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How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

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

#51

Earlier quoted context omitted.

The same is true for men and women. The narrative we like to repeat is that men and women are the same except for the shapes of their genitals but there are numerous biochemical and metabolic differences that should affect dosages for several classes of medication [1]. The real tragedy is that many drug trials were never done with women so we may not even be sure of what the doses should should be [2]. The same probl…

>The same problem exists with children. I feel like the problem is worse with children due to them having a developing brain, where the impacts of medication can have impacts into changing the very person taking them. I am especially concerned with medication for mental illnesses that are prescribed to children, often times off label, but the risk exists for most any medication.

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

#52
post #6

Earlier quoted context omitted.

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 dru…

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

Which has always bothered me, since there are other explanations (lifestyle habits, genetics, poverty) that would explain the difference, in whole or in part. It's a politically convenient assumption that goes contrary to Occam's Razor.

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

#53
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

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

You have just demonstrated what is called "attribution of intention" (as in you attributed an intention to the other person), which is a good indicator of a conversation going south.

(More general bias is "attribution bias")

HN guideline:

>Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith.

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

#54
post #27

Earlier quoted context omitted.

No single group that is currently a "minority" would overtake the white population, therefore every other population in the US would still be considered a Minority until there is an equal or more number of a single minority than there are white Americans.

Mathematically, if no population is a majority, then the country is 100 percent minority. You might be hang up on the additional narrative attached to the word “minority”. Consider using “underpriviledged ethnic group", as a. not even today all ethnic groups are equal and b. it is entirely possible some other ethnic group to raise to demographic majority status, and still exhibit the socioeconomic characteristics of…

Or maybe words are imprecise and fluid and the majority of people understand the intended message even if it's "technically incorrect".

>You might be hang up on the additional narrative attached to the word “minority”.

You can't separate words from their "additional narratives" and expect all people to understand what you're attempting to convey. The context and connotation around words is absolutely necessary for communication, and to eschew it leads to poorer communication.

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

#55
post #47

Earlier quoted context omitted.

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 dru…

>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... Speaking about medical research specifically: You seem to say these outcomes are because of white racists "devaluing" black and native peoples' well-being in an evil act of collective racism. A simpler explanation…

You completely missed the point. I specifically put statistics in my article to refute this.

In many clinical trials African Americans that contract various conditions at the same rate or higher than White Americans represent only 1% of the clinical trial versus 15% of the population. While 95% of the trial are White Americans but they are only 60% of the population. There is clearly a disparity here.

I also use the word "Neglect" they haven't recently purposefully ignored minorities (although in the past they did), But the people that want to run the trials put the trials in the neighborhoods (read mostly white populations) that they have worked with before and want to cover. Therefore trials aren't being run where Minorities live.

This is where the "systemic racism" comes into play.

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

#56
post #47

Earlier quoted context omitted.

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 dru…

>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... Speaking about medical research specifically: You seem to say these outcomes are because of white racists "devaluing" black and native peoples' well-being in an evil act of collective racism. A simpler explanation…

When people try to explain why you're coming to broken conclusions due to broken reasoning, they get attacked as radical leftists for using the straightforward terminology we have for describing the phenomenon we're discussing.

Here, you've provided a perfect illustration of why we have the term "structural racism". Structural racism is the emergent discrimination arising from the circumstances that created our status quo. You'd think an audience of computer scientists would have an especially good intuition for emergent systems properties.

Here's a simple explanation for how African Americans can be discriminated against in health care without any of the doctors or nurses involved having overtly racist impulses:

Until the nineteen seventies --- within many of our conscious lifespans! --- African Americans were actively, overtly, deliberately discriminated against in real estate. They were redlined out of white neighborhoods and into low-income neighborhoods. Naturally, once real estate lenders would allow them to buy houses in any neighborhood they wanted, African Americans of means began buying houses anywhere they wanted. Unlike low-income "white" people, low-income "black" people were stuffed into neighborhoods that were first deliberately underfunded, and then further disinvested by the vicious cycle of neighborhood flight ---- like a run on a bank.

The hospitals, doctors offices, pharmacies, and medical service providers available in those neighborhoods are poorer than those in white neighborhoods due to disinvestment.

The unbelievably awful people who designed and executed on redlining are probably long retired by now. Many of them are no doubt deceased. Most of us would recoil from racial barriers in real estate lending. We all believe ourselves to be well-intentioned. Samuel L. Jackson has a retort our best intentions.

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

#57
post #14

Earlier quoted context omitted.

We haven't done extensive research in populations outside of the United States, but for the last 50-100 years the US (and Europe) has been leading the charge, but in both these locations, Minorities have been a low percentage participation in research. As well, many of these outcomes he mentioned are the indirect result of years of research. Think of diabetes, 100 years of research was 99% spent on a white population…

So none of the asian countries (for example SK or Japan) retest the drugs on their own population before approval for use?

Japan retests, and interestingly recreates the same problems in a local way.

Taking medical checks for foreigners or minorities in japan means the guidance numbers are mostly irrelevant. Doctors might not know very well how to deal with you, a lot of advice for common but non critical illness can be summed up to “you do you”

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

#58
post #52

Earlier quoted context omitted.

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 dru…

>When US sociologists and political scientists talk about “systemic and structural racism” this is one of the manifestations. Which has always bothered me, since there are other explanations (lifestyle habits, genetics, poverty) that would explain the difference, in whole or in part. It's a politically convenient assumption that goes contrary to Occam's Razor.

I'm going to quote what someone said below because this is blatantly false

"This is not only false, but dangerously false. We are in the process of discovering that certain classes of popularly-prescribed drugs (eg ACE inhibitors for blacks, certain chemotherapy drugs for Asians) are ineffective or even toxic for populations not represented in the relevant drug development research cohorts. It's not identity politics to note that pharmacokinetics can differ between individuals and populations. These differences do not explain all of the population-level morbidity and mortality differences between ethnicities, but they are significant when investigating differences between groups on the same course of treatment."

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

#59

Earlier quoted context omitted.

> Asians who typically have a lower BMI than white individuals have higher incidences of Diabetes? Perhaps I missed it but where in that link does it say Asians have "higher incidences of Diabetes" than whites?

It is an indirect correlation. BMI is a factor related to the likelihood of having diabetes, and what's considered a safe range for white people is an unsafe range for Asians. Thus if you have a white person at a 25 BMI and an Asian person at 25 BMI, the Asian person has a higher likelihood of getting diabetes. "The educated [Asian] population knows that they're getting diabetes and hypertension and all these things…

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

#60

Earlier quoted context omitted.

> Asians who typically have a lower BMI than white individuals have higher incidences of Diabetes? Perhaps I missed it but where in that link does it say Asians have "higher incidences of Diabetes" than whites?

It is an indirect correlation. BMI is a factor related to the likelihood of having diabetes, and what's considered a safe range for white people is an unsafe range for Asians. Thus if you have a white person at a 25 BMI and an Asian person at 25 BMI, the Asian person has a higher likelihood of getting diabetes. "The educated [Asian] population knows that they're getting diabetes and hypertension and all these things…

oh its mentioned in the linked research

> However, the impact of increasing BMI on risk of hypertension and diabetes was significantly greater in Asians. For each one unit increase in BMI, Asians were significantly more likely to have hypertension (OR 1.15; 95 % CI 1.13–1.18) compared to non-Hispanic whites, blacks, and Hispanics.

https://link.springer.com/article/10.1007%2Fs10900-013-9792-...

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