mar/01/racism-science-human-genomes-darwin
Or as geneticist @AdamRutherford puts it
'race doesn’t exit, racism does' https://www.theguardian.com/science/2015/mar/01/racism-science-human-genomes-darwin
Yet the scientific community continues to observe diff outcomes between people of diff racial & ethnic b/grounds & translates these into research questions which presuppose a genetic basis for race. Let me take an example in my own speciality tuberculosis: https://journals.lww.com/retinajournal/Fulltext/2019/08000/THE_COLLABORATIVE_OCULAR_TUBERCULOSIS_STUDY.21.aspx
This paper clearly suggests the category ‘caucasian’ is an ethnicity rather than a race. Caucasian is often used as a synonym for white race, encompasses heterogenous populations and is unrelated to ethnicity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1509085/?page=3
The paper goes on to suggest genetic differences might explain the variations between races.
Confusingly genetic lineages such as ‘African’ or ‘European’ are in widespread use in studies exploring an association between race and disease.
Confusingly genetic lineages such as ‘African’ or ‘European’ are in widespread use in studies exploring an association between race and disease.
A researcher once said to me, 'I don’t trust how people self report their ethnicity, I check their genetic lineage in the lab'. However, in the NHS for example, ethnicity data is supposed to be self-reported. For one commentary on this see here: https://europepmc.org/article/pmc/pmc2857388
Prof Bhopal defines ethnicity as “The social group a person belongs to & either identifies with or is identified with by others, as a result of a mix of cultural & other factors inc >1 of language, diet, religion, ancestry & physical features traditionally associated with race”
However, ethnicity is poorly defined in the medical literature. https://www.sciencedirect.com/science/article/pii/S0895435619302446?casa_token=Gzy7-WpONm0AAAAA:LUEQjK2f6H5bq_t3RYf67iCoiq-ZfVvfgksRBMCTi2EqL2B5phe0xvRmMm2Z2VvbkdKkkQgwWGs
And is often poorly collected
https://diversityhealthcare.imedpub.com/improving-ethnicity-data-collection-for-health-statistics-in-the-uk.php?aid=2045
And is often poorly collected
https://diversityhealthcare.imedpub.com/improving-ethnicity-data-collection-for-health-statistics-in-the-uk.php?aid=2045
Sometimes ethnicities are lumped together e.g South Asians here https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3181-z
Even when genes are not mentioned, this categorisation presumes a shared cultural heritage in a hugely diverse population.
Even when genes are not mentioned, this categorisation presumes a shared cultural heritage in a hugely diverse population.
Recent research on blood pressure measurement between populations often categorised as South Asian (frequently Bangladeshi, Indian and Pakistani) showed ‘stark heterogeneity’ between these subgroups https://pubmed.ncbi.nlm.nih.gov/30181657/
So why do we continue to take observational data on race/ethnicity and translate it into a causal genetic search?
E.g @NIHRresearch recent call for evidence on the association between #COVID19 & ethnicity gave, as their number 1 suggestion of study types,
E.g @NIHRresearch recent call for evidence on the association between #COVID19 & ethnicity gave, as their number 1 suggestion of study types,
“Studies to improve our understanding of genetic risk factors and how these manifest clinically, including in terms of immune responses to COVID-19 infection..” https://www.nihr.ac.uk/documents/highlight-notice-covid-19-and-ethnicity/24657
Data collection on race/ethnicity is vital. Links between individual & collective experience are important to understand. But we must be critical about the questions we choose to ask of our data & conclusions we draw.
I would argue, in the context of our globalised world, many census listed ethnicities obscure the diversity within each group. And for those listed as BAME, perhaps the only experience that is shared is one of structural inequities rooted in racialised colonial histories?
