Exploring the Role of Race in Today's Medicine

The Role of Race in Medicine

Explore The Role Of Race In Today’s Medicine. Focusing On One Of The Specific Examples Below, Argue Either For Or Against The Inclusion Of a Biological Concept Of Race In The Diagnosis, Risk Reporting, And/Or Treatment Of This Condition. Conditions You May Consider

Salt-Sensitive Hypertension

Diabetes Mellitus

Cystic Fibrosis

The term race is considered as one of the most widely used and referred term while discussing human nature. According to the father of the modern taxonomy, four different and unique racial groups were proposed for the human beings, such as the Americans, the Asian, Africans and the Europeans. These not only helped in encompassing the physical characteristics and the origin from where the people belonged. The concept of race in terms of medicine is not considered as a biological phenomenon. It has been observed that there are more higher level of genetic variation considered amongst the racial groups rather cross them. The paper discusses how race plays a part in the development of today’s medicine (Feldman, 2014). Additionally, the paper also discusses the ways, race is involved in terms of discussing a medical condition such as diabetes mellitus. The paper lastly discusses the ways with which the biological concept of race affects the diagnosis, treatment or mentions the risk of reporting the respective condition.

Even though with the belief that race represents genetically and clear-cut groups of people, there has been no presence of any kind of evidence that refers or indulges with other personality traits, abilities or any kind of skills. Moreover, the race itself is not considered as a variable in the biological field and the evidences project that the presence of race-related variations in the disease acts as a risk, affects in the way the treatment responses back or the side effects related to the treatment incorporated. Thereby, the important role of race or ethnicity, which acts as a marker for the ancestors and culture as well. The variables present helps in understanding the main concepts of beliefs in respect to health and the behaviors related to it. Moreover, the response to the therapeutic interventions and access to the care provided also further helps in the understanding. The indiscrimination in relation to the sociodemographic factors and the generalizations that are filtered through the factors of race and ethnicity should not be encouraged as well. It has been further observed that with the lack in the formal cordial behavior in between the patients and their racial stereotypes, there has been an increase in the mixture of the racial and ethnic groups within and across the population. Although the genomic data present are used further in predicting risks regarding to a particular disease as well determine their treatment protocol. The final goal I  determining a particular point where medicines are made with personalized traits or biological makeup, with the inclusion of the medical factors such as the age, gender and other traits. The main aim is to take a step closer to invent personalized medicine, that can help in influencing a patient’s health and improve their well being.

Race and Diabetes Mellitus

The health disparities in cases of diabetes mellitus and the complications that are arise exist in a worldwide equilibrium. With respect to many documentations, the race and ethnic minorities (Montesi, Caletti and Marchesini, 2016) have been observed to have a hike in the probability of developing diabetes than the individuals who are in the non-minority genre. Moreover, it has been further observed that a quite number of factors as such the biological, clinical factors inclusive of the social factors and the health system factors aid in increasing the health disparities.

Diabetes Mellitus is one of the most important worldwide health disparity. The population in the Great Britain is considered multiethnic as well as dynamic with respect to the growth of the number in the minority ethnic population by a percentage of 53 % from 3.0 million in between the 1991 to 4.6 million in the year 2001. The population of the total minority population in the South Asian region that is amongst Indian, Pakistani, Bangladeshi, was surveyed as 25% of the African to the Caribbean ethnicity. The gradual variation in the composition of the developing countries and the gradual increase in the population along with the increase in numbers of the ethnic groups, aided to the increase in the risk of developing diabetes at a higher level. Type 1 diabetes  (Atkinson, Eisenbarth and Michels, 2014) is observed to be less in occurrence than the Type 2 diabetes. The occurrence of this type of  diabetes has been observed to occur mostly in the younger age or in the adolescent. Mostly seen to be occurring in the temperate regions and the occurrence rate has been checked to be higher on a wider world view level. The respective type 1 diabetes has been coined as one of the autoimmune conditions such as the hypothyroidism or pernicious anemia. The ethnic differences amongst the autoimmune conditions with respect to the Type 1 diabetes (Katsarou et al, 2017) are not reported as such yet. However, the Type 2 diabetes are diagnosed amongst 90 % of the patients around the globe. The act of showing more prevalence to the white European population was surveyed to be varying in between 2 % to 10 % in the age group above the age of 70 years. It has further been checked that the ethnic minorities group that reside in the developing countries such as the African-Caribbean groups in the United Kingdom have a higher probability of developing the disease. Type 2 diabetes have been found prevalent and are observed to range from a 2 % in China to 50 % amongst the Indians. The American-Indians are considered as one of the examples that showcases the development of the Type 2 diabetes. Research predicts that the probability of occurrence of Type 2 diabetes is found out to be higher for about three to five times amongst the African-Caribbean population.

Type 1 and Type 2 Diabetes

The predisposition to Type 2 diabetes amongst few ethnic groups in the presence of risk factors are provided with evidences. The nutritional factors such as the lower intake of folate and vitamin B12, due to the cooking excessively of some of the specific vegetables and very low level of practice of physical activity. These two factors are the main reason of the increase in the chances of developing diabetes in the group. Severe risks are observed to happen in the childhood according to the South Asian children in the United Kingdom. The hypothesis regarding the developmental origins infers that the restriction in the growth, results in the greater risk of developing diabetes in the adulthood. Obesity  (Agha and Agha, 2017) is one of the most important factor that helps in contributing to the increase in the concentration levels of the insulin and reduction in the sensitivity of the insulin. This further lead to the increase in the portal blood free fatty acids that are further derived from the visceral fat. Studies project that the risk of developing type 2 diabetes have been seen to increase progressively from the increase in the BMI over the range of 20 kg/m² post adjustment of the age, range of performing physical activities or with reference to the family history of diabetes. It has also been seen that obesity is seen to occur more frequently amongst the black that the white populations and that many levels of ethnic differences with respect to the younger age is observed as well. The ethnic differences incorporated into the lifestyle and the economic factors are seen to be accountable for the cause of the ethnic disparities in the diseases that are caused due to obesity. Additionally the Insulin-like growth factor 1 (IGF1) is considered as one of the most important part in the metabolism of glucose and the occurrence of homeostasis. Other than Insulin, IGF bioactivity is controlled with respect to a rage of specific high affinity binding proteins (IGFBPs). Amongst the six  IGFBPs , the IGF protein 1 (IGFBP1) is regarded as the main hour to the function of regulating and circulating IGF activity. It has been further observed in the studies related to United Kingdom, that the combination of the lower levels of IGFI and IGFBP1 aids in the worsening of the glucose tolerance levels along with the lower circulations of IGFII concentrations. These concentrations were associated with the increase in the risk of gaining weight with normal glucose tolerance level, amongst men and women. Surveys further show that over a follow up of 20 years, the people have showed prevalence of complications lower in the African-Caribbean with respect to the Europeans. The treatment of the Type 1 diabetes is similar as practiced in all the ethnic groups. A variety of drugs have been seen to be incorporated that help in the prevention of progress to diabetes. Studies have projected the usage of tolbutamide and have been further observed to show lower levels in the blood glucose levels. The Metformin (Kinaan, Ding and Triggle, 2015) incorporated in the Diabetes prevention program (DPP) have been observed to project a gradual fall in the 31% in the decrease in the diabetes as compared to the incorporation of tolbutamide. Acarbose is also one of the drugs considered to reduce the risk of developing diabetes amongst the people by 56 %. There have been high probability of diabetes observed in the certain ethnic minorities in the United Kingdom and the need to incorporate the interventions amongst the crowd through culture specific interventions is highly needed.

Predisposition to Type 2 Diabetes Among Ethnic Groups

Diabetes Mellitus is one of the heterogeneous disease that has been regulated due to the presence of the metabolic disorders with respect to the deficiency or low production of insulin. The conditions if persists for a longer time may lead to renal disorders, cerebral or cardiovascular,. Initially affecting through the factors that pose as risk such as inflammation, high blood pressure and, the growth of the differences in the ethnic origin although remain unclear but the genetic factors along with the intergenerational social traits remain to be modulating the chronology and morphology of the disease along with its evolution.

References

Agha, M. and Agha, R., 2017. The rising prevalence of obesity: part A: impact on public health. International journal of surgery. Oncology, 2(7), p.e17.

Atkinson, M.A., Eisenbarth, G.S. and Michels, A.W., 2014. Type 1 diabetes. The Lancet, 383(9911), pp.69-82.

Attridge, M., Creamer, J., Ramsden, M., Cannings‐John, R. and Hawthorne, K., 2014. Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, (9).

Feldman, N.M., 2014. Race, Genes and Health: Public Conceptions about the Effectiveness of Race-Based Medicine and Personalized Genomic Medicine (Doctoral dissertation, Mailman School of Public Health, Columbia University).

Katsarou, A., Gudbjörnsdottir, S., Rawshani, A., Dabelea, D., Bonifacio, E., Anderson, B.J., Jacobsen, L.M., Schatz, D.A. and Lernmark, Å., 2017. Type 1 diabetes mellitus. Nature reviews Disease primers, 3(1), pp.1-17.

Kinaan, M., Ding, H. and Triggle, C.R., 2015. Metformin: an old drug for the treatment of diabetes but a new drug for the protection of the endothelium. Medical principles and practice, 24(5), pp.401-415.

Maahs, D.M., Hermann, J.M., Holman, N., Foster, N.C., Kapellen, T.M., Allgrove, J., Schatz, D.A., Hofer, S.E., Campbell, F., Steigleder-Schweiger, C. and Beck, R.W., 2015. Rates of diabetic ketoacidosis: international comparison with 49,859 pediatric patients with type 1 diabetes from England, Wales, the US, Austria, and Germany. Diabetes Care, 38(10), pp.1876-1882.

Meeks, K.A., Freitas-Da-Silva, D., Adeyemo, A., Beune, E.J., Modesti, P.A., Stronks, K., Zafarmand, M.H. and Agyemang, C., 2016. Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis. Internal and emergency medicine, 11(3), pp.327-340.

Montesi, L., Caletti, M.T. and Marchesini, G., 2016. Diabetes in migrants and ethnic minorities in a changing world. World journal of diabetes, 7(3), p.34.

Moore, M.D., 2018. Food as medicine: diet, diabetes management, and the patient in twentieth century Britain. Journal of the History of Medicine and Allied Sciences, 73(2), pp.150-167.

Ricci-Cabello, I., Ruiz-Pérez, I., Rojas-García, A., Pastor, G., Rodríguez-Barranco, M. and Gonçalves, D.C., 2014. Characteristics and effectiveness of diabetes self-management educational programs targeted to racial/ethnic minority groups: a systematic review, meta-analysis and meta-regression. BMC endocrine disorders, 14(1), p.60.

VALLES, S.A., 2016. Race in Medicine. In The Routledge Companion to Philosophy of Medicine (pp. 433-445). Routledge.

Weiler, R., Allardyce, S., Whyte, G.P. and Stamatakis, E., 2014. Is the lack of physical activity strategy for children complicit mass child neglect?.

Willi, S.M., Miller, K.M., DiMeglio, L.A., Klingensmith, G.J., Simmons, J.H., Tamborlane, W.V., Nadeau, K.J., Kittelsrud, J.M., Huckfeldt, P., Beck, R.W. and Lipman, T.H., 2015. Racial-ethnic disparities in management and outcomes among children with type 1 diabetes. Pediatrics, 135(3), pp.424-434.