Racial discrimination: how not to do it

Racial, Ethnic, and Insurance-Based Disparities Upon Initiation of Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema in the US

PURPOSE

This study characterizes the association of risk factors including race, ethnicity, and insurance status with presenting visual acuity (VA) and diabetic retinopathy (DR) severity in patients initiating treatment with anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema (DME).

DESIGN

Retrospective, cross-sectional study.

PARTICIPANTS

The Academy Intelligent Research in Sight (IRIS) Registry database was queried for patients who initiated anti-VEGF injection treatment for DME between 2012 and 2020 (n = 203 707).

METHODS

Multivariate regression analyses were conducted to understand how race, ethnicity, insurance status, and geographic location were associated with baseline features.

MAIN OUTCOME MEASURES

Visual acuity and DR severity.

RESULTS

Patients on Medicare and private insurance presented with higher baseline VA compared with patients on Medicaid (median of 2.31 and 4.17 greater Early Treatment Diabetic Retinopathy Scale [ETDRS] letters, respectively P < 0.01). White and non-Hispanic patients presented with better VA compared with their counterparts (median of 0.68 and 2.53 greater ETDRS letters, respectively; P < 0.01). Black and Hispanic patients presented with a worse baseline DR severity compared with White and non-Hispanic patients (odds ratio, 1.23 and 1.71, respectively; P < 0.01).

CONCLUSIONS

There are ethnic and insurance-based disparities in VA and disease severity upon initiation of anti-VEGF therapy for DME treatment. Public health initiatives could improve timely initiation of treatment.

Resurecting raciology? Genetic ethnology and pre-1945 anthropological race classification

This article places the current high-profile and controversial scientific project that I call 'genetic ethnology' within the same two-century tradition of biologically classifying modern peoples as pre-1945 race anthropology. Similarities in how these two biological projects have combined political and scientific agendas raise questions about the liberalism of genetics and stimulate concerns that genetic constructions of human difference might revive a politics of hate, division and hierarchy. The present article however goes beyond existing work that links modern genetics with race anthropology. It systematically compares their many similar practices and organisational features, showing that both projects were political-scientific syntheses. Studying how the origins, geography, filiations, 'travels and encounters of our ancestors' affect 'current genetic variation', both seem to have responded to a continuous public demand for biologists to explain the histories of politically significant peoples and give them a scientific basis. I challenge habitual contrasts between apolitical scientific genetics and racist pseudoscience and use race anthropology as a parable for how, in the era of Brexit and Trump, right-wing identity politics might infect genetic ethnology. I argue however that although biology-based identities carry risks of essentialism and determinism, the practices and organisation of classification pose greater political dangers.

Human ancestry correlates with language and reveals that race is not an objective genomic classifier

Genetic and archaeological studies have established a sub-Saharan African origin for anatomically modern humans with subsequent migrations out of Africa. Using the largest multi-locus data set known to date, we investigated genetic differentiation of early modern humans, human admixture and migration events, and relationships among ancestries and language groups. We compiled publicly available genome-wide genotype data on 5,966 individuals from 282 global samples, representing 30 primary language families. The best evidence supports 21 ancestries that delineate genetic structure of present-day human populations. Independent of self-identified ethno-linguistic labels, the vast majority (97.3%) of individuals have mixed ancestry, with evidence of multiple ancestries in 96.8% of samples and on all continents. The data indicate that continents, ethno-linguistic groups, races, ethnicities, and individuals all show substantial ancestral heterogeneity. We estimated correlation coefficients ranging from 0.522 to 0.962 between ancestries and language families or branches. Ancestry data support the grouping of Kwadi-Khoe, Kx’a, and Tuu languages, support the exclusion of Omotic languages from the Afroasiatic language family, and do not support the proposed Dené-Yeniseian language family as a genetically valid grouping. Ancestry data yield insight into a deeper past than linguistic data can, while linguistic data provide clarity to ancestry data.

Race: Deflate or pop?

Neven Sesardic has recently defended his arguments in favour of racial naturalism-the view that race is a valid biological category-in response to my criticism of his work. While Sesardic claims that a strong version of racial naturalism can survive critique, he has in fact weakened his position considerably. He concedes that conventional racial taxonomy is arbitrary and he no longer identifies 'races' as human subspecies. Sesardic now relies almost entirely on Theodosius Dobzhansky's notion of race-as-population. This weak approach to 'race'-according to which all genetic difference between populations is 'racial' and 'the races' are simply the populations we choose to call races-survived its early critiques. As it is being mobilised to support racial naturalism once more, we need to continue the debate about whether we should weaken the concept of race to mean 'population', or abandon it as a failed biological category. I argue that Sesardic's case for racial naturalism is only supported by his continued mischaracterisation of anti-realism about biological race and his appeal to Dobzhansky's authority. Rather than deflating the meaning of 'race', it should be eliminated from our biological ontology.

Unnaturalised racial naturalism

Quayshawn Spencer (2014) misunderstands my treatment of racial naturalism. I argued that racial naturalism must entail a strong claim, such as "races are subspecies", if it is to be a substantive position that contrasts with anti-realism about biological race. My recognition that not all race naturalists make such a strong claim is evident throughout the article Spencer reviews (Hochman, 2013a). Spencer seems to agree with me that there are no human subspecies, and he endorses a weaker form of racial naturalism. However, he supports his preferred version of 'racial naturalism' with arguments that are not well described as 'naturalistic'. I argue that Spencer offers us an unnaturalised racial naturalism.