SXSW: Can Precision Medicine Tackle Racial Inequities in Health Care?

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Chiquita Collins, vice dean for inclusion and diversity at UT Health San Antonio, speaks on a panel about how racism has historically seeped into the health care system. Other panelists are Renee Chapman Navarro, vice chancellor at the University of California San Francisco, and René Salazar, assistant dean for diversity at the Dell Medical School at The University of Texas at Austin.

JJ Velasquez / Rivard Report

(From left) Chiquita Collins, vice dean for inclusion and diversity at UT Health San Antonio; Renee Chapman Navarro, vice chancellor at the University of California, San Francisco; and René Salazar, assistant dean for diversity at the Dell Medical School at the University of Texas at Austin, speak on a panel about scientific racism's impact in health care.

AUSTIN – “Believe it or not, [race] is a social construct.”

Those words delivered Monday by Dr. Chiquita Collins, UT Health San Antonio’s chief diversity officer, at the South by Southwest Conference & Festivals were probably not revelational to the audience attending a panel on precision medicine, an emerging medical discipline customizing treatment for genetic, environmental, and lifestyle variations.

Rather, they served to remind the attendees of the racist pseudoscience and government policies that created the medical realities that still exist today for ethnic minorities and other marginalized segments of the population. There is no biological basis for the concept of race, she said.

Collins and her fellow panelists – Dr. René Salazar, assistant dean for diversity at the Dell Medical School at the University of Texas at Austin, and Dr. Renee Chapman Navarro, vice chancellor of diversity and outreach for the University of California, San Francisco – spoke about scientific racism’s still-experienced impact in today’s health care climate: disproportionately poor patient outcomes, unethical practice and research, and mistrust of the medical community among racial and ethnic minorities. They also discussed the action the medical community would need to take to correct systemic inequities in treating minority groups.

Chapman Navarro characterized the health care system today as not “one size fits all” but “one size fits very few.” Care is typically not tailored to a patient’s genetic information (the U.S. government mapped the human genome in 2003) or environmental information, such as where they live, what they ingest, and what medicines they take.

But data analytics tools are making such customized care possible, she said.

“Now that we have the ability to be more precise … we can then use all of these data and with analytic tools that exist today to take vast amounts of data and distill them down to very specific directions, and we will actually be able to move to a one-size-fits-more-precisely [approach],” Chapman Navarro said.

Nineteenth-century physician Samuel G. Morton posited that blacks, Native Americans, and Asians were all intellectually inferior to Caucasians because they had smaller skulls. It’s an idea that carried into the eugenics movement at the turn of the 20th century, which was later used to justify racial science in Nazi Germany. The underlying pseudoscience that prompted such notions has continued to reverberate in American society today.

For black and Latino Americans, these biases have led to lower life expectancies compared to their Caucasian counterparts.

“Blacks and Latinos die at far higher rate than whites and, even, Asians in our country,” Chapman Navarro said. “So how do we start to close the gap as it relates to the disparities in health that we’re seeing within this country today?”

In a now-infamous study that began in 1932, a federal agency known as the U.S. Public Health Service failed to treat or inform African-American men in Tuskegee, Alabama, whom researchers knew had syphilis even though penicillin had become the standard treatment for the disease by the 1940s. Guatemalans were intentionally injected with syphilis in a 1946 clinical study.

Collins said even though medical institutions are beginning to embrace the idea of cultural competency – that physicians should be prepared to treat and interact with patients from diverse groups effectively – the country’s “ugly history” when it comes to racial discrimination needs to be confronted societally so that it doesn’t rear its head again.

“We need to address this in the context of our society,” she said. “We can’t expect things to change from that point of view if we don’t deal with our history.”

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