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Comment by BugsJustFindMe | Hacker News Reader

> Don't black people get sickle cell at higher rates than other races?

Except that "black people" describes the color of someone's skin, and sickle cell prevalence is more properly tied to things that are much more specific than skin color, like the geographic origins of sickle cell disease. Which is why black people in Ethiopia and South Africa have low prevalence, and white people on mediterranean towns like Orchomenos have high prevalence. It's your social construct that lumps the idea of "black people" into a racial category in the first place and then associates that with sickle cell disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708126/

https://web.archive.org/web/20140917070248/https://www.thegu...

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Playing Devil's Advocate here - how about recommended levels of vitamin D? That's directly influenced by pigmentation.

Or melanoma? According to this, "white, non-hispanic" people develop melanoma at a rate of 26.1 per 100k while "black, non-hispanic" people develop it at a rate of 0.8 per 100k.

It seems apparent to me that there are at least _some_ cases where the social construct of "race" is useful in a clinical setting.

> how about recommended levels of vitamin D? That's directly influenced by pigmentation.

People generally don't consider dark skinned Indians and dark skinned Nigerians and dark skinned Peruvians to be the same race because they all have dark skin. They're just as different from each other as they are from me despite having more melanin.

> It seems apparent to me that there are at least _some_ cases where the social construct of "race" is useful in a clinical setting.

The concept of skin pigmentation is useful for things related to skin pigmentation. The concept of "race" is still artifice and absolutely the least useful proxy there is for whatever you're actually trying to measure in any given moment.

> Playing Devil's Advocate here

Please don't. https://bofh.org.uk/2018/10/25/devils-advocacy-without-tears...

I appreciate this, thanks. Sure, sickle cell was a really quick example and definitely highlights my presuppositions here. It was the best one I could come up with off the top of my head.

But it seems we agree that my highly generalized social construct wouldn't invalidate the biological factors at play that expose more specific racial groups to higher/lower risk of certain conditions.

My fear is that we have to make certain we are only removing the social constructs and not the biological ones when we purge racial considerations from medicine. Quality of patient care will inevitably suffer otherwise.

There is more genetic diversity within the "black" race than outside it. Skin color and hair type are I'm sure useful categories for dermatology, but probably not much else

Well black people in the US generally are a mix of central African + European + other. So like any group like that can have genetic factors that predispose them to certain diseases. Besides kidney disease problem people have much higher rates of sarcoidosis. It is what it is.

In this case sounds like dummkopfs decided to adjust the test to normalize black peoples rates of kidney disease to those of white people.

I'll be over here banging my head against my desk.

> But it seems we agree that my highly generalized social construct wouldn't invalidate the biological factors at play

There are always biological factors at play, but this premise of "race" as applied by anyone ever is always basically mythological and not related to biological differences in a meaningful way that isn't (at the risk of sounding dismissive, for which I apologize up front) racist. Sickle cell is actually the perfect example of this. The people of Namibia and Angola look the same to me. They're even from neighboring countries. And yet their cultures are very different certainly, their languages are different, one has high sickle cell prevalence and the other does not... So are black people from Namibia and Angola the same race if they don't have that genetic variation in common? What about other genetic things they don't share? What about the genetic things they share with white Americans? Are a black person from Tamil Nadu, a black person from Ethiopia, a black person from Mali, and a black person from Papua New Guinea the same "race"? They don't look the same to me aside from having dark skin. Are my black neighbors the same race? They also don't look the same aside from having dark skin. Probably none of them are carriers of sickle cell trait. Is there something identifiable they all share that they don't also often share with white populations?

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