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How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

hdphealth.com

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Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#31
post #5

" Not only do minorities get asthma at a higher rate, but [UCSF] pulmonologist Dr. Esteban Burchard ... has found that ethnicity is the most important factor in determining if a patient will respond to asthma therapy. Unfortunately, for the most most commonly prescribed asthma medication, Albuterol, 67 percent of Puerto Ricans and 47 percent of African-Americans show no improvement when taking it, yet Albuterol works…

Advances in personalized medicine can't come soon enough.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#32

https://www.propublica.org/article/nothing-protects-black-wo... This is a longer article on the subject of poorer health outcomes for minorities, covering the situation for black women and one family's experience, which is very much worth reading, but here are the key points: Statistics: * A black woman is 22% more likely to die from heart disease than a white woman * ...71 percent more likely to perish from cervical…

According to the CDC, the average weight [1] of a black woman aged 20-39 years in the US is 179 lbs, 158 lbs for a white woman. Converting to BMI (to adjust for height differences), the story is the same with an average 30.2 vs 26.7, or 'moderately obese' versus 'overweight.' Remove any notions of race and compare the stats based entirely on equivalent weight/BMI I you will find nearly all differences would disappear…

Then why is asthma medication less effective on Latino's and African Americans? And why did my friend have to visit 5 doctors and it wasn't until he found the Black doctor that his skin condition (which is common to only African Americans regardless of weight) was properly diagnosed and treated?

I'm not saying weight is not a problem, I come from a black family where unhealthy diets are a tradition (but that leads back to the fact that traditional african american diets come from the slave food which was unhealthy but taken in as cultural meals, much longer discussion there), but that does not mean that taking out weight in this discussion solves all or even most of the issues at hand.

As well using your same logic, why do Asians who typically have a lower BMI than white individuals have higher incidences of Diabetes? It's not one size fits all

https://health.usnews.com/wellness/articles/2016-03-11/asian...

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#33
It's weird to frame this as 'neglect'. Some minority groups are uniquely distrusting of medical professionals (I'll cite this later when I'm not on a work network) - that's going to impair testing participation.

In the past, medical researchers went out of their way to use minority test subjects and that's been understood to be more problematic than our volunteer-based system.

The vast majority of medicine was developed in white and asian countries, it's not surprising that medicine is optimized for people in those clusters. And it's only unethical that it winds up this way if you think it's unethical for people to advance their self-interest. Personally, I think that motivates most of the research so I'd rather have medicine that isn't tailored for me than no medicine.

I'm sure we can make things better, but to act as though any disparity is conclusive evidence of neglect/racism/prejudice/structural barriers isn't helpful and isn't going to get us any closer to improving medicine.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#34
post #18

Earlier quoted context omitted.

Do you find the opening statement "With more than 50 percent of the population estimated to be a minority by 2044" ridiculous? When did we start ignoring what words mean? That's not what the word "minority" means. There's many ways you can rephrase it and still be correct, mind you.

Incorrect, the actual definition is "Majority minority" https://en.wikipedia.org/wiki/Majority_minority and yes those of us that are currently Minorities, would still be considered minorities in such a case.

According to the definition, the term applies when local majority is country's minority.

If you're no longer country's minority, you cannot be majority-minority.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#35

I'm the founder of HDP Health, if you have any questions or want clarifications please ask away!

In more social/cultural discussions of genetics and race, there are often different assertions on various sides that race does or does not imply a specific definable genetic makeup. How might that contrast with the more medically focused approach and use of the term minorities with work of HDP Health?

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#36
post #35

I'm the founder of HDP Health, if you have any questions or want clarifications please ask away!

In more social/cultural discussions of genetics and race, there are often different assertions on various sides that race does or does not imply a specific definable genetic makeup. How might that contrast with the more medically focused approach and use of the term minorities with work of HDP Health?

Actually environmental factors are a big portion of clinical research. Most people think of just the precision medicine approach, but often taking in environmental factors and developing treatment plans that take that into account are a big part of clinical research, and most of the envioronmental/cultural focus on this has been toward white american culture.

While we "focus on medical" clinical research isn't just testing new drugs, it's determining if one diet is better than other, it's finding prevention mechanisms and much much more. We work with any center that is running any type of research. And while we focus mostly on cancer treatments (70% of research dollars are spent here) we're building technology and want to expand to cover all types of clinical research as we grow.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#37
post #18

I'm the founder of HDP Health, if you have any questions or want clarifications please ask away!

Do you find the opening statement "With more than 50 percent of the population estimated to be a minority by 2044" ridiculous? When did we start ignoring what words mean? That's not what the word "minority" means. There's many ways you can rephrase it and still be correct, mind you.

When you're main concern is "What is a minority" rather than "minorities are dying" that is very indicative of the problem still existing

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#38
post #6

https://www.propublica.org/article/nothing-protects-black-wo... This is a longer article on the subject of poorer health outcomes for minorities, covering the situation for black women and one family's experience, which is very much worth reading, but here are the key points: Statistics: * A black woman is 22% more likely to die from heart disease than a white woman * ...71 percent more likely to perish from cervical…

But this seems to be different situation from what the article is talking about which is the inadequate involvement of minorities in drug trials. You are highlighting the lack of adequate health coverage which is a different issue in the US. But this bring up a question if blacks and other minorities have the poorer health outcomes in other countries? Japan, China, South Korea for example does their own drug testing…

Or generally if historically oppressed minorities get poorer health outcomes.

It seems a complex question that has many facets. Two tickets that come to mind:

1. When US sociologists and political scientists talk about “systemic and structural racism” this is one of the manifestations.

That in general the well being of Native peoples in the US, of African Americans is devalued. It is witnessed in the exclusion in drug trials, in the diseases that pharma considers worthwhile to address, in the staffing of hospitals, in the access to healthcare,etc.

2. The unique inefficiency of the US healthcare system among those of wealthy countries has been documented in depth so I don’t know if is possible to do an adequate comparison of progressive health systems (e.g. Japan, UK, Finland) against that of the US.

It might be worthwhile to pull in progressive health systems that focus primarily upon Black people —- Botswana comes to mind —- as a point of comparison.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#39
post #18

Earlier quoted context omitted.

Do you find the opening statement "With more than 50 percent of the population estimated to be a minority by 2044" ridiculous? When did we start ignoring what words mean? That's not what the word "minority" means. There's many ways you can rephrase it and still be correct, mind you.

When you're main concern is "What is a minority" rather than "minorities are dying" that is very indicative of the problem still existing

I agree with your mission statement.

It's important to match the demographics of the population with the demographics of trial users. It's important to prevent as many deaths as we can.

It's important to account for differences between groups when you're developing healthcare.

But please, don't mangle mathematical terms.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#40
post #31
post #5

" Not only do minorities get asthma at a higher rate, but [UCSF] pulmonologist Dr. Esteban Burchard ... has found that ethnicity is the most important factor in determining if a patient will respond to asthma therapy. Unfortunately, for the most most commonly prescribed asthma medication, Albuterol, 67 percent of Puerto Ricans and 47 percent of African-Americans show no improvement when taking it, yet Albuterol works…

Advances in personalized medicine can't come soon enough.

Cytochrome P450 is a family of closely related enzymes that are involved in drug metabolism. There are certain isoforms that have variants with wildly different activity in certain populations. In drug discovery we screen for their involvement and do not like to develop compounds that are metabolized by one of these isoforms because the variation in pharmacokinetics would be too huge. This is kind of the opposite of personalized medicine, making response uniform across the population.

This article gives an overview: https://www.aafp.org/afp/2007/0801/p391.html

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