Racial Profiling: Not Always a Bad Thing
by Leah Sammons
African-Americans suffer from heart-related illnesses and death at a significantly higher rate than whites. In fact, cardiovascular disease is one of the leading causes of death in the African-American community. But help is on the horizon.
A new drug proven to be highly effective in its clinical trial stage is now on the fast track to approval. The drug is historic for its healing potential, but it is also controversial because it was basically identified to be effective through a process of racial profiling.
The U.S. Food and Drug Administration this year officially approved the drug BiDil after initially rejecting it in 1997. Why the change? While the 1997 trials were conducted primarily on a white group, recent tests were conducted exclusively on blacks. This second trial produced very different results.
Black heart patients suffer, in part, from a lack of nitric oxide in the bloodstream. BiDil enhances nitric oxide levels. When BiDil's manufacturer, NitroMed, discovered the drug was especially effective when given to African-Americans, it teamed up with the Association of Black Cardiologists to sponsor the new tests. The results showed a significant decrease in heart failure deaths (43 percent) and a reduced need for hospitalization (33 percent).
"The success of BiDil for African-American patients demonstrates that there can be significant therapeutic differences for subgroups of the population that may not show up in clinical trials that only produce 'general population' results," notes Adolph P. Falcon, the co-author of the National Alliance for Hispanic Health study Genes, Culture and Medicines.
Critics nonetheless worry that race designations will be linked with biological differences to reinforce or fuel traditional racist opinions and similarly exploit blacks. "This approval of BiDil isn't about personalizing medicine. It's about exploiting race to make money by extending patent protection," claims Jonathan Kahn, a law professor and ethicist at Hamline University. But many black health care organizations are showing support for the new drug and don't want BiDil categorized as a "race drug."
Different physical responses to BiDil may ultimately result from genetic differences among individuals rather than simply race. That means certain whites and Hispanics may respond better to the drug than some African-Americans. Ngozi T. Robinson, Director of Health Disparities Initiatives, says race is simply a proxy right now. He encourages cellular testing to find how effective the drug could be on particular individuals. But, for now, the social classification of race must serve as a necessary distinction - one that may greatly reduce a major health risk plaguing the African-American community.
While our society's laws and intentions seek to treat everyone equally despite differences in race, sex, ethnicity and other factors, it's clear that there are genetic differences. Dr. James S. Winshall M.D. of Harvard Medical School observes: "It also appears that certain genes, and therefore certain diseases, seem to be more common in people who come from a particular geographical location or have a particular color skin." Some geneticists refer to race or skin color as a "placeholder" - a way to help us to understand something about a person's underlying genetic make-up.
If African-Americans suffering from heart problems benefit from BiDil, it should be celebrated instead of feared. The Human Genome Project, which mapped human DNA, found that humans share more than 99 percent of the exact same genes, but that leaves room for differences. Should a drug be withheld simply because it may play into the fear of a racist agenda?
Deliberately targeting someone for mistreatment or unmerited benefit due to the color of their skin is abhorrent, but the concept of racial profiling has acquired an unwarranted bad reputation over the past few years. It may now be a tool for improving the health of African-Americans.
In the case of BiDil, thinking along racial lines is saving lives.
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Leah Sammons is a research associate with the black leadership network Project 21. Comments may be sent to Project21@nationalcenter.org.
Published by The National Center for Public Policy Research. Reprints
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