Thread by @Lachelle_Dawn

Saw this paper on floating on the TL and decided to take a break from death by R™️

A lot to unpack...but we’re in the middle of a pancetta so I’m gonna leave most of it in the bag 🧵

nejm.org/doi/metrics/10…

I almost quit after the section on “Racial Categorizations in the United States” b/c it oversimplifies & inaccurately recounts the history of census racial designations.

(No “Black” or “Native” in the 8/2/1790 census, btw. Indigenous ppl were first counted in the 1860 census)

https://twitter.com/lachelle_dawn/status/1268287563086925825

Many weren’t “white” until coming to the US & many immigrated to access “whiteness”

The US census can’t be used to demonstrate the merits of race as a proxy for biology or ancestry - white is a group for the non-Black/non-othered & includes Northern European & North African folx

The authors then refer to ethnicity as a way to capture “common values, cultural norms”

The oversimplification is offensive. Hispanic/Latino is not a monolithic grouping of people. The authors even show in (figure 1) how different ancestry can be *within* this ethnic group.

That difference in ancestry translates to VERY different cultures in terms of food, customs, & even language. Sociopolitical relations also translate to different ways that people are treated based on the precise origins of their Hispanic identity.

Anyway-not going to pick the whole thing apart- the authors are basically like: race/ethnicity is an epidemiologically important variable and we shouldn’t toss it.

But no one has actually argued that people should stop studying racial differences and inequities

We’ve argued that we should study race w/ the same scientific rigor & scrutiny as other variables-that we should explicitly define race like we do other exposures & avoid overstating what data show about a cohort chopped up into Black/White/Other using poorly defined criteria

We’ve argued against using race as a proxy for a stereotyped composite of socioeconomic exposures. Want to studying how housing, or personal experience of racism or income or zip code impacts health? Then, Beloved, THOSE are your exposure variables, not race.

We’ve argued that when designing studies or framing discussion of data, researchers shouldn’t selectively ignore prior research/writing from @DorothyERoberts and others that debunks race biology & demonstrates genetic variation within racial/ethnic groups

We’ve argued for research that addresses (not just describes) health disparities

Maybe we could also abolish the convention of reporting racial inequities as a deficit in the historically “othered” populations?

Centering whiteness as the “normal” against which all else is compared reinforces the falsehood of the supremacy of whiteness.

It warps perspective & leads to blaming the culture & genes of minoritized people for illness. Problematic if the goal is equity & anti-racism, no?

Where we currently report “Black people have less survival compared to white people for X disease” what if we discussed the pathology that influences *excess survival* - hoarding of privilege, power, access, & resources?

Would we-by using traditionally excluded/othered populations as the reference -be less inclined to search for polymorphismes of uncertain significance to explain major racial inequities?

Would we be better positioned to avoid research w/ intrinsically racist hypotheses?

So the “reckoning” : are y’all really trying to be anti-racist or are y’all just playing?

Cuz if you’re really trying to be anti-racist & dismantle structural racism & all the things that are oft said these days, it’s kind of an all or nothing thing.

No sprinkle of racism is acceptable-it’s all bad. It’s all got to go-not slowly, but expeditiously.

Nah fam, we’re not keeping racist hypotheses b/c the outcome might be net good for some.

Why?
B/c racism always deprives.
Always excludes.
Always harms.